How Does It Affect Your Body
Immune system cells move from the blood into your joints and the tissue that lines them. This is called the synovium. Once the cells arrive, they create inflammation. This makes your joint swell as fluid builds up inside it. Your joints become painful, swollen, and warm to the touch.
Over time, the inflammation wears down the cartilage, a cushy layer of tissue that covers the ends of your bones. As you lose cartilage, the space between your bones narrows. As time goes on, they could rub against each other or move out of place. The cells that cause inflammation also make substances that damage your bones.
The inflammation in RA can spread and affect organs and systems throughout your body, from your eyes to your heart, lungs, kidneys, blood vessels, and even your skin.
What Are The Goals Of Treating Rheumatoid Arthritis
The most important goal of treating rheumatoid arthritis is to reduce joint pain and swelling. Doing so should help maintain or improve joint function. The long-term goal of treatment is to slow or stop joint damage. Controlling joint inflammation reduces your pain and improves your quality of life.
How Do You Treat And Manage Rheumatoid Arthritis
Unfortunately, there is no cure for RA. Doctors may prescribe a combination of medication and lifestyle changes to reduce the intensity of the disease.
You can manage the disease by:
- Getting physically active. By exercising, you reduce the inflammation and the risk of becoming obese. Your doctor will recommend starting with light exercises like stretching before working up to strength training.
- Getting some rest. When your joints feel inflamed, dont force yourself to do any physical activity. When you do, you risk injuring your joint and its nearby tissue structures.
- Changing your diet. Experimenting with dietary changes can help you identify which food types trigger or relieve RA symptoms. For example, that Taiwanese oolong tea you bought offline reduces inflammation, while foods with high sugar could intensify joint pain.
- Joining a self-management class. Attending a self-management class helps you learn how to manage your symptoms. You can also meet people who have the same disease.
RA is a cruel disease that restricts your movement. Although there is no cure, medication and lifestyle changes can minimize the pain and let your live your healthy life.
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Whats The Age Of Onset For Rheumatoid Arthritis
RA usually starts to develop between the ages of 30 and 60. But anyone can develop rheumatoid arthritis. In children and young adults usually between the ages of 16 and 40 its called young-onset rheumatoid arthritis . In people who develop symptoms after they turn 60, its called later-onset rheumatoid arthritis .
How Rheumatoid Arthritis Can Hurt Your Heart
Higher levels of inflammation in people with rheumatoid arthritis increase the risk of heart disease, especially heart attacks and strokes, Greer says.
These heart conditions can also be more fatal. In people with systemic inflammatory diseases like RA, heart attacks in those under 50 are twice as likely to be fatal as for people without an inflammatory condition, according to a study published in the European Journal of Preventive Cardiology in March 2021.
To lower your risk, youll want to get your RA under control and also reduce heart risk factors, such as high blood pressure and high cholesterol. A healthy diet like the Mediterranean diet will lower your risk of heart disease.
Another way to both assist your heart and improve your RA: Dont smoke and if you do smoke, quit as soon as possible in addition, avoid exposure to secondhand smoke.
Finally, know that certain RA medications themselves have been linked to heart problems these side effects are rare, and are not a reason to skip drug treatment. The negative effects of not treating RA with medication are much, much worse than the side effects of RA drugs, cautions Greer.
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Rheumatoid Arthritis Flare Treatment
If your symptoms are revving up while youre on RA meds, your doctor may add an injectable or oral steroid to the mix. These drugs help to curb the inflammation quickly, says Saika Sharmeen, M.D., assistant professor in the division of rheumatology at Stony Brook Medicine in Stony Brook, NY. Beyond that, you might consider one of these home remedies or supplements to help ease your symptoms:
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Symptoms That Affect Your Skin
Some people with RA get rheumatoid nodules. These are bumps under the skin. Most of the time, they arenât painful, and they move easily when you touch them. About one in four people with RA get these skin bumps.
They usually happen on your elbows, but they might show up on other bony areas like:
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Your Ra Is In Remission Now What
With aggressive treatment, RA can go into remission (no visible signs or symptoms. Learn if its possible to take less medication or even a drug holiday.
Your RA is in Remission! Now What?
There is no cure for rheumatoid arthritis , but remission can feel like it. Today, early and aggressive treatment with disease-modifying antirheumatic drugs and biologics makes remission more achievable than ever before. But how likely are you to reach remission, and how likely are you to sustain it? And when you reach it, do you stay on your medications or go off them?
When remission in RA was first defined 1981, it was characterized as elimination of all disease. Thats a very hard target. Were more likely to be able to reach limited or small amount of disease, explains David T. Felson, MD, professor of medicine at Boston University and a practicing rheumatologist.
With that in mind, the American College of Rheumatology and the European League Against Rheumatism developed criteria for defining remission so researchers could compare the effectiveness of different treatment regimens.
Definitions of Remissionin Rheumatoid Arthritis
These criteria are used by scientists when conducting clinical trials. Your rheumatologist may use these or slightly different measures to determine if your disease is in remission:
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One or fewer swollen joints
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One or fewer tender joints
The Odds of Remission
Drug-free Remission
Should You Take a Drug Holiday?
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Signs And Symptoms Of Rheumatoid Arthritis
The main joint symptoms are related to the inflammation and include pain, swelling, redness, warmth, weakness and limitation in range of motion of the affected joints. These joints will be tender to pressure and can occasionally appear red. Inside the joints, the immune system has been activated, and many cells proliferate in the joints producing fluid, and mediators of pain. If left untreated, this process can lead to joint damage.
The joint pains in RA behave in a specific manner and affect multiple joints on both sides of the body in what is called a symmetric pattern. That is, if your left knee is affected, your right knee will likely also be affected.
The joints most likely to be affected are the:
- small joints of the hands and feet
- elbows
- knees
- ankles.
The external signs of inflammation reflect a potentially damaging disease process that can lead to injury to bone, cartilage, and soft tissues such as tendons. If left untreated, this can cause deformities and limitation in function. Fortunately, today we have excellent treatments that can stop this inflammation and avoid further damage.
When the disease is very active, one may also experience weight loss, loss of muscle mass and immune response effects on other organs.
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Symptoms Of Progressive Rheumatoid Arthritis
Here are some general warning signs and symptoms that you may have developed progressive rheumatoid arthritis:
The active state of the disease is becoming more frequent Flare-ups are occurring regularly and lasting for longer periods of time Your pain and swelling are becoming more intense, spreading throughout other areas of your body Your diagnosis occurred early on, and so the disease has had a long time to develop You are beginning to develop rheumatoid nodules that you didnt have before Your blood tests show high levels of Rheumatoid Factor or anti-CCP
If you suspect that your rheumatoid arthritis has become progressive, consult your rheumatologist to determine the changes in your condition and discuss potential adjustments to your treatment plan.
The Causes And Complications Of Ra
Medical experts have yet to determine the cause of RA. However, risk factors like age, environment, and lifestyle could accelerate the onset of the disease. Women are also most likely to get rheumatoid arthritis than men.
Being diagnosed with RA means living with physical and social consequences that can affect your quality of life:
- Difficulty in working. RA lowers your chances of employment. As the disease gets worse, youll struggle with tasks that require physical movement. The frustration of being unable to move can also cause depression.
- Increased risk of diseases. The difficulty with movement leads to a sedentary lifestyle, increasing your chance of being obese. Obesity and lack of action increase your risk of heart disease and diabetes.
- Weakened immune system. RA and its medications could affect the immune system, making you more prone to infections.
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How Is An Ra Flare Defined
Although there is currently no set definition of what constitutes an RA flare, there is agreement that a flare is associated with a worsening of key RA symptoms and an impact on certain areas of daily functioning. Your doctor may use clinical tools including standard RA laboratory tests, counts of swollen and tender joints, and a global assessment of your condition to determine whether you are experiencing a flare.1
These simple methods may work:
- Use canes, special jar openers, and padded handles.
- Make it easier to lift, carry, or bend. Use your bigger joints instead of your smaller ones. Use your whole arm to lift things, not just your hands and wrists.
- Wear safety gear like knee and elbow pads, or wrist guards when you play sports or do outdoor activities.
- Put your joints through their full range of motion. Use slow, gentle movements.
- Strengthen the muscles and ligaments around your joints. If you donât have a physical therapist, ask your doctor to help you find one.
- Try to avoid extra weight, which puts pressure on your joints. Your doctor can tell you what your goal should be.
How Is Rheumatoid Arthritis Diagnosed
Your healthcare provider may refer you to a physician who specializes in arthritis . Rheumatologists diagnose people with rheumatoid arthritis based on a combination of several factors. Theyll do a physical exam and ask you about your medical history and symptoms. Your rheumatologist will order blood tests and imaging tests.
The blood tests look for inflammation and blood proteins that are signs of rheumatoid arthritis. These may include:
- Erythrocyte sedimentation rate or sed rate confirms inflammation in your joints.
- C-reactive protein .
- About 80% of people with RA test positive for rheumatoid factor .
- About 60% to 70% of people living with rheumatoid arthritis have antibodies to cyclic citrullinated peptides .
Your rheumatologist may order imaging tests to look for signs that your joints are wearing away. Rheumatoid arthritis can cause the ends of the bones within your joints to wear down. The imaging tests may include:
In some cases, your provider may watch how you do over time before making a definitive diagnosis of rheumatoid arthritis.
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What Are The Risk Factors For Developing Rheumatoid Arthritis
There are several risk factors for developing rheumatoid arthritis. These include:
- Family history: Youre more likely to develop RA if you have a close relative who also has it.
- Sex: Women and people designated female at birth are two to three times more likely to develop rheumatoid arthritis.
- Smoking:Smoking increases a persons risk of rheumatoid arthritis and makes the disease worse.
- Obesity: Your chances of developing RA are higher if you have obesity.
What Tests Are Done For Rheumatoid Arthritis
The diagnosis of RA is based on a person’s clinical signs and symptoms, but it is supported by laboratory tests, including X-rays and various blood tests, including but not exclusively the rheumatoid factor, anti-CCP.
If a person exhibits a clinical pattern of symptoms and signs that suggestive they have rheumatoid arthritis, a variety X-rays and blood tests will be performed. Certain blood tests can help to confirm the diagnosis, but a negative test does not necessarily mean a person does not have RA.
Approximately half of people developing rheumatoid arthritis will have blood test results that demonstrate inflammation. These tests are called acute phase reactants. Examples of these are an erythrocyte sedimentation rate and a C-reactive protein . These tests are performed to assess the activity of the disease in combination with an assessment of the patients symptoms and physical findings.
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Rheumatoid Factor And Anti
Specific blood tests can help to diagnosis rheumatoid arthritis, but are not accurate in every person. About half of all people with rheumatoid arthritis have a positive rheumatoid factor present in their blood when the disease starts, but about one in every 20 people without rheumatoid arthritis also tests positive for this.
Another antibody test known as anti-CCP is also available. People who test positive for anti-CCP are very likely to develop rheumatoid arthritis, but not everybody found to have rheumatoid arthritis has this antibody.
Those who test positive for both rheumatoid factor and anti-CCP may be more likely to have severe rheumatoid arthritis requiring higher levels of treatment.
What Causes Rheumatoid Arthritis
The exact cause of rheumatoid arthritis is unknown. Researchers think its caused by a combination of genetics, hormones and environmental factors.
Normally, your immune system protects your body from disease. With rheumatoid arthritis, something triggers your immune system to attack your joints. An infection, smoking or physical or emotional stress may be triggering.
Is rheumatoid arthritis genetic?
Scientists have studied many genes as potential risk factors for RA. Certain genetic variations and non-genetic factors contribute to your risk of developing rheumatoid arthritis. Non-genetic factors include sex and exposure to irritants and pollutants.
People born with variations in the human leukocyte antigen genes are more likely to develop rheumatoid arthritis. HLA genes help your immune system tell the difference between proteins your body makes and proteins from invaders like viruses and bacteria.
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Can A Test Determine The Stage Of Ra
Blood tests can show a persons levels of rheumatoid factor and anti-citrullinated protein antibodies . Knowing these levels can help a doctor determine the approximate stage of a persons RA.
However, the presence of these proteins in a persons blood is not a definitive sign. Although having ACPAs in the blood will be indicative of RA in most cases, RF can also indicate other conditions, such as Sjögrens disease or hepatitis.
Doctors also need to look at the symptoms that a person is experiencing to determine whether they have RA. They will also evaluate the level of disease impact based on other testing, such as an MRI scan, ultrasonography, or an X-ray of the joints.
is also associated with RA.
Smoking causes further inflammation, which can worsen the progression of RA. It also increases the risk of complications, such as respiratory conditions and heart disease.
Leading A Sedentary Lifestyle
Regular physical activity is necessary for everyone, including people with RA, and there are numerous health benefits associated with it. Improved muscle strength, as well as better bone and joint health, is essential for people with RA. Rest is also needed, to restore the body from the episodes of intense pain and fatigue that are characteristic of RA. But rest cant become a way of life striking a balance between rest and activity is optimal. A sedentary lifestyle actually does the opposite of what you want, leading to increased pain, fatigue, and weakness.
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Medical Treatments For The Ra/oa Combo
The good news: There are many effective ways to manage RA. The not-so-great news: Treatments for OA are not as advanced, says Dr. Bhatt they temporarily ease pain, but do little to help long-term. Your doctor will likely recommend over-the-counter pain relievers including ibuprofen and acetaminophen or a corticosteroid injected directly into your inflamed joint every three-to-six months. Doctors also often prescribe duloxetine, a depression drug that is also approved to treat OA pain. A recent study, though, found that the drug had no effect in people with chronic knee or hip OA pain.
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What Does Ra Look And Feel Like
RA may be most visible in your hands and feet, particularly as the disease progresses and especially if you dont currently have a treatment plan.
Swelling of fingers, wrists, knees, ankles, and toes are common. Damage to ligaments and swelling in the feet can cause a person with RA to have trouble walking.
If you dont get treatment for RA, you may develop severe deformities in your hands and feet. Deformities of the hands and fingers may cause a curved, claw-like appearance.
Your toes can also take on a claw-like look, sometimes bending upward and sometimes curling under the ball of the foot.
You may also notice ulcers, nodules, bunions, and calluses on your feet.
Lumps, called rheumatoid nodules, can appear anywhere on your body where joints are inflamed. These can range in size from very small to the size of a walnut or larger, and they can occur in clusters.