Arthritis is a common health problem in which the joints are inflamed. There are many types of arthritis. In rheumatoid arthritis, the body's own immune system attacks the joints. This causes pain, stiffness, and swelling in the joints, especially in the hands and feet. It can become hard to open jars, write, and do other daily tasks. Sometimes rheumatoid arthritis can also cause bumps to form under the skin.
Over time, rheumatoid arthritis can damage and deform joints. Early treatment with medicines may reduce your chances of having a lasting disability.
Rheumatoid arthritis is a type of arthritis in which your body's immune system attacks healthy tissue in your joints. This makes the joints swollen, stiff, and painful. Over time, it may destroy the joint tissues and make it hard for you to walk and use your hands.
Medicine may help control rheumatoid arthritis or keep it from getting worse.
RA usually progresses slowly, over months or years. RA mostly affects the joints. But it can also cause problems in the eyes, lungs, heart, blood vessels, muscles, and nerves. If the disease progresses it can cause lasting disability. But early treatment may control it and keep it from getting worse.
Rheumatoid nodules are small bumps under the skin, located in pressure point areas such as the elbow, back of the hand, or back of the heel. These bumps may be as small as a grain of rice or as large as a golf ball. But they are usually not painful, and they tend to come and go.
Your doctor may remove rheumatoid nodules if your disease is under good control and the nodules are painful or very bothersome.
RA is most often treated with medicine. Some medicines help to control the symptoms. Other medicines, especially when used early, can help to prevent the disease from getting worse.
Many of the medicines used to treat rheumatoid arthritis have side effects. Have regular checkups. And talk with your doctor about any problems. This will help your doctor find a treatment that works for you.
Physical therapy and finding the best balance between rest and activity can also help your symptoms.
If your treatment doesn't help, surgery may be an option. The type of surgery you can have depends on which joints are causing problems. Sometimes surgery to replace a joint (such as a hip or knee) is an option. Other types of surgery can remove debris or inflamed tissue from a joint, or relieve pressure on nerves.
Figure 1 courtesy of Intermountain Medical Imaging, Boise, Idaho. Figure 2 courtesy of Paul Traughber, M.D., Boise, Idaho.
The X-ray on the left shows a normal hand.
The X-ray on the right shows a hand with advanced rheumatoid arthritis. "Bone erosion" means cartilage and bone are worn away. "Bone displacement" means that a bone has moved out of its normal position. This X-ray shows how bone erosion and bone displacement can change the shape of the hand.
Medicines are the main treatment for RA. The types of medicines used, the amount you take, and the length of time you take them depends on how severe your RA is, how fast it's progressing, and how it affects your daily life.
Medicines are used to:
Medicines called disease-modifying antirheumatic drugs (DMARDs) can slow or sometimes prevent joints from being destroyed. An early start to treatment with DMARDs can reduce how severe RA is. These medicines are most often taken over a long period to help control the disease.
Other medicines may be combined with DMARDs to relieve symptoms. They include:
Surgical treatment for RA is used to relieve severe pain and improve function of severely deformed joints that don't respond to medicine and physical therapy.
Surgery options include:
Things that may increase your risk for rheumatoid arthritis include:
Exercise can reduce pain and improve function in people who have RA. It may also help prevent the buildup of scar tissue. This can lead to weakness and stiffness. Exercise for arthritis takes three forms:
Stretching involves moving joint and muscle groups through and slightly beyond their normal range of motion and holding them in position for at least 15 to 30 seconds.
Strengthening involves moving muscles against some resistance. Strengthening exercise helps people who have RA stay more active and able to do their daily activities. It even seems to help their outlook.
Conditioning exercise improves aerobic fitness. It may help reduce pain and help you stay more active. Even moderate activity, such as walking, can improve your health and may prevent disability from RA.
Be sure to follow your doctor's advice about your exercise program.
Rheumatoid arthritis often affects small and large joints on both sides of the body (symmetry), such as both hands, both wrists or elbows, or the balls of both feet.
Rheumatoid arthritis (RA) is a condition in which the body's own immune system attacks the joints. This causes swollen, stiff, and painful (inflamed) joints, especially in the hands and feet. Over time, RA can damage and deform joints.
The cause of RA isn't fully understood. But it's an autoimmune disease. This means that the body's natural defense system attacks the joints.
Genes play a role, but experts don't know exactly what that role is. For most people with RA, the disease doesn't run in their families and they don't pass it along to their children. One or more genes may make it more likely that the body's immune system will attack the tissues of the joints. This immune response may also be triggered by bacteria, a virus, or some other foreign substance.
Call your doctor now or seek immediate medical care if:
Watch closely for changes in your health, and be sure to contact your doctor if:
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