Rheumatoid Arthritis

An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. In addition to causing painful and sometimes deformed joints, rheumatoid arthritis sometimes can affect various organs of the body. Skin, eyes, lungs and blood vessels may be affected.

RA is a chronic inflammatory disorder and often affects the small joints in your hands and feet. The damage RA causes is distinct from the wear-and-tear of osteoarthritis in that the joint lining is the source of the pain. RA affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.

Although rheumatoid arthritis can occur at any age, it usually begins after age 40. The disorder is much more common in women than in men. Treatment focuses on controlling symptoms and preventing joint damage.

Symptoms

RA is a progressive disease if untreated properly. The small joint of the hands and feet are typically the first joint affected, but the pain tends to spread from the smaller joints to the larger joints – such as ankles, knee, hips, wrists, elbows and shoulders. The pain of RA is usually bilateral, which is also distinctive from osteoarthritis, which is more often one-sided. The symptoms of RA may come in episodic waves or “flares”, with periods of remission between flares. The following symptoms are frequently associated with RA:

  • Tender, warm, swollen joints
  • Morning stiffness that may last for hours
  • Firm bumps of tissue under the skin on your arms (rheumatoid nodules)
  • Fatigue, fever and weight loss

Hand Deformity Typical of RA

Treatment

No cure currently exists for RA. The goal of treatment is reduce the inflammation and pain, and to slow progression and joint damage. Occupational and Physical Therapy can help you work around the pain in everyday activities using practical aids and techniques.

Pharmacological Intervention. NSAID’s, Corticosteroids, Disease Modifying Anti-rheumatic Drugs (DMARD’s), Immunosuppressants, and Tumor Necrosis Factor-alpha are examples of drug classes that may be used to help diminish pain and to slow the immune system’s attack on your joints. It is best to start with the drugs that have the least side-effects first. Often a combination of medications is necessary. More powerful medications may be required as the disease progresses.

Therapy. A therapist can help you maintain flexibility in affected joints and also educate you on how to avoid further joint damage or aggravation to already painful joints during everyday activities. Often the use of assistive devices to lessen the strain on affected joints is necessary. Learning alternative ways to perform everyday activities, such as removing a jar lid, is accomplished as well.

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