Rheumatoid arthritis is an autoimmune inflammatory condition which most notably causes pain, stiffness, and swelling in the body's joints. However, it is also a systemic disease which can affect the whole body and lead to damage to major organs and a shortened life span.
According to Jonathan Greer, MD, a rheumatologist in Boynton Beach, Florida, the earlier you begin medication treatment, the better your chances are of halting joint damage, protecting your organs, and living a longer life without pain and disability.
There are several things you can do to protect various parts of your body if you have RA.
What causes RA?
In RA, we know the root cause of inflammation and how to properly treat it.
There is still some mystery surrounding what exactly causes RA, but what we do know is that it is likely a combination of genetic and environmental factors.
RA is not only caused by genetics. Even if you don't have anyone in your family with RA, genetics are still involved. This has been extensively studied and it is clear that genes are not the only factor. Identical twins provide evidence for this, as even if one twin has RA, the other only has a one in six chance of developing the disease, despite having the same genes.
There are many theories about what environmental triggers are, but nothing has been conclusively identified. Environmental triggers can be viruses, infections, or traumas of some kind, or having a very stressful episode in your life, such as bereavement, divorce, or childbirth.
If you smoke, you are more likely to develop RA. If you have certain genes, and you smoke, your risk of developing RA increases considerably. If you do develop RA, it is more likely to be aggressive. So, if you smoke, this is another good reason to give up.
Doctors believe that they will eventually be able to find a cure for RA through all the research that is being done around the world.
Diagnosing RA
Rheumatoid arthritis can be tricky to? Diagnose? Why??
The main reason people don't go to the doctor with RA symptoms is because they don't know they have it. Only about one percent of the population has RA, so when people start experiencing symptoms, they usually attribute them to something else, like overworking out or playing with the kids. This is why it's important to be aware of the symptoms of RA so you can catch it early.
If someone experiences a painful joint, it could have several possible causes. GPs are not experts on the matter and there is no one test they can do in order to determine whether it is RA. Your GP may not be entirely sure what is causing the symptoms. He or she may prescribe an anti-inflammatory and ask the person to come back in a month if the symptoms do not improve. RA symptoms can come and go, so the person may feel better for a while before the symptoms come back again.
Getting a diagnosis
There is not a single test that can definitively diagnose RA. Certain types of doctors, called rheumatologists, are specially trained to look for synovitis, which is the swelling of joints. A diagnosis is usually made or confirmed after consulting with one of these specialists. The rheumatologist also takes other information into account:
- What symptoms have you been having? (e.g. joint pain, stiffness and swelling).
- Can blood tests help? Your blood may show signs of inflammation (a raised ESR or CRP). One sign is something called rheumatoid factor in the blood, but it isn’t conclusive.? About 30% of people with RA don’t have rheumatoid factor, and people with some other conditions can have rheumatoid factor too. Another blood test, for something called anti-CCP antibody, is more specific for RA. ?But blood tests don’t tell the whole story.
- Are there signs of joint damage? If damage is already visible on x-rays you have had inflammation in your joints for some time. ?You may also have an ultrasound scan, especially if there’s any doubt about whether there is inflammation of the joints (for example, you have lots of pain but no obvious swelling).? Less often, doctors use Magnetic Resonance Imaging (MRI) scans, as these can detect inflammation and damage more accurately and earlier than x-rays.
- Do you have any family history of inflammatory arthritis? You can’t directly inherit RA, but if it’s in your family you may be more susceptible to getting it when an environmental trigger occurs.? This certainly does not mean that you will automatically get it just because someone in your family has RA.
- Have you had other illnesses such as skin diseases (psoriasis, for example) and bowel problems (colitis and Crohn’s disease)? These can indicate other, slightly different types of inflammatory arthritis which also require treatment by a rheumatologist.?
The Eyes: How Rheumatoid Arthritis May Affect Them
Some people with rheumatoid arthritis may get either dry eye syndrome or episcleritis because of inflammation around the eyes. These can generally be managed with over-the-counter or prescription drops.
Scleritis is a more serious eye condition where the deeper part of the white area, the sclera, is affected. If left untreated, scleritis can lead to vision loss.
Uveitis is a condition where the middle layer of the eye, the uvea, becomes inflamed. This can cause symptoms like floaters (cobwebs or black spots in the field of vision), blurred vision, and pain, according to Ana-Maria Orbai, MD, a rheumatologist and an assistant professor of medicine at the Johns Hopkins University School of Medicine in Baltimore.
There are many ways to reduce stress in your life if you have rheumatoid arthritis. Some stress-reducing techniques include yoga, meditation, and deep breathing exercises. You can also try to get regular exercise, eat a healthy diet, and get enough sleep. If you find that your stress levels are still high, you may want to consider talking to a therapist or counselor. There are many ways that you can reduce the amount of stress in your life if you have rheumatoid arthritis. Some of the ways that you can do this include practicing yoga, meditation, and deep breathing exercises. You can also try to get regular exercise, eat a healthy diet, and get enough sleep. If you find that your stress levels are still high, you may want to consider talking to a therapist or counselor.
If uveitis is left untreated, it can lead to glaucoma, which causes pressure to build up in the eye and can damage the optic nerve, causing blindness. Both scleritis and uveitis can be treated with corticosteroid eye drops.
Additionally, up to half of patients with RA also have inflammation of the lining of the blood vessels (vasculitis). Approximately 15 percent of individuals who have RA also develop Sjögren's syndrome (SS). SS is an autoimmune disease that affects tear glands and salivary glands, which can cause symptoms such as dry eyes. In addition, up to half of patients with RA also experience inflammation of the lining of blood vessels, known as vasculitis.
An ophthalmologist should be seen by everyone living with RA every year to help catch any eye diseases early on.
How Rheumatoid Arthritis May Affect Your Mouth
People with rheumatoid arthritis may be more likely to develop periodontal disease, which is usually caused by a gum infection.
People with Sjögren's syndrome are more likely to have a dry mouth, which can lead to tooth decay. This is especially true for people with Sjögren's syndrome who also have another autoimmune disorder.
The other side of this may also be true: Poor oral health may lead to the beginning or worsening of RA. Experts believe that inflammation in the mouth may stimulate the immune system, and in people predisposed to RA, the inflammation may trigger the body to start making antibodies associated with the disease.
The mechanism behind this is being researched by professionals in order to have a greater understanding. The main point is that treating gum disease and preventing unnecessary gum infections is good for RA. Checkups should be scheduled frequently to avoid bigger issues.
Rheumatoid Arthritis and Your Hands and Feet
RA is a condition that affects the joints and can cause pain in the hands and feet. If it is not treated early, it can cause deformities.
Locking joints, ulnar drift, swan neck deformities, and ruptured tendons are all common hand symptoms that can make everyday tasks difficult.
If you experience muscle cramping in your hands, you can relieve it by gentle movements and warm compresses. If you experience swelling in your hands from RA, it may be causing pressure on the median nerve, which can lead to numbness or carpal tunnel syndrome. See your doctor if you experience any of these.
Uncontrolled inflammation in the feet can result in painful conditions like hammertoes (abnormal bending of the toes), bunions (a bony nodule on the outside edge of the big toe), pes planus (loosening of the arch joint in the middle of the foot), and valgus hind foot (loosening of the joint below the ankle, causing the foot to bend forward).
RELATED: How to Relieve Rheumatoid Arthritis Related Foot Pain
It may also be beneficial to consult an occupational or physical therapist in addition to seeing your rheumatologist and, if necessary, a podiatrist. These experts can help you learn ways to move that are less painful and can help to strengthen your muscles, says Rebecca Manno, MD, a rheumatologist and adjunct assistant professor of medicine at the Johns Hopkins University School of Medicine in Baltimore.
Rashes, Ulcers, and Bumps: How RA Affects Your Skin
If rheumatoid arthritis goes untreated for a long time, people may develop skin rashes or ulcers on their arms or legs, Dr. Greer explains.
According to research published in the journal Autoimmunity Reviews, up to 30 percent of people with RA develop rheumatoid nodules. Rheumatoid nodules are knots of inflammatory tissue that appear just under the skin near a joint. Most often, they appear on the elbows, hands, and feet. If they become bothersome, they can be treated with a steroid injection.
All the conditions that affect the skin will improve once RA is controlled with DMARD medications.
How Rheumatoid Arthritis Can Hurt Your Heart
Greer stated that people with rheumatoid arthritis who have higher levels of inflammation are more at risk for heart disease, particularly heart attacks and strokes.
People with systemic inflammatory diseases, such as RA, are twice as likely to die from a heart attack at a young age, according to a March 2021 study in the European Journal of Preventive Cardiology.
To reduce your risk, you will 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 reduce your risk of developing heart disease.
There are two ways you can help your heart and reduce the symptoms of RA: don't smoke and avoid exposure to secondhand smoke.
The text is saying that while some RA medications have been linked to heart problems, the negative effects of not treating RA with medication are much worse.
Rheumatoid Arthritis and Your Lungs
RA is commonly associated with interstitial lung disease (ILD), a condition that causes inflammation and scarring of lung tissue. ILD can be difficult to detect, but occurs when lung tissue becomes inflamed and eventually scarred.
The exact number of people who develop RA is unknown, but French researchers found that 18 percent of people who have had RA for 12 years have asymptomatic ILD. Other studies have found that the figure is over 50 percent.
This scarring decreases the amount of oxygen that is able to travel from the lungs to the blood and to other organs. The condition can cause difficulty breathing and coughing, but sometimes there are no symptoms. If the condition is not treated, it can get worse and result in a permanent scarring of the lungs.
The text states that people with RA are more likely to get COPD, which is a disease where it is hard to breathe. There is no cure for COPD, but there are some treatments that can help make it easier to breathe.
If you have pleurisy, the tissue around your lungs becomes inflamed. This can cause fluid to build up at the base of your lungs.
Nodules can form on the lungs, throat, and vocal cords of people with RA, causing difficulty speaking.
If you want to address inflammation and minimize the risk of developing lung problems, it is important to be proactive and diligent about your RA treatment. Quitting smoking is also key.
Rheumatoid Arthritis and Your Circulatory System: RA Can Trigger Anemia and Fatigue
Approximately a lot of individuals who have RA also have anemia, which is a lack of red blood cells or the iron-containing hemoglobin in red blood cells. Red blood cells transfer oxygen from your lungs to all other cells in your body, so when your organs don't receive enough oxygen, you can feel weak, tired, have headaches, feel out of breath, dizzy, and more.
This form of anemia occurs when inflammation from RA suppresses the bone marrow's ability to make new red blood cells. There are different types of anemia, the most common type in RA patients being called anemia of inflammation and chronic disease (AI/ACD), as explained by rheumatologist Robert W. Lightfoot, MD, a professor of medicine in the division of rheumatology at the University of Kentucky College of Medicine in Lexington. This form of anemia occurs when inflammation from RA suppresses the bone marrow's ability to make new red blood cells.
The exact reason for the correlation between anemia and RA is unknown, but it is thought that the inflammatory molecules associated with RA interfere with the body's ability to properly use iron. This eventually leads to anemia. supplementing with iron can help to alleviate the issue, but the best course of treatment is to keep the inflammation of RA under control with DMARD medication.
A second factor that can lead to fatigue is inflammation. This can cause the body to release cytokines, which are associated with feeling tired. Furthermore, the depression and pain that can come with RA can quickly use up a person's energy.
Rheumatoid Arthritis and Kidney Function: What to Know
The condition of amyloidosis, which is caused by the abnormal buildup of certain proteins that can impair kidney function, may occur in people who also have RA. This usually happens in the later stages of RA, or if the person's disease is not well-controlled by medication. The symptoms of amyloidosis are often vague, such as weakness or swelling. They can also include an enlarged spleen and gastrointestinal issues.
Rheumatologists regularly check kidney function in order to detect amyloidosis.
You can damage your kidneys by taking too many nonsteroidal anti-inflammatory painkillers (NSAIDs), like ibuprofen and naproxen.
Rheumatoid Arthritis Can Drain Your Brain and Mood
Having a chronic illness can be very scary and depressing. RA, or rheumatoid arthritis, is a chronic illness that has a clear link to depression, according to Daniel Solomon, MD, MPH. It is not yet clear how much of the depression is a reaction to the disease and how much is because of the inflammation of the disease, but both play a role.
Depression and RA are interconnected, with treating one helping to treat the other. This was presented in research at the annual congress of the European Alliance of Associations for Rheumatology (EULAR).
How rheumatoid arthritis affects joints:
What are the symptoms?
The important signs and symptoms to be aware of are:
- pain, swelling and possibly redness around your joints.? Hands and feet are often affected first, though RA can start in any joint
- stiffness in your joints when you get up in the morning or after sitting for a while, which lasts for more than 30 minutes and has no other obvious cause
- fatigue that’s more than just normal tiredness
If you experience any of the following symptoms, it is recommended that you see your GP. Early diagnosis and treatment of RA generally leads to better long-term outcomes.
Most people experience pain as a symptom, which is initially caused by inflammation in the joints. Later on, pain can be the result of damage to the joints. Pain levels can vary from day to day.
The stiffness caused by arthritis is most severe when you first wake up in the morning, and can last for several hours if you're not taking medication. The joints become difficult to move from a position after you've been resting, which also happens when you've been sitting for a while.
Anemia can cause fatigue, but so can inflammation. Fatigue has been linked to a number of things, including pain levels.
People with cancer may experience flu-like symptoms with fever, muscle pains, and fatigue, especially in the early days before or during diagnosis.
Although RA can have a negative impact on people's lives, there are now effective treatments available. People may feel low or depressed because of RA's overall effect on their body and the pain they are experiencing, but there is hope for managing the condition.
