Symptoms of Rheumatoid Arthritis
Rheumatoid Arthritis is an autoimmune disease characterized by sore, swollen joints that often feel warm to the touch.
The joints become stiff overnight, or during periods of inactivity, making it painful and difficult to get moving again. Severe rheumatoid arthritis can be accompanied by fatigue, fever, and weight loss, and eventually causes deformity of the affected joints. Most RA sufferers are diagnosed between the ages of 45 and 64, although the disease can manifest in children as well, and in North America, nearly half of all adults over the age of 65 report some form of doctor-diagnosed arthritis.
What causes Rheumatoid Arthritis?
Medical science has not yet discovered the cause of any autoimmune disease. Autoimmune diseases happen when the body’s immune system malfunctions, and normal body tissue is identified as an alien intruder. The body’s immune system then tries to protect the body by attacking the intruder and killing it. Unfortunately, the “intruder” is you, and therefore your immune system is actually causing you injury instead of protecting you. While medical science has come up with many effective treatments for autoimmune diseases, we do not yet know what the underlying cause is. Therefore, autoimmune diseases cannot be prevented, they can only be treated after they have manifested.
How does Genetics Factor in ?
There appears to be a genetic component to RA, but your genes do not cause the disease. It appears to take an added environmental factor, such as a viral or bacterial infection, to trigger the disease. Some of the other risk factors for RA are your sex (women are more likely to suffer from RA than men) your age (RA is most commonly diagnosed between the ages of 40 and 60, but it can manifest at any age) your smoking history (smoking increases your risk of developing RA, and it is also associated with more severe forms of the disease) and even environmental exposures to irritants such as asbestos or silica.
Signs and Symptoms:
The most common symptom of RA is joint pain. Joints feel stiff and sore, and they are often red and swollen and feel warm to the touch. It is common for RA to affect the smaller joints first, and then progress to the larger joints, therefore, most people feel RA in their hands and feet before they feel it in their knees or hips.
What Causes this ?
The pain of RA is caused by the fact that RA causes inflammation in the lining of the membranes that surround your joints (these are called synovium) and the inflammation eventually causes the synovium to thicken and stop allowing the joint to bend properly.
Ligaments & Tendons
RA also causes the ligaments and tendons surrounding your joints to become weaker, and eventually to stretch out of shape. The whole process causes the joint to become deformed, the cartilage and bone in the joint can be destroyed, and the joint loses its shape and becomes misaligned. When you see someone with severely deformed joints, what I have just described is the process that has happened to them.
What Else is Affected ?
Rheumatoid Arthritis, however, can affect more than just your joints. Approximately 40% of RA sufferers have symptoms that do not involve the joints at all, but do affect things like nerve tissue, eye function, kidney function, heart function, lung function, the salivary glands, and even the skin. In rare cases, RA can affect bone marrow and blood vessels as well.
Nerve tissue and RA: RA can affect nerve tissue in two ways: compression and demyelination. Nerve tissue can be irritated by being compressed by damaged joint structures, such as in the spine, causing pain and loss of feeling in the hands and feet, or in the wrist, causing carpal tunnel syndrome. Demyelination is the stripping away of the protective myelin coating on the nerves, making them sensitive and easily irritated. This can be caused by either the immune system damaging blood vessels that feed the nerves, or by drugs used to treat the RA.
Eye function and RA: The most common eye-related symptom of RA is dry eyes (this can be associated with Sjogren’s Syndrome, but is not always), but other parts of the eye can be affected, such as the sclera (the white part of the eye) which can become red and sore and inflamed. Any eye pain or vision abnormality should be investigated by an ophthalmologist, in order to prevent permanent damage or vision loss.
Kidney function and RA: It has long been known that autoimmune diseases often affect the kidneys, but the exact mechanism by which RA causes kidney damage is not yet completely established. It has been suggested that many of the treatments for RA are damaging to the kidneys, and that is where the increased rate of kidney disease in RA patients comes from, and it is true that many of the older treatments for RA were toxic to the kidneys, and even today, NSAIDS are commonly prescribed for RA sufferers, even though it is known that they may cause damage to the kidneys. The possibility also exists, however, that it is vasculitis (an inflammation of the small blood vessels) caused by RA that causes kidney damage.
Heart function and RA: More than half of all premature deaths in people who have a history of RA can be attributed to heart disease. It is not yet completely understood why RA sufferers have an increased incidence of heart disease, but it seems to be related to the levels of inflammation in the body.
Lung function and RA: There are several types of lung involvement that are associated with RA, such as pleural disease (where the pleurae, or sacs surrounding the lungs, become inflamed), rheumatoid nodules (where nodules form on the surface of the lungs, causing symptoms ranging from mild discomfort to a collapsed lung), interstitial lung disease (characterized by changes to the alveoli, which makes breathing less efficient), pulmonary hypertension (which is high blood pressure that affects the arteries in your lungs and on the right side of your heart), and drug-induced lung disease (caused by drugs like methotrexate, which is often used to treat RA). As with many other aspects of RA, the exact mechanisms that cause lung damage are not yet fully understood.
Salivary glands and RA: The most common cause of salivary gland involvement in RA is Sjogren’s Syndrome, which is primarily characterized by dry eyes and mouth. Sjogren’s Syndrome is often associated with other autoimmune diseases. The syndrome is treatable, but the continued irritation from dry eyes and mouth can be debilitating.
Skin and RA: Rheumatoid nodules are the most common manifestation of RA in the skin. These are hard lumps that usually show up over joints, and can range from the size of a pea to that of a golf ball. They usually disappear on their own, but on rare occasions can become infected and need surgical repair. Most skin rashes are associated with the drugs used to treat RA, such as Plaquinil or Methotrexate.
Do I have Rheumatiod Arthritis or Osteoarthritis ?
These Two conditions are both classified as Arthritic because they affect our Joints but the similarities stop there.
If you are unsure what you may have please consult our Arthiritis comparison.
What to expect when you have RA:
Each case of rheumatoid arthritis is different. Your case will be as unique as you are, and it is not usually possible to predict the course the disease will take in your particular case. That said, there is a common progression that happens to a fairly large percentage of RA patients. It starts in the small joints, and progresses to the larger joints, causing pain and deformity as it goes. For many patients, drug therapy is effective, but can result in unwanted side effects. There is no cure for rheumatoid arthritis, but with proper treatment and careful management, its effects can be minimized, and you can live a long and full life in spite of the disease.
Treatment of RA:
There are many drug treatments for RA, and it may take some time to discover the drug treatment that works for you. Some people may find that the side effects caused by the drugs are severe enough to make taking the drugs more trouble than they’re worth. In any event, there are things that you can do to minimize the bad effects of RA, and help to give you the best life possible.
A healthy diet is extremely important. If you stay away from highly processed foods, and eat mostly vegetables, (at least half your diet should consist of vegetables, with carbs and protein each making up 25%) you will be giving your body the nutrition it needs to heal damaged tissues as best it can.
If you smoke, do your best to stop, as smoking not only increases your chances of getting RA, it makes the disease worse when you do get it. Exercise is also an important factor in controlling your RA symptoms, as it can help joints to remain flexible, and even help with the fatigue associated with RA.
Remember that any exercise you do should be gentle, such as walking or swimming or yoga. If your joints are extremely inflamed, it is best to wait until the inflammation lessens before exercising. Applying hot or cold compresses can help with arthritis pain, as can soaking affected joints in warm water with Epsom salts.
There are mobility aids and handy gadgets that can make your life easier as well – you can avoid putting stress on your hand and finger joints when opening jars or bottles by getting a battery-operated jar opener, and a cane can provide needed balance when your feet are sore. Your doctor may send you to a physical therapist who can suggest many different ways to overcome the limitations placed on you by rheumatoid arthritis.
Rheumatoid arthritis can be debilitating and life-altering, but with proper care and treatment those who suffer from it can life long, full lives. This is one of those diseases where it really matters whether you take good care of yourself or not – how you take care of yourself may make the difference between being incapacitated by the disease, and being inconvenienced by it.