Rheumatoid Arthritis

What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is an inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints. It occurs when the immune system starts attacking the membrane lining the joints. RA has several features that make it different from other kinds of arthritis. For example, rheumatoid arthritis generally occurs in a symmetrical pattern, meaning that if one knee or hand is involved, the other one also is. The disease often affects the wrist joints and the finger joints closest to the hand. It can also affect other parts of the body besides the joints.

The course of rheumatoid arthritis can range from mild to severe. In most cases, it is chronic, meaning it lasts a long time—often permanently. For many people, periods of relatively mild disease activity are punctuated by flares, or times of heightened symptoms.

Joint symptoms

The primary symptoms are pain and stiffness of affected joints. The stiffness is usually worse first thing in the morning, or after you have been resting. There is visible inflammation around the affected areas.

Other symptoms

These are known as extra-articular symptoms of RA (meaning outside of the joints). A variety of symptoms may occur. Some of these are not fully explicable:

  • Small painless lumps (nodules) develop in a few cases. These commonly occur on the skin over the elbows and forearms, but usually harmless.
  • Inflammation around tendons may occur.
  • Anaemia and tiredness.
  • A high temperature, feeling unwell, weight loss, and muscle aches and pains

In a few cases, inflammation develops in other parts of the body, such as the lungs, heart, blood vessels, or eyes. This is uncommon but can occur in rare cases and give way to other problems.

The importance of early diagnosis and treatment

If your doctor suspects that you have rheumatoid arthritis (RA), you will usually be referred to a joint specialist (a rheumatologist). It is very important to start treatment as early as possible because any joint damage done by the disease is permanent.

What are the treatments for rheumatoid arthritis (RA)?

There is no cure for RA. However, treatments can make a big difference to reduce symptoms and improve the outlook. The main aims of treatment are:

  • To decrease the disease activity as much as possible to prevent joint damage
  • To reduce pain and stiffness in affected joints
  • To minimise any disability caused by pain, joint damage, or deformity
  • To treat other symptoms of the disease if they develop

Most people who have rheumatoid arthritis take medications. Some medications (analgesics) are used only for pain relief; others, such as corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs), are used to reduce inflammation.

There are several medicines called disease-modifying antirheumatic drugs (DMARDs). DMARDs ease symptoms but also reduce the damaging effect of the disease on the joints. They do this by blocking certain chemicals involved in the inflammation process.

Surgical treatment

Rheumatoid arthritis patients, after prolonged disease, could develop advanced arthritis, affecting the joint function and mobility. In these patients who suffer from primary RA or secondary OA (osteoarthritis), surgical treatment in the format of joint replacement, commonly for the hip and knee, is offered.