House Call Doctor explains the symptoms and probable causes of RA, and recommends being proactive in fighting it.
In rheumatoid arthritis, joints are swollen and painful, and multiple joints throughout the body are often affected. Typically there is the presence of an antibody against the cartilage in the joints, which is known as rheumatoid factor, although some cases of RA happen without it. It was initially thought that the rheumatoid factor was the cause of RA, but now it isn’t so clear. It is, however, believed that the immune system is involved, as drugs that blunt the immune response can improve symptoms significantly.
The onset of RA is generally gradual, and it more frequently affects the joints further away from the trunk, with the hands and feet bearing the brunt of the pain and swelling. There are cases where RA starts in a single joint, and cases where it starts in other parts of the body like the lungs, but the majority of the time its main focus is in the arms and legs.
The main early symptom of RA is stiffness lasting over one hour in the morning. The swelling of certain joints, such as the knuckles at the base of the fingers and the wrist, and swelling in a symmetrical pattern are also strongly suggestive of RA. The course RA takes in a person can vary widely, from a slowly progressive, milder disease, to a rapidly progressive and severe arthritis. If left untreated, it can cause crippling deformity and pain.
In the past, there wasn’t much that could be done about RA, and what could be done had significant side effects. But recently things have changed dramatically, with the development of very effective medications that can significantly reduce symptoms and slow the progression of the disease. This is probably the most important message I can give about RA: don’t leave it be. Get treatment, and not just with the short term medications like prednisone or anti-inflammatory drugs, but with the newer medications. Go to a rheumatologist to create a customized plan of action that's right for you.
Arthritis image courtesy of Shutterstock.