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Rheumatoid Arthritis

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Jun.30.2020
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 Rheumatoid Arthritis

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a long-term (chronic) disease that causes inflammation in your joints. RA may start slowly. It most often affects the small joints of the hands and feet. Usually, the same joints are affected on both sides of your body. Inflammation from RA can also affect other parts of your body, including your heart, eyes, or lungs.

There is no cure for RA, but medicines can help your symptoms and halt or slow down the progression of the disease.

What are the causes?

RA is an autoimmune disease. When you have an autoimmune disease, your body's defense system (immune system) mistakenly attacks healthy body tissues. The exact cause of RA is not known.

What increases the risk?

You are more likely to develop this condition if you:
  • Are a woman.
  • Have a family history of RA or other autoimmune diseases.
  • Have a history of smoking.
  • Are obese.
  • Have been exposed to pollutants or chemicals.

What are the signs or symptoms?

The first symptom of this condition may be morning stiffness that lasts longer than 30 minutes.
  • Symptoms usually start gradually. They are often worse in the morning.

As RA progresses, symptoms may include:
  • Pain, stiffness, swelling, warmth, and tenderness in joints on both sides of your body.
  • Loss of energy.
  • Loss of appetite.
  • Weight loss.
  • Low-grade fever.
  • Dry eyes and dry mouth.
  • Firm lumps (rheumatoid nodules) that grow beneath your skin in areas such as your forearm bones near your elbows and on your hands.
  • Changes in the appearance of joints (deformity) and loss of joint function.

Symptoms of this condition vary from person to person.
  • Symptoms of RA often come and go.
  • Sometimes, symptoms get worse for a period of time. These are called flares.

How is this diagnosed?

This condition is diagnosed based on your symptoms, medical history, and physical exam.
  • You may have X-rays or an MRI to check for the type of joint changes that are caused by RA.

You may also have blood tests to look for:
  • Proteins (antibodies) that your immune system may make if you have RA. These include rheumatoid factor (RF) and anti-CCP.
    • When blood tests show these proteins, you are said to have "seropositive RA."
    • When blood tests do not show these proteins, you may have "seronegative RA."
  • Inflammation in your blood.
  • A low number of red blood cells (anemia).

How is this treated?

The goals of treatment are to relieve pain, reduce inflammation, and slow down or stop joint damage and disability. Treatment may include:
  • Lifestyle changes. It is important to rest as needed, eat a healthy diet, and exercise.
  • Medicines. Your health care provider may adjust your medicines every 3 months until treatment goals are reached. Common medicines include:
    • Pain relievers (analgesics).
    • Corticosteroids and NSAIDs to reduce inflammation.
    • Disease-modifying antirheumatic drugs (DMARDs) to try to slow the course of the disease.
    • Biologic response modifiers to reduce inflammation and damage.
  • Physical therapy and occupational therapy.
  • Surgery, if you have severe joint damage. Joint replacement or fusing of joints may be needed.

Your health care provider will work with you to identify the best treatment option for you based on assessment of the overall disease activity in your body.

Follow these instructions at home:

Activity

  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Rest when you are having a flare.
  • Start an exercise program as told by your health care provider.

General instructions

  • Keep all follow-up visits as told by your health care provider. This is important.
  • Take over-the-counter and prescription medicines only as told by your health care provider.

Where to find more information

  • American College of Rheumatology: www.rheumatology.org
  • Arthritis Foundation: www.arthritis.org

Contact a health care provider if:

  • You have a flare-up of RA symptoms.
  • You have a fever.
  • You have side effects from your medicines.

Get help right away if:

  • You have chest pain.
  • You have trouble breathing.
  • You quickly develop a hot, painful joint that is more severe than your usual joint aches.

Summary

  • Rheumatoid arthritis (RA) is a long-term (chronic) disease that causes inflammation in your joints.
  • RA is an autoimmune disease.
  • The goals of treatment are to relieve pain, reduce inflammation, and slow down or stop joint damage and disability.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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