It can affect anyone of any age. It can get worse quickly, so early diagnosis and intensive treatment are important. To understand how rheumatoid arthritis develops, it helps to understand how a normal joint works. A joint is where two bones meet. Most of our joints are designed to allow the bones to move in certain directions and within certain limits.
For example, the knee is the largest joint in the body and one of the most complicated. It must be strong enough to take our weight and must lock into position, so we can stand upright. It also has to act as a hinge, so we can walk, and needs to twist and turn when we run or play sports.
The end of each bone is covered with cartilage that has a very smooth, slippery surface. The cartilage allows the ends of the bones to move against each other, almost without rubbing.
The joint is held in place by the synovium, which contains thick fluid to protect the bones and joint. The synovium has a tough outer layer that holds the joint in place and stops the bones moving too far. If you have rheumatoid arthritis, your immune system can cause inflammation inside a joint or a number of joints. Inflammation is normally an important part of how your immune system works. It allows the body to send extra fluid and blood to a part of the body under attack from an infection.
For example, if you have a cut that gets infected, the skin around it can become swollen and a different colour. However, in the case of rheumatoid arthritis, this inflammation in the joint is unnecessary and causes problems. This can cause the joint to become unstable and move into unusual positions. Rheumatoid arthritis can affect any joint in the body, although it is often felt in the small joints in the hands and feet first. A few people develop fleshy lumps called rheumatoid nodules, which form under the skin around affected joints.
They can sometimes be painful, but usually are not. Rheumatoid arthritis affects adults of any age, although most people are diagnosed between the ages of 40 and Around three-quarters of people with rheumatoid arthritis are of working age when they are first diagnosed.
Rheumatoid arthritis develops because of a combination of genetic and environmental factors, such as smoking and diet.
It is unclear what the genetic link is, but it is thought that having a relative with the condition increases your chance of developing the condition. If you are overweight, you have a significantly greater chance of developing rheumatoid arthritis than if you are a healthy weight. The body mass index BMI is a measure that calculates if your weight is healthy, using your height and weight.
To work out your BMI, use the healthy weight calculator. Cigarette smoking significantly increases the risk of developing rheumatoid arthritis. If you would like to stop smoking, visit the Smokefree website. This is because:. Physical activity is also important, as it can improve your symptoms and benefit your overall health. Blood tests and x-rays will help your doctor assess how fast your arthritis is developing and what the outlook for the future may be.
This will also help your doctor to decide which form of treatment to recommend. The outlook for people with rheumatoid arthritis is improving all the time, as new and more effective treatments become available.
It is possible to lead a full and active life with the condition, but it is important to take your medication as prescribed and make necessary lifestyle changes. A diagnosis of rheumatoid arthritis is based on your symptoms, a physical examination and the results of x-rays, scans and blood tests. It can be difficult to diagnose because there isn't a test that can prove you definitely have it.
There are also quite a few conditions that have the same symptoms. Your doctor will ask about your symptoms and do a physical examination. They will look for swollen joints and check how well your joints move. Rheumatoid arthritis can affect different parts of your body at once, so it's important to tell your doctor about all the symptoms you've had, even if they don't seem to be related. If they think you have rheumatoid arthritis, they will refer you to a rheumatologist and may arrange blood tests to help confirm a diagnosis.
There's no single blood test that can confirm you have rheumatoid arthritis. However, there are a few tests that can show possible signs of the condition. Some of the main tests are outlined below. A sample of your red blood cells are put into a test tube of liquid. The cells are timed to see how long they take to get to the bottom of the tube. If the cells sink faster than usual, you may have levels of inflammation that are higher than normal. Rheumatoid arthritis is just one possible cause.
This test can show if there is inflammation in your body. It does this by checking how much CRP there is in your blood. If there is more CRP than usual, you may have inflammation in your body. A full blood count measures the number of red blood cells you have. These carry iron around your body, and a low number of red blood cells means you have a low iron content. This may mean you have anaemia an-ee-me-er and is common in people with RA, although having anaemia doesn't prove you have RA.
About half of all people with rheumatoid arthritis have rheumatoid factor in their blood when the condition starts. However, around 1 in every 20 people without rheumatoid arthritis also test positive for rheumatoid factor.
There is another antibody test called anti-CCP that you can take. People who test positive for anti-CCP are very likely to get rheumatoid arthritis. However, not everyone that has the condition has this antibody.
Scans may be used to check for joint inflammation and damage. These can be used to diagnose rheumatoid arthritis and to check how the condition is developing. There are a variety of treatments available for rheumatoid arthritis. The earlier that intensive treatment is started, the more likely it is to work. Many people with rheumatoid arthritis need to take more than one drug. This is because different drugs work in different ways. Eventually, it can destroy the joint completely.
Various theories of why the immune system attacks the joints have been suggested, such as an infection being a trigger, but none of these theories has been proven.
There are several things that may increase your risk of developing rheumatoid arthritis, including:. Getting enough sleep will help to reduce inflammation and pain as well as fatigue. Ice packs or cold compresses can help to reduce inflammation and pain. They may also be effective against muscle spasms. You can alternate cold with hot treatments such as warm showers and hot compresses.
This may help to reduce stiffness. Certain devices such as splints and braces can hold your joints in a resting position. This may help to reduce inflammation. Canes and crutches can help you maintain mobility, even during flares. You can also install household devices, such as grab bars and handrails in bathrooms and along staircases.
Learn more about these and other remedies to help you manage life with RA. Your healthcare provider or dietitian may recommend an anti-inflammatory diet to help with your symptoms.
This type of diet includes foods that have lots of omega-3 fatty acids. Foods high in omega-3 fatty acids include:. Antioxidants, such as vitamins A , C , and E , and selenium , may also help reduce inflammation. Foods high in antioxidants include:. Eating lots of fiber is also important. According to some researchers, fiber may help reduce inflammatory responses which may decrease C-reactive protein levels. Choose whole grain foods, fresh vegetables, and fresh fruit. Strawberries may be particularly beneficial.
Foods containing flavonoids can also help to counter inflammation in the body. They include:. Make sure to avoid trigger foods. These include processed carbohydrates and saturated or trans fats. Avoiding trigger foods and choosing the right foods in trying to follow an anti-inflammatory diet may help you manage your RA. There are several different types of RA.
Knowing which type you have may help your healthcare provider provide the best type of treatment for you. Get more details on the types of RA and their differences. Seropositive RA is the most common type of RA. This type of arthritis may run in families. Seropositive RA may come with more severe symptoms than seronegative RA. Some people with seropositive RA can experience inflammation in the eyes, salivary glands, nerves, kidneys, lungs, heart, skin, and blood vessels.
However, certain factors seem to play a role in increasing the risk of developing RA or triggering its onset. The cause may not be known but there are several risks and triggers. Arthritis in the hands may start as a low-level burning sensation that you feel at the end of the day. If the cartilage in your joints wears away, you may notice some deformities in your hands.
You may also have a grinding feeling in the joints of your hands, fingers, and large joints, if the cartilage deteriorates completely.
As the disease progresses, fluid-filled sacs or synovial cysts typically develop in the wrists, knees, elbows, ankles and around the small joints of the hands. Nodule biopsy. Tiny tissue samples are taken to look at under a microscope. This helps to check for cancer or other abnormal cells. Blood tests. These tests are done to find certain antibodies, called rheumatoid factor, cyclic citrullinated antibody, and other signs of RA.
Ultrasound or MRI. These imaging tests can look for bone damage and inflammation. How is rheumatoid arthritis treated? Your healthcare provider will figure out the best treatment for you based on: How old you are Your overall health and medical history How sick you are How well you handle certain medicines, treatments, or therapies If your condition is expected to get worse Your opinion or preference There is no cure for RA.
Treatment may include: Medicines. Some medicines may be used for pain relief. Some are used to treat inflammation. Others can help to slow the disease from getting worse. Medicines should be managed by a rheumatologist. This is a doctor who specializes in arthritis and rheumatic diseases.
You may need regular blood tests to check how the medicines affect your blood cells, liver, and kidneys. Splints may be used to help protect the joints and strengthen weak joints. Physical therapy. Physical therapy may be used to help increase the strength and movement of the affected areas. Joint repair or reconstruction can be done in many ways, including: Surgical cleaning.
This surgery removes inflamed and diseased tissues in the hands to help increase function. Joint replacement arthroplasty. This type of surgery may be used in cases of severe arthritis of the hand. It may be done on older adults who are not so active. Joint replacement may reduce pain and help increase joint function. During the surgery, a joint that has been destroyed by the disease is replaced with an artificial joint.
The new joint may be made out of metal, plastic, or silicone rubber.
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