Rheumatology

Chronic diseases that cause pain, stiffness, and swelling of joints, which can lead to reduced motion and function of joints in the body.

Rheumatoid Arthritis

What is Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is one of the most disabling forms of arthritis. People in the past have feared this disease but recently the outlook has improved due to effective treatment.

RA is the most common form of autoimmune arthritis that can begin between the ages of 40-60. The disease is estimated to affect more than 1.3 million Americans, 75% of whom are women.

RA is a chronic disease that causes pain, stiffness, and swelling of joints, which can lead to reduced motion and function of joints in the body. The most affected parts of the body are small joints in the hands and feet. More severe symptoms of RA can affect organs such as the eyes and lungs.

What causes Rheumatoid Arthritis?

RA is a disease where immune cells function improperly and attack healthy joints, eyes and lungs. This form of disease is commonly referred to as an autoimmune disease. The exact cause of RA is unknown, however, when this autoimmune response is triggered, it can causes inflammation. This inflammation in turn can result into the release of certain chemicals that damage cartilage and cause pain.

What is the difference between osteoarthritis and rheumatoid arthritis?

Osteoarthritis is a disease that is characterized as the “wear” and “tear” of the joints. RA is a disease that results in your own body’s immune cells attacking the joints. Many of the symptoms in osteoarthritis and RA are similar, however, signs and symptoms unique to RA include:

  • Loss of energy
  • Low fevers
  • Loss of appetite
  • Dry eyes and mouth
  • Firm lumps (Rheumatoid Nodules) under the skin near the elbows and hands

How is Rheumatoid Arthritis (RA) diagnosed?

RA is best diagnosed with the expertise of a rheumatologist. The diagnosis of RA is dependent on the symptoms and results of a physical exam. Blood tests can also be utilized which can measure the following:

  • Hemoglobin level
  • Rheumatoid factor
  • anti-CCP
  • ESR

It is important to note there is no single test that can diagnose RA. It is the combination of symptoms, blood tests and physical exam that diagnose RA.

How is Rheumatoid Arthritis (RA) treated?

Current treatments provide patients good or excellent relief of symptoms and allow individuals to maintain a normal level of functioning. Although there is cure for RA, treatment is available for some patients to achieve “remission” or relief of symptoms.

The goal of treatment is to reduce symptoms and slow progression of the disease. Treatment is most successful when medical therapy is initiated as soon as possible. The most common medication class prescribed for treatment are disease-modifying antirheumatic drugs (DMARDs). These are also commonly prescribed with a non-steroid anti-inflammatory drug (NSAID) such as ibuprofen or naproxen and/or low-dose corticosteroid.

DMARDs have greatly improved the symptoms, function and quality of life in patients living with RA. Common DMARDs that are used are methotrexate, leflunomide, hydroxychloroquine, and sulfasalazine, however these are commonly known to cause unpleasant side effects. Always discuss with your physician or pharmacist on which DMARD is best for you.

Patients with more serious symptoms are often prescribed another class of drugs called biologic response modifiers or biologic agents. These drugs can target the improperly functioning immune cells and reduce inflammation in the body. The biologic agents used in RA include (click the medication name in order to be taken to the manufacturer website):

These biologic agents can be taken along with methotrexate. It is important to discuss with your physician or pharmacist to determine which combination of therapies is right for you.

How to live with Rheumatoid Arthritis?

It is important to continue to remain physically active, however, occasional flare-ups can require scaling back due to increased inflammation of the joints. During this period, it is important to continue to stretch. Low-impact aerobic exercises such as walking and swimming will help increase muscle strength, reduce pressure on joints and improve overall health. Additional resources for rheumatology patients: