What Is Rheumatoid Arthritis?

You’ve undoubtedly heard of arthritis. And you probably have a good idea of what someone means when they say they have arthritis. They’re bothered by stiff and painful joints. But what many people don’t know is that there are several kinds of arthritis.

“The most common type is osteoarthritis (OA),” says Brian DelVecchio, DO, a rheumatologist with LVPG Rheumatology in Hometown and Pottsville. “When people complain of pain and stiffness in their joints, particularly weight-bearing joints such as the spine, knees and hips, oftentimes they are referring to osteoarthritis. However, depending on the clinical scenario, other forms of arthritis may be the underlying cause.”

Rheumatoid arthritis (RA) is a very different disease from OA.

Although many of the symptoms of RA can feel the same as those of OA, RA is an autoimmune disease; OA is not. “As an autoimmune disease, RA is more like multiple sclerosis, Crohn’s disease and lupus. Like these and other autoimmune diseases, RA develops when your own immune system attacks your body,” says Dr. DelVecchio. In the case of RA, the immune system attacks the tissue lining the joints. Usually, it’s the joints in your hands, wrists, ankles and feet that are initially affected. But over time, RA can affect larger joints as well.

In the early stages of RA, the symptoms are pain, swelling and inflammation. But over time the disease can cause bone erosion and deform your joints. Even more serious complications are possible.

“Sometimes the inflammation associated with RA can damage other parts of your body, too, including your lungs and heart,” says Nina Bhambhani, MD, a rheumatologist with LVPG Rheumatology–Independence Road.

Doctors aren’t sure what causes RA, but there is some evidence it could be triggered by an infection, smoking, stress or something in the environment, like pollution. Researchers also think genetics and hormones could be involved. “One reason to suspect hormones is the fact that females are more likely than males to get the disease,” says Kourtney Rudzinski, DO, a rheumatologist with LVPG Rheumatology–Hecktown Oaks. “RA is as much as three times more common in females.”

More than 1.3 million Americans have RA. That includes about 300,000 children. (In those under age 18, the disease is called Juvenile RA.) Although anyone can develop RA, it usually first appears in people between ages 30 and 50. Your chances of getting RA are higher if someone in your family has RA, if you smoke or if you are obese. “Gum disease and diseases of the lungs and airways may also be associated with developing RA,” says Dr. Bhambhani. “For example, it is known that periodontal disease and respective microorganisms in overgrowth can be a trigger for RA.”

Early signs of RA include tenderness or pain in small joints like those in your fingers or toes. Or you might notice pain in a larger joint like your knee or shoulder. It’s important not to ignore these signs because the sooner you’re diagnosed with RA, the sooner your treatment can begin.

Delays in treatment give the disease more time to do lasting damage to your joints. Getting a diagnosis and beginning proper treatment promptly is the best way to slow or stop the damage.

See your doctor if you have any of these symptoms:

• Joint pain and stiffness
• Joint swelling and redness
• Symptoms in four or more joints, including the hands and fingers
• Symptoms that affect both the left and right sides of your body
• Morning stiffness that lasts longer than 30 minutes
• Symptoms that last longer than six months

But understand, too, that the symptoms of RA can be subtle, especially at first.

“If you’re not feeling well and you’re wondering what’s going on, make an appointment to see your doctor,” says Dr. Rudzinski.

If your doctor determines that you do have RA, he or she will likely refer you to a rheumatologist, a doctor who specializes in the treatment of RA and similar diseases. Rest assured that there is a lot that you, your rheumatologist, and the rest of your health care team can do to treat your condition.

Often simple things like lifestyle changes and nutrition therapy can make a difference. Physical therapy and occupational therapy can be useful, too. And, there is a wide range of medications available to reduce pain and swelling and slow or halt joint damage. Finally, in cases where it’s necessary, damaged joints can be repaired or replaced with surgery. Your doctor might also recommend surgery if your pain is not well controlled with medication. Surgeries that treat RA include knee replacement, hip replacement and other surgeries to correct deformities.

Unfortunately, there is no cure for RA. It’s a condition you will likely have for the rest of your life. But you may have periods of remission, stretches of time when you don’t notice any symptoms. There are times, too, when you might experience “flares.” These are periods when your symptoms are worse than usual. Flares appear to be triggered by stress, environmental factors like cigarette smoke or viral infections, and too much activity. Stopping your medications can also bring on a flare. In some cases, there may be no clear cause.

“The good news is that if you work with your doctors and other clinicians, you can expect to live a full life despite your RA,” Dr. Bhambhani says. “Don’t hesitate to begin.”

“Some people will suffer for years before they seek out the care they need and deserve,” says. Dr. Rudzinski. “There’s no reason to wait.”