What is Rheumatoid Arthritis? Rheumatoid arthritis (RA) is an autoimmune disease that is known to cause joint pain and inflammation. Depending on the severity of the disease, it can also cause damage throughout the body including organ damage.
The joint pain and damage that RA causes usually affects both sides of the body. As such, if a joint is affected in one of your arms or legs, the same joint in the other arm or leg will likely be affected. This mirroring effect is one of the ways that a physician can distinguish rheumatoid arthritis from other forms of arthritis, like osteoarthritis (OA).
Like many diseases and conditions, treatments perform best when rheumatoid arthritis is diagnosed early, so it’s important to learn the risks and warning signs. See below to learn everything you need to know about RA, from types and symptoms to home remedies, diets and other viable treatment methods.
Rheumatoid Arthritis Symptoms
Rheumatoid arthritis is a chronic disease characterized by inflammation and pain in the joints. These symptoms generally occur during periods known as flare ups or exacerbations. Sometimes, the symptoms disappear completely but you can still be a carrier. This period is known as remission. While RA has been known to affect several organs in the body, the symptoms affecting the joints of the body include:
- joint pain
- joint swelling
- joint stiffness
- loss of joint function and deformities
The symptoms of rheumatoid arthritis can vary greatly, from mild to severe. As such, it’s critically important not to ignore the symptoms, particularly if they leave and return. Being able to identify the early signs and symptoms of RA will help your physician more effectively treat and manage the disease.
Rheumatoid Arthritis Diagnosis
Arriving at a confirmed diagnosis for RA can take time and patience, and may require multiple tests to confirm. A physician or healthcare provider will use a multi-pronged approach to confirm and diagnose RA. To begin, your doctor will ask you for details about your symptoms and medical history. They will very likely perform a physical exam of your joints, which will include an assessment of:
- swelling and redness
- joint function and range of motion
- warmth and tenderness in the joints
- reflexes and muscle strength
If your health care provider determines that you have the common signs and symptoms of RA, they will likely refer you to a specialist known as a rheumatologist. As there is no single test that can confirm a diagnosis of RA, your physician or rheumatologist will complete several different tests to arrive at a confirmed diagnosis. They will test your blood for substances like antibodies and acute phase reactants, which can become elevated for individuals suffering from inflammatory conditions. These biological markers can provide a strong sign of RA and help support the diagnosis.
They may also request diagnostic imaging tests, such as an ultrasound, X-Ray or MRI. These tests will not only show if joint damage has occurred, but also the extent of any damage done. The doctor might also complete an evaluation of other organ systems to assess any potential complications beyond joint pain.
Blood Tests for Rheumatoid Arthritis
There are several blood tests that your health care provider or rheumatologist can administer to determine whether or not you have rheumatoid arthritis, including:
Rheumatoid Factor Test
The Rheumatoid Factor (RF) blood test can determine if a protein called rheumatoid factor is present in your blood stream. Research has shown that high levels of rheumatoid factor are highly prevalent in those suffering from autoimmune diseases, particularly RA.
Anti-Cyclic Citrullinated Peptide Test (anti-CCP)
This blood test looks for an antibody called cyclic citrullinated peptide, which is frequently associated with RA. The vast majority of people with this antibody are diagnosed with rheumatoid arthritis, but not everyone with RA tests positive for this antibody. This is one reasons that a firm diagnosis poses challneges for health care providers and patients.
Antinuclear Antibody Test (ANA)
The purpose of the antinuclear antibody test is to evaluate antinuclear antibodies in a patient’s blood and to determine if your immune system is producing antibodies as expected. The human body produces antibodies as a response to many different health conditions, including rheumatoid arthritis.
Erythrocyte Sedimentation Rate Test (ESR)
The Erythrocyte Sedimentation Rate test is a blood test that can reveal inflammatory activity in your body. It is also helpful in determining the extent of inflammation throughout your body. This test has certain limitations, as the test result can determine whether inflammation is present, but it does not indicate the root cause of the inflammation.
C-Reactive Protein Test (CRP)
A major infection or significant inflammation in your body can cause your liver to produce something called C-reactive protein. Research has shown that high levels of this inflammatory marker are frequently associated with RA.
Rheumatoid Arthritis Treatments
While there is no cure for rheumatoid arthritis, there are a number of highly effective treatments that can help you better manage the condition.
Recent advances in treatment strategies have resulted in significantly improved outcomes for those individuals suffering with rheumatoid arthritis. The “Treat to Target” (T2T) approach to treating rheumatoid arthritis is one such example. The treat-to-target approach has resulted in reduced symptoms and higher remission rates for those individuals afflicted with RA. The treatment strategy involves:
- Setting a specific testing goal that signals either remission or low disease state.
- Testing acute phase reactants and performing monthly monitoring to assess progress of treatment and management plan.
- Switching medication regimen promptly if progress isn’t made.
- Treatments for RA help to manage the pain and control the inflammatory response which can in many cases result in remission. Decreasing the inflammation can also help to prevent further joint and organ damage.
Treatments may include some or all of the following:
- alternative or home remedies
- dietary changes
- specific types of exercise
Your doctor or primary health care provider will work with you to determine the most appropriate treatment plan for your individual medical needs. For a great many people, these treatments help them live an active, healthy life and effectively reduce the risk of long-term health complications.
Rheumatoid Arthritis Medications
There are numerous medications used in the treatment and management of RA. Some of these medications reduce the pain and inflammation associated with RA, while others can help prevent flare-ups and help limit the damage to your joints and organs. The following over-the-counter (OTC) medications can help reduce the pain and inflammation caused by RA flare-ups:
- nonsteroidal anti-inflammatory drugs (NSAIDs)
The following prescription medications work to limit the damage that RA can cause to your body:
Disease-modifying antirheumatic drugs (DMARDs) work by blocking your body’s immune system response, helping to slow down the progression of RA.
Biologics are a new generation of biologic DMARDs that provide a targeted response to inflammation, rather than blocking your body’s entire immune response. Biologic DMARDs provide an effective treatment option for people who don’t respond well to traditional DMARDs.
Janus kinase (JAK) inhibitors are a new subcategory of DMARDs that block specific immune responses in the body. These medications can be used to prevent inflammation and damage to your joints when DMARDs and biologic DMARDs have proven ineffective.
Home Remedies for Rheumatoid Arthritis
Various home remedies and life style modifications can help improve your quality of life when diagnosed with RA. These remedies include exercise, rest and assistive devices like canes and crutches.
Low-impact exercises can improve the range of motion in your joints and increase your general mobility. Exercise plays in important role in strengthening muscles, which can relieve some of the pressure on your joints. Yoga is another excellent low-impact exercise that can help you regain strength and flexibility in your muscles and joints.
Rest & Relaxation
Sleep is an important method to help your body recoup from the physical stresses of everyday life. You may find that you require more rest during rheumatoid arthritis flare-ups and less rest during periods of remission. Quality sleep will help you reduce inflammation, pain and fatigue.
Hot & Cold Compresses
Ice packs and cold compresses can effectively reduce inflammation and pain. Additionally, they are highly effective at preventing muscle spasms. Try alternating between cold and hot treatments, as warm showers and hot compresses can significantly reduce the pain and stiffness of sore muscles.
Assistive devices like splints and braces can hold your joints in a comfortable resting position, thus helping to reduce pain and inflammation.
Canes and crutches can also help RA sufferers maintain their mobility, even during periods of painful flare-ups. You might also consider installing household devices such as grab bars and handrails in the bathrooms and along the staircases.
Rheumatoid Arthritis Diet
As part of your treatment for rheumatoid arthritis, your physician or dietitian may recommend an anti-inflammatory diet to help you cope with and manage your symptoms. This type of diet includes foods that have a high concentration of omega-3 fatty acids. Foods high in omega-3 fatty acids include:
- fatty fish like salmon, tuna, herring, and mackerel
- chia seeds
- flax seeds
Antioxidants, such as vitamins A, C, and E, and selenium can also help reduce inflammation in your joints. Some examples of foods high in antioxidants include:
- berries, such as blueberries, cranberries, goji berries, and strawberries
- dark chocolate
- kidney beans
Eating a lot of fiber is also important, as fiber may help reduce inflammatory responses which may in turn decrease C-reactive protein levels. Seek out whole grain foods, fresh vegetables and fresh seasonal fruits like strawberries. Foods containing a high concentration of flavonoids can also help to mitigate the effects of inflammation in the body. They include:
- soy products, such as tofu and miso
- green tea
The foods you avoid are just as important as the foods you eat. Make every effort to avoid trigger foods, particularly those that include processed carbohydrates and saturated / trans fats. Avoiding trigger foods and maintaining a consistent diet including the right foods is an important part of an anti-inflammatory diet.
Types of Rheumatoid Arthritis
As you are likely aware, there are several different types of rheumatoid arthritis:
Seropositive Rheumatoid Arthritis
If you are diagnosed with seropositive RA, you have tested positive during the rheumatoid factor blood test. This means the antibodies that cause your immune system to attack your joints is present is your system.
Seronegative Rheumatoid Arthritis
If you receive a negative RF blood test result, as well as a negative anti-CCP result, yet you still have RA symptoms, you may have seronegative RA. In time, you may eventually develop antibodies, and that would change your diagnosis to seropositive RA.
Juvenile Idiopathic Arthritis
Juvenile idiopathic arthritis (JIA) refers to RA in children ages 17 and below. The condition is also known as juvenile rheumatoid arthritis (JRA). The symptoms of JIA are very much the same as other types of RA, but they also include issues with physical development and eye inflammation.
Seropositive Rheumatoid Arthritis
Seropositive RA is by far the most common form of RA. This type of arthritis is very likely hereditary, as in it runs in families. Individuals diagnosed with seropositive RA often experience more severe symptoms than those afflicted with seronegative RA. Symptoms of seropositive RA often include:
- morning stiffness lasting 30 minutes or more
- pain and swelling in multiple joints
- pain and swelling in symmetrical joints
- rheumatoid nodules
- weight loss
As mentioned above, RA isn’t always confined to the joints. Some people diagnosed with seropositive RA experience inflammation in the eyes, nerves, kidneys, lungs, salivary glands, heart, skin and blood vessels.
Rheumatoid Arthritis Causes
The explicit cause of RA is not currently known. However, a number of factors appear to play a role in increasing the risk of developing RA or triggering its onset in certain individuals. Factors that have shown an increased risk for RA include:
- being a woman
- having a family history of RA
Factors that may trigger onset of RA involve:
- exposure to certain types of bacteria, such as those associated with periodontal disease
- having a history of viral infections, such as the Epstein-Barr virus, which causes mononucleosis
- trauma or injury, such as bone breakage or fracture, dislocation of a joint, and ligament damage
- smoking cigarettes
Rheumatoid Arthritis in the Hands
Arthritis in the hands may start out as a slight burning sensation that you experience in the latter part of the day. You may also feel some or all of the following symptoms:
If the cartilage in your joints wears away, you may start to notice some deformities appearing on your hands. You may also experience a grinding feeling in the joints of your hands, fingers and large joints. As the disease progresses, fluid-filled sacs or synovial cysts develop in the wrists, knees, elbows, ankles and around the small joints of the hands. You may also develop knobby growths, also known as bone spurs, in the afflicted joints.
If you have been diagnosed with rheumatoid arthritis in your hands, your doctor or rheumatologist can advise on special exercises that can help you retain movement and function in your hands. Exercise, in addition to other forms of treatment, can greatly reduce inflammation and help you defend against the progression of the disease.