Rheumatoid arthritis (2022)

  • Overview
  • Symptoms
  • Who can get it
  • Diagnosis
  • Treatment
  • Living with
  • Complications

Overview

Rheumatoid arthritis is a long-term condition that causes pain, swelling and stiffness in the joints. The symptoms usually affect the hands, feet and wrists.

There may be periods where symptoms become worse, known as flare-ups or flares.

A flare can be difficult to predict, but with treatment it's possible to decrease the number of flares and minimise or prevent long-term damage to the joints.

Some people with rheumatoid arthritis also experience problems in other parts of the body, or more general symptoms such as tiredness and weight loss.

When to seek medical advice

You should see your GP if you think you have symptoms of rheumatoid arthritis, sothey can try to identify the underlying cause.

Diagnosing rheumatoid arthritis quickly is important because early treatment can help stop the condition getting worse and reduce the risk of further problems such as joint damage.

Causes of rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease. This means your immune system – which usually fights infection – attacks the cells that line your joints by mistake, making the joints swollen, stiff and painful.

Over time, this can damage the joint itself, the cartilage and nearby bone.

It's not clear what triggers this problem with the immune system, although you're at an increased risk if:

  • you are a woman
  • you have a family history of rheumatoid arthritis
  • you smoke

Treatingrheumatoid arthritis

There's no cure for rheumatoid arthritis. However,early diagnosis and appropriate treatment enables many people with rheumatoid arthritis to have periods of months or even years between flares. This can helpthem to lead full lives and continue regular employment.

The main treatment options include:

  • medication that is taken in the long-term to relieve symptoms and slow the progress of the condition
  • supportive treatments, such as physiotherapy and occupational therapy, to help keep you mobile and find ways around any problems you have with daily activities
  • surgery to correct any joint problems that develop

Depending on how much pain, stiffness and joint damage you have, you may have to adapt the way you carry out simple daily tasks. They can become difficult or take longer to complete.

Complications of rheumatoid arthritis

Having rheumatoid arthritis can lead to several other conditions that may cause additional symptoms and can sometimes be life-threatening.

Possible complications include:

  • carpal tunnel syndrome
  • inflammation of other areas of the body (such as the lungs, heart and eyes)
  • an increased risk of heart attacks and strokes

Ensuring that rheumatoid arthritis is well controlled helps reduce your risk of complications such as these.

Symptoms

The main symptoms of rheumatoid arthritis are joint pain, swelling and stiffness. It may also cause more general symptoms, and inflammation in other parts of the body.

The symptoms of rheumatoid arthritis often develop gradually over several weeks, but some cases can progress quickly over a number of days.

The symptoms vary from person to person. They can come and go, and may change over time. Youmay occasionally experience flares when your condition deteriorates and your symptoms become more severe.

Symptoms affecting the joints

Rheumatoid arthritis mainly affects the joints. It can cause problems in any joint in the body, although the small joints in the hands and feet are often the first to be affected.

Rheumatoid arthritis typically affects the joints symmetrically (both sides of the body at the same time and to the same extent), but this isn't always the case.

Pain

Thejoint pain associated with rheumatoid arthritisis usually a throbbing andaching pain. It is often worse in the mornings and after a period of inactivity.

Stiffness

Joints affected by rheumatoid arthritis can feel stiff. For example, if your hands are affected, you may not be able to fully bend your fingers or form a fist.

Like joint pain, the stiffnessis oftenmore severe in the morning or after a period of inactivity.

Morning stiffness associated with another type of arthritis calledosteoarthritis usually wears off within 30 minutes of getting up, but rheumatoid arthritis morning stiffness oftenlasts longer than this.

Swelling, warmth and redness

The lining ofjoints affected by rheumatoid arthritis become inflamed, which can cause the joints to swell, and become hot and tender to touch.

In some people, firm swellings called rheumatoid nodules can also develop under the skin around affected joints.

Additional symptoms

As well as problems affecting the joints, some people with rheumatoid arthritis experience a range of more general symptoms, such as:

  • tiredness and a lack of energy
  • a high temperature (fever)
  • sweating
  • a poor appetite
  • weight loss

The inflammation associated with rheumatoid arthritis can also sometimes cause problems affecting other areas of the body, such as:

  • dry eyes– if the eyes are affected
  • chest pain – if the heart or lungs are affected

Who can get it

Rheumatoid arthritis is an autoimmune condition, which means it's caused by the immune system attacking healthy body tissue. However, it's not yet known what triggers this.

Your immune system normally makes antibodies that attack bacteria and viruses, helping to fight infection.

If you have rheumatoid arthritis, your immune system mistakenly sends antibodies to the lining of your joints, where they attack the tissue surrounding the joint.

This causes the thin layer of cells (synovium) covering your joints to become sore and inflamed,releasing chemicals that damage nearby:

  • bones
  • cartilage – the stretchy connective tissue between bones
  • tendons – the tissue that connects bone to muscle
  • ligaments – the tissue that connects bone and cartilage

If the condition isn't treated, these chemicals gradually cause the joint to lose its shape and alignment.Eventually, it can destroy the joint completely.

Various theories of why the immune system starts to attack the joints have been suggested, such as an infection orvirus being a trigger, but none of these theories has been proven.

Possible risk factors

There are a number of things that may increase your risk of developing rheumatoid arthritis, including:

  • your genes –there's some evidence that rheumatoid arthritis can run in families, although the risk of inheriting the condition is thought to be low as genes are only thought to play a small role in the condition
  • hormones – rheumatoid arthritis is more common in women than men, which may be because of the effects of the hormone oestrogen, although this link hasn't been proven
  • smoking – some evidence suggests that people who smoke are at an increased risk of developing rheumatoid arthritis

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Diagnosis

Rheumatoid arthritis can be difficult to diagnose because many conditions cause joint stiffness and inflammation and there's no definitive test for the condition.

(Video) Rheumatoid arthritis - causes, symptoms, diagnosis, treatment, pathology

You should see your GP if you have these symptoms so they can try to determine the cause.

Seeing your GP

Your GP willcarry out a physical examination, checking your joints for any swelling and to assess how easily they move. Your GP will also ask you about your symptoms.

It's important to tell your GP about allyour symptoms, not just ones you think are important, as this will helpthem tomake the correct diagnosis.

If your GP thinks you have rheumatoid arthritis,they'll refer you to a specialist (rheumatologist).

Blood tests

Your GP may arrangeblood tests to help confirm the diagnosis.

Noblood test candefinitively prove or rule out a diagnosis ofrheumatoid arthritis, buta number of tests can show possible indications of the condition.

Some of the main tests usedinclude:

  • erythrocyte sedimentation rate (ESR) - which can help assess levels of inflammation in the body
  • C-reactive protein (CRP) - another test that can help measure inflamation levels
  • full blood count - this test can be used to help rule out other possible causes of your symptoms as well as provide an indicator of your general health

The full blood count measures your red cells to rule out anaemia. Anaemia meansthe blood is unable to carry enough oxygen, because of a lack of blood cells.

Anaemia is common in people withrheumatoid arthritis, althoughhaving anaemiadoesn't prove you have rheumatoid arthritis.

Rheumatoid factor and anti-CCP antibodies

Specific blood tests can help diagnose rheumatoid arthritis, but aren't accurate in everyone.

About half of all people with rheumatoid arthritis have a positive rheumatoid factor present in their blood when the disease starts, but about one in 20 people without rheumatoid arthritis also tests positive.

A related blood test known as anti-cyclic citrullinated peptide (anti-CCP) test is also available. Anti-CCPs are antibodies also produced by the immune system.

People who test positive for anti-CCP are very likely to develop rheumatoid arthritis, but not everybody with rheumatoid arthritis has this antibody.

Those who test positive for both rheumatoid factor and anti-CCP may be more likely to have severe rheumatoid arthritis requiring higher levels of treatment.

Joint scans

Scans may be done to check for joint inflammation and damage.

These can help tell the difference between types of arthritisand can be used to monitor howyour condition is progressing over time.

Scans that may be done to diagnose and monitor rheumatoid arthritis include:

  • X-rays
  • MRI scans(where strong magnetic fields and radio waves are used to produce detailed images of your joints)

Assessing your physical ability

If you have been diagnosed with rheumatoid arthritits, your specialist will do an assessment to see how well you're coping with everyday tasks.

You may be asked to fill in a questionnaire on how well you can do things like dress, walk and eat, and how good your grip strength is.

This assessment may be repeated later on after your treatment to see if you have made any improvements.

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Treatment

Treatment forrheumatoid arthritis can help reduce inflammation in the joints, relieve pain, prevent or slow joint damage, reduce disability and enable you to live as active a life as possible.

Although there's no cure for rheumatoid arthritis, early treatment and support – including lifestyle changes, medication, supportive treatments and surgery – can reduce the risk of joint damage and limit the impact of the condition.

Your treatment will usually involve care from your GP anda number of different specialists.

There are medicines available to help stop rheumatoid arthritis from getting worse and reduce your risk of further problems.

These are often divided into main 2 types: disease-modifying anti-rheumatic drugs (DMARDs) and biological treatments.

Disease-modifying anti-rheumatic drugs (DMARDs)

If you've been diagnosed with rheumatoid arthritis, you'll normally be offered a combination of DMARD tablets as part of your initial treatment.

These medications are particularly effective ineasing symptoms of the condition and slowing down its progression.

DMARDs work byblocking the effects of the chemicals released when the immune system attacks the joints, which could otherwisecause further damage to nearby bones, tendons, ligaments and cartilage.

There are many different DMARDs that can be used, including:

  • methotrexate
  • leflunomide
  • hydroxychloroquine
  • sulfasalazine

Methotrexate isnormally the firstmedicine given for rheumatoid arthritis, often alongside another DMARD anda short-course of corticosteroids to relieve anypain.

It may also be combined with the biological treatments mentionedbelow.

Common side effects of methotrexate include:

  • feeling sick
  • loss of appetite
  • a sore mouth
  • diarrhoea
  • headaches
  • hair loss

The medicationcan also sometimes have an effect on your blood count and your liver,so you'll have regular blood tests to monitor this.

Less commonly, methotrexate can affect the lungs, so you'll usually have a chest X-ray and possibly breathing tests when you start taking it to provide a comparison if you developshortness of breath or a persistent drycough while taking it. But most people tolerate methotrexate well.

It can take a few months to notice a DMARD working. It's important to keep taking the medication, even if you don't notice it working at first.

You may have to try 2 or 3 types of DMARD before you find the one that's most suitable for you.

Once you and your doctor work out the most suitable DMARD, you'll usually have to take the medicine in the long term.

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Biological treatments

Biological treatments, such as etanercept and infliximab, are a newer form of treatment for rheumatoid arthritis.

They're usually taken in combination with methotrexate or another DMARD, and are usually only used if DMARDs have not been effective on their own.

Biological medicines are given by injection. They work by stopping particular chemicals in your blood from activating your immune system to attack your joints.

Side effects from biological treatments are usually mild but include:

  • skin reactions at the site of the injections
  • infections
  • feeling sick
  • a high temperature
  • headaches

Some people may alsobe at risk of getting more serious problems, including the reactivation of infections such as tuberculosis (TB)if they have had them in the past.

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Jak inhibitors

JAK inhibitors are a new type of medicine available on the NHS to adults with severe rheumatoid arthritis.

(Video) Rheumatoid Arthritis Nursing NCLEX Lecture: Symptoms, Treatment, Interventions, Medications

It is offered to people who cannot take DMARDs or biologicals, or tried them but found they were not effective.

This medicine is taken as a tablet once or twice a day, and is usually used in combination with methotrexate. These medicines include:

  • tofacitinib
  • baricitinib

JAK inhibitors can also be taken on their own by adults who cannot take methotrexate.

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Medication to relieve pain

In addition to the medications used to control the progression of rheumatoid arthritis, you may also need to take medication specifically to relieve pain.

Painkillers

In some cases, you may be advised to use painkillers such as paracetamol, or a combination of paracetamol and codeine (co-codamol), to relieve the pain associated with rheumatoid arthritis.

These medications don't help treat the underlying inflammation of your joints, but they can sometimes be helpful in relieving pain.

For example, they may be recommended while you're waiting to see a specialist or during periods where your symptoms are particularly bad (flare-ups).

Non-steroidal anti-inflammatory drugs (NSAIDs)

In addition to – or instead of – the painkillers mentioned above, your doctor may prescribe a non-steroidal anti-inflammatory drug (NSAID).

This may be a traditional NSAID (such as ibuprofen, naproxen or diclofenac) or an alternative type called a COX-2 inhibitor (such as celecoxib or etoricoxib).

These medications can help relieve pain while also reducing inflammation in the joints, although they won't stop rheumatoid arthritis getting worse over time.

Your doctor will discuss with you what type of NSAID you should take, and the benefits and risks associated with each of them.

Although uncommon, taking an NSAID tablet can increase the risk of serious stomach problems, such as internal bleeding.

This is because the medications can break down the lining that protects the stomach against damage from stomach acids.

If you're prescribed an NSAID tablet, you'll often have to take another medicine, such as a proton pump inhibitor (PPI), as well.

Taking a PPI reduces the amount of acid in your stomach, which greatly reduces the risk of damage to your stomach lining.

Steroids

Steroids are powerful medications that can help reduce pain, stiffness and inflammation.

They can be used as:

  • a tablet (for example, prednisolone)
  • an injection directly into a painful joint
  • an injection into the muscle (to help lots of joints)

They're usually used to provide short-term pain relief – for example, while you're waiting for DMARD medication to take effect or during a flare-up.

Steroids are normally only used in this way because long-term use of corticosteroids can have serious side effects, such as:

  • weight gain
  • osteoporosis (thinning of the bones)
  • easy bruising
  • muscle weakness
  • thinning of the skin

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Supportive treatments

Your doctor may also refer you to other services that might be able to help you with your rheumatoid arthritis symptoms.

Physiotherapy

A physiotherapist may help you improve your fitness and muscle strength, and make your joints more flexible.

They may also be able to help with pain relief using heat or ice packs, or transcutaneous electrical nerve stimulation (TENS).

A TENS machine applies a small pulse of electricity to the affected joint, whichnumbs the nerve endings and can help ease the pain of rheumatoid arthritis.

Occupational therapy

If rheumatoid arthritis causes youproblems with everyday tasks,occupational therapy may help.

An occupational therapist can provide training and advice that will help you to protect your joints, both while you're at home and at work.

Some type of support for your joints, such as a splint, may also be recommended, or devices that can helpopen jars or turn on taps.

Podiatry

If you have problems with your feet, a podiatrist may be able to help.

You may also be offered some type of support for your joints or shoe insoles that can ease pain.

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Surgery

Sometimes, despite medication, damage to your joints may occur. In such cases, you may need surgery to help restore your ability to use your joint.

Surgery may also be recommended to reduce painor correct deformities.

Finger, hand and wrist surgery

There are different types of surgery to correct joint problems in the hand.

Examples include:

  • carpal tunnel release (cutting a ligament in the wrist to relieve pressure on a nerve) – see treating carpal tunnel syndrome for more information
  • release of tendons in the fingers to treat abnormal bending
  • removal of inflamed tissue that lines the finger joints

Arthroscopy

This is a procedure to remove inflamed joint tissue.

During the operation, a thin tube with a light source and camera (arthroscope) is inserted into the joint through a small cut in the skin so the surgeon can see the affected joint.

Special surgical instruments are inserted through other small cuts in the skin to remove the damaged tissue.

You usually don't have to stay overnight in hospital for this kind of surgery, but the joint will need to be rested at home for several days.

(Video) What is Rheumatoid Arthritis? | Johns Hopkins Rheumatology

Joint replacement

Some people with rheumatoid arthritis need surgery toreplace part or all of a joint, such as the hip, knee or shoulder joint.

This is known as a joint replacement or arthroplasty.

Replacement of these joints is a major operation that involves several days in hospital followed by months of rehabilitation.

Thelatest joints have a limited lifespan of 10 to 20 years. They're not perfect and some function may not be restored after the damaged joint is replaced by a new one.

Read about knee replacement and hip replacement.

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Complementary and alternative therapies

Many people with rheumatoid arthritis try complementary therapies, such as:

  • acupuncture
  • chiropractic
  • massage
  • osteopathy

In most cases, there's little or no evidence these are effective in the long term, although some people may experience a short-term benefit from them.

Nutritional supplements and dietary changes

There's no strong evidence to suggest that specific dietary changes can help improve rheumatoid arthritis, although some people with rheumatoid arthritis feel their symptoms get worse after they've eaten certain foods.

If you think this may be the case for you, it may be useful to try avoiding problematic foods for a few weeks to see if your symptoms improve.

But it's important to ensure your overall diet is still healthy and balanced. A Mediterranean-style diet, which is based on vegetables, fruits, legumes, nuts, beans, cereals, grains, fish and unsaturated fats such as olive oil, is recommended.

There's also little evidence supporting the use of supplements in rheumatoid arthritis, although some can be useful in preventing side effects of medicines you may be taking.

For example,calcium andvitamin D supplements may help prevent osteoporosis if you're taking steroids, andfolic acid supplements may help prevent some of the side effects of methotrexate.

There's some evidence to suggest that taking fish oil supplements may help reduce joint pain and stiffness caused by rheumatoid arthritis.

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Living with

Rheumatoid arthritis can be life-changing. You may need long-term treatment to control your symptoms and reduce joint damage.

Depending on how much pain and stiffness you feel and how much joint damage you have, simple daily tasks may become difficult or take longer to do.

You may need to adapt the way youdoeveryday tasks, or make changes to your lifestyle, to help you manage your condition.

Here are some things you can do to help.

Self-care

Self care is an important part of daily life. It involves taking responsibility for your own health and wellbeing with support from people involved in your care.

It includes what you do every day to stay fit and maintain good physical and mental health, prevent illness and accidents, and manage minor ailments and long-term conditions.

People who have a long-term condition, such as rheumatoid arthritis, can benefit enormously from being supported to care for themselves. They can live longer, have a better quality of life, and be more active and independent.

Take your medication

It's important to take your medicine as instructed, even if you start to feel better, as medicine can help prevent flare-ups and reduce the risk of further problems, such as joint damage.

If you have any questions or concerns about the medicine you're taking or side effects, talk to your healthcare team.

It may also be useful to read the information leaflet that comes with the medicine, as this tells you about possible interactions with other medicines or supplements.

Check with your healthcare teambefore taking any over-the-counter remedies, such as painkillers ornutritional supplements. These may interfere with your medicine.

Regular reviews

Asrheumatoid arthritis is a long-term condition, you'll be in contact with your healthcare team regularly so they cancheck to ensure your condition is under good control and your treatment is right for you.

You may have your disease activity score (DAS) measured regularly, which can help your healthcare team to decide on the best treatment.

Read more aboutthe DAS score on the National Rheumatoid Arthritiswebsite.

The more the team knows, the morethey can help you, so discuss any concerns you have with them.

Reducing your medicine

Some people find their symptoms go away or get much better. If your symptoms stay better for at least 1 year without needing to take steroids, your treatment can be reviewed.

Your doctor may suggest slowly reducing your dose of medicine, then seeing if you can stop taking it.

You'll be monitored during this time. If your symptoms come back, you'll need to start taking disease-modifying anti-rheumatic drugs (DMARDs) straight away.

Keeping well

If you have rheumatoid arthritis, you may be advised to have a yearlyflu jab to protect against flu.

You may also be advised to have a pneumococcal vaccination, a one-off injection that protects against a specific serious chest infection called pneumococcal pneumonia.

Try to get plenty of rest during a flare-up, when your joints can be particularly painful and inflamed.

Putting further strain on very swollen and painful joints can often make the pain and inflammation worse.

Healthy eating and exercise

Regular exercise and a healthy diet are recommended for everyone, not just people with rheumatoid arthritis.

They can help prevent many conditions, including heart disease and many forms of cancer.

Exercising regularly can help relieve stress, help keep your joints mobile and strengthen the muscles supporting your joints.

Exercise can also help you lose weight if you're overweight, which can put extra strain on your joints.

However, it's important to strike a balance between rest and exercise. Rest will make inflamed joints feel more comfortable, but without movement your joints will stiffen and your muscles will become weaker. You need to find out the best activities and the right balance for you.

When starting exercise it's always best to increase the amount of exercise you do gradually and if a particular activity causes your joints to become warm and swollen or if it causes severe pain then stop and rest. If not, you should be fine to continue.

If a particular activity always causes a flare-up then it's probably best to avoid it and find an alternative. In general, exercises involving high impact such as step exercises or contact sports such as rugby and football are more likely to cause problems. Forms of exercise that put less strain on your joints include swimming, cycling, walking and aqua aerobics.

(Video) Rheumatoid Arthritis - Mayo Clinic

If you need further help, your physiotherapist is a good person to help advise on appropriate exercises for you.

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Self-management

Taking control of rheumatoid arthritis will help you cope with its impact on your lifestyle.

A self-management programme specifically for people with rheumatoid arthritis has been developed by the NRAS.

The 6-week programme can help you learn more about your condition and provide practical tips on how to manage everyday life, such as:

  • how to get the best from your medicine
  • techniques to manage pain
  • goal-setting exercises

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Talk to others

Many people find it helpful to talk to others in a similar position. There may be a local support group where you can meet others with the same condition as you.

Call theNRAS helpline freeon0800 298 7650 from Monday to Friday, 9.30am to 4.30pm. You can speak to a trained rheumatoid arthritis adviser. You can also arrange to speak to someone who has rheumatoid arthritis.

Or call the Versus Arthritis free helpline on 0800 5200 520 from Monday to Friday,9am to 8pm.

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Your feelings

It can be hard to deal with the unpredictable nature of rheumatoid arthritis. Some days, the pain and stiffness will be much worse than others, and there's no way of knowing when a flare-up will occur.

The difficult nature of rheumatoid arthritis can mean some people developdepression or feelings of stress and anxiety. Sometimes, these feelings can be related to poorly controlled pain or fatigue.

Living with any long-term condition makes you more likely to have a range of emotions such as frustration, fear, pain, anger and resentment.

Speak to your healthcare team if you're struggling to deal with your condition emotionally. They may be able to offer medication or psychological interventions to help.

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Starting and raising a family

If you're taking medicines for rheumatoid arthritis, let your healthcare team know if you want to start a family or ifyou're worried about becoming pregnant while on medication.

Some medications, such as methotrexate, leflunomide and biological treatments, shouldn't be taken by men or women while they're trying for a baby. The doctors and nurses will work with you to ensure your rheumatoid arthritis is controlled while you're trying to get pregnant.

Babies and young children are physically and mentally demanding for any parent, but particularly so if you have rheumatoid arthritis. If you're struggling to cope, it may help to talk to other people in the same situation as you.

You may also be able to get additional support from your health visitor or occupational therapist to help you manage your young family.

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Sex and relationships

Pain, discomfort and changes in the way you feel can affect your sex life. Your self-esteem or thoughts about how you look may affect your confidence.

Although many people find it difficult to talk about such private issues, there are resources that might help you.

Talking to your partner or GP about the impact of rheumatoid arthritis on your sexuality and sexual relationships may help.

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Money and benefits

If you have to stop work or work part time because of your rheumatoid arthritis, you may find it hard to cope financially.

You may be entitled to one or more of the following types of financial support:

You may also be eligible for other benefits if you have children living at home or if you have a low household income.

Complications

Rheumatoid arthritis can put you at a higher risk of developing other conditions, particularly if it's not well controlled.

Some of these conditions are described below.

Carpal tunnel syndrome

Carpal tunnel syndromeisa common condition in people with rheumatoid arthritis.

It's the result of compression of the nerve that controls sensation and movement in the hands (median nerve) and can cause symptoms such as:

  • aching
  • numbness
  • tingling in your thumb, fingers and part of the hand

Symptoms of carpal tunnel syndrome can sometimes be controlled with wrist splints orcorticosteroid injections, although surgery to release the pressure on the median nerve may beneeded in severe cases.

Read about treating carpal tunnel syndrome.

Widespread inflammation

Rheumatoid arthritis is an inflammatory condition which can cause inflammation to develop in other parts of your body, such as the:

  • Lungs–inflammation of the lungs or lung lining can lead to pleurisy or pulmonary fibrosis, which can cause chest pain, a persistent cough and shortness of breath.
  • Heart – inflammation of the tissue around the heart can lead to pericarditis, which causes chest pain.
  • Eyes– inflammation of the eyes can lead to scleritis or Sjogren's syndrome. Scleritis can cause eye redness and pain, whereas Sjogren's syndrome can cause dry eyes.
  • Blood vessels–known as vasculitis– this can lead to the thickening, weakening, narrowing and scarring of blood vessel walls. In serious cases, it can affect blood flow to your body's organs and tissues and can be life-threatening.

However, thanks to early treatment, inflammation due to rheumatoid arthritis affecting other parts of the body is becoming less common.

Joint damage

If rheumatoid arthritis isn't treated early or isn't well controlled, the inflammation in your joints could lead to significant and permanent damage.

Problems that can affect the joints include:

  • damage to nearby bone and cartilage (a tough, flexible tissue that covers the surface of joints)
  • damage to nearby tendons (flexible tissue that attach muscle to bone), which could cause them to break (rupture)
  • joint deformities

These problems sometimes need to be treated with surgery to prevent loss of function in the affected joints.

Cardiovascular disease

If you have rheumatoid arthritis, you're at a higher risk of developing cardiovascular disease (CVD) than the population at large.

CVD isa general term that describes conditions affecting the heart or blood vessels, and it includes life-threatening problems such as heart attacks and strokes.

It's not clear exactly why people with rheumatoid arthritis are at an increased risk of these problems. You can reduce your risk by ensuring your arthritis is well controlled and by reducing the impact of other factors that contribute to CVD, such as:

  • stopping smoking
  • eating healthily
  • exercising regularly

Cervical myelopathy

If you've had rheumatoid arthritis for some time, you're at increased risk of developing cervical myelopathy and you may need a special assessment of your neck before any operation where you're put to sleep.

This condition is caused by dislocation of joints at the top of the spine, which put pressure on the spinal cord. Although relatively uncommon, it's a serious condition that can greatly affect your mobility and can lead to permanent spinal cord damage if not treated promptly with surgery.

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The information on this page has been adapted by NHS Wales from original content supplied by Rheumatoid arthritis (1) NHS website nhs.uk

Last Updated: 14/07/2021 13:27:15

FAQs

Rheumatoid arthritis? ›

Rheumatoid arthritis is an autoimmune disease. This means your immune system (which usually fights infection) attacks the cells that line your joints by mistake, making the joints swollen, stiff and painful. Over time, this can damage the joints, cartilage and nearby bone.

What is the main cause of rheumatoid arthritis? ›

Rheumatoid arthritis is an autoimmune condition, which means it's caused by the immune system attacking healthy body tissue. However, it's not yet known what triggers this. Your immune system normally makes antibodies that attack bacteria and viruses, helping to fight infection.

What are the warning signs of rheumatoid arthritis? ›

The early warning signs of RA include:
  • Fatigue. Before experiencing any other symptoms, a person with RA may feel extremely tired and lack energy. ...
  • Slight fever. Inflammation associated with RA may cause people to feel unwell and feverish. ...
  • Weight loss. ...
  • Stiffness. ...
  • Joint tenderness. ...
  • Joint pain. ...
  • Joint swelling. ...
  • Joint redness.

How serious is rheumatoid arthritis? ›

Rheumatoid arthritis (RA) has many physical and social consequences and can lower quality of life. It can cause pain, disability, and premature death. Premature heart disease. People with RA are also at a higher risk for developing other chronic diseases such as heart disease and diabetes.

What are three signs of rheumatoid arthritis? ›

Signs and symptoms of rheumatoid arthritis may include: Tender, warm, swollen joints. Joint stiffness that is usually worse in the mornings and after inactivity. Fatigue, fever and loss of appetite.

Can rheumatoid arthritis go away? ›

Rheumatoid arthritis is a lifelong disease. When it's treated, it may go away for a little while, but it usually comes back. It's important to see your doctor as soon as symptoms begin. The earlier you start treatment, the better your outcome.

Is RA caused by stress? ›

Rheumatoid arthritis (RA) is a chronic inflammatory joint condition and an autoimmune disease that can be caused by stress, according to research. Stress triggers rheumatoid arthritis by setting off the immune system's inflammatory response in which cytokines are released.

What age does RA usually start? ›

You can get rheumatoid arthritis (RA) at any age, but it's most likely to show up between ages 30 and 50. When it starts between ages 60 and 65, it's called elderly-onset RA or late-onset RA. Elderly-onset RA is different from RA that starts in earlier years.

How do they test for rheumatoid arthritis? ›

There is no one blood test or physical finding to confirm the diagnosis. During the physical exam, your doctor will check your joints for swelling, redness and warmth. He or she may also check your reflexes and muscle strength.

Is rheumatoid arthritis a big deal? ›

RA is a very serious autoimmune disease, in which your immune system mistakenly attacks your own body's tissues and causes severe joint pain, stiffness, severe fatigue, and sometimes deformity, usually in the hands, shoulders, knees, and/or feet.

Does rheumatoid arthritis show up on xray? ›

Scans that may be done to diagnose and monitor rheumatoid arthritis include: X-rays. MRI scans (where strong magnetic fields and radio waves are used to produce detailed images of your joints)

How quickly does rheumatoid arthritis spread? ›

Clinical History. The typical case of rheumatoid arthritis begins insidiously, with the slow development of signs and symptoms over weeks to months. Often the patient first notices stiffness in one or more joints, usually accompanied by pain on movement and by tenderness in the joint.

How do I know if I have osteoarthritis or rheumatoid arthritis? ›

Disease Onset

Osteoarthritis tends to develop gradually over several years, as the joint cartilage wears away. Eventually the bones of your joints rub against each other. In contrast, the pain and stiffness of rheumatoid arthritis can develop and worsen over several weeks or a few months.

What is the best pain relief for rheumatoid arthritis? ›

1. NSAIDs. Most people with RA are advised to take a non-steroidal anti-inflammatory drug to decrease pain and inflammation. NSAIDs are sold over-the-counter, under such names as Advil and Aleve, as well as by prescription, under names such as Mobic and Celebrex.

What are the 4 stages of rheumatoid arthritis? ›

The four stages of rheumatoid arthritis are known as synovitis, pannus, fibrous ankylosis, and bony ankylosis.
  • Stage I: Synovitis. During stage I, you may start having mild symptoms, including joint pain and joint stiffness. ...
  • Stage II: Pannus. ...
  • Stage III: Fibrous Ankylosis. ...
  • Stage IV: Bony Ankylosis.
Oct 12, 2021

Can rheumatoid arthritis come on suddenly? ›

In a few people with RA -- about 5% to 10% -- the disease starts suddenly, and then they have no symptoms for many years, even decades. Symptoms that come and go. This happens to about 15% of people with rheumatoid arthritis. You may have periods of few or no problems that can last months between flare-ups.

How can I prevent rheumatoid arthritis naturally? ›

Exercise. In addition to performing targeted stretches, some dynamic, low-stress forms of exercise can benefit people living with RA. Activities such as swimming or cycling can strengthen the muscles around the affected joints. This can help reduce the overall impact on the joints and slow the progression of RA.

Videos

1. Rheumatoid Arthritis - Signs & Symptoms | Johns Hopkins Medicine
(Johns Hopkins Rheumatology)
2. Rheumatoid Arthritis - Diagnosis | Johns Hopkins
(Johns Hopkins Rheumatology)
3. Rheumatoid Arthritis Flares: What Triggers a RA Flare? | Johns Hopkins Medicine
(Johns Hopkins Rheumatology)
4. Treatment Options for Rheumatoid Arthritis | Johns Hopkins Rheumatology
(Johns Hopkins Rheumatology)
5. Rheumatoid Arthritis Update: 2020
(Icahn School of Medicine)
6. What are the treatments for rheumatoid arthritis?
(MD Anderson Cancer Center)

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