Rheumatoid Arthritis

16 December 2024

Rheumatoid arthritis causes inflammation in the joints which can cause joint pain, stiffness and tenderness. Discover the causes, symptoms, diagnosis and management of this condition.

What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes inflammation in the joints, leading to pain, stiffness, swelling, and loss of function.

Unlike the occasional wear-and-tear arthritis, RA attacks the synovial membrane, the lining of your joints, causing it to thicken and inflame. This inflammation can damage the joint cartilage and bone over time, leading to deformity and disability if not managed effectively.

While RA can affect any joint in the body, it most commonly targets the hands, wrists, knees, feet, and ankles.

Causes

The exact cause of RA remains unknown, but it’s believed to be a combination of genetic and environmental factors. Here’s what we know:

Genetics: Certain genes may increase your susceptibility to RA. However, having the genes doesn’t guarantee you’ll develop the disease, and many people with RA don’t have a family history.
Immune system dysfunction: In RA, the immune system mistakenly attacks healthy tissues in the joints, leading to inflammation and damage.
Environmental triggers: Smoking is a major risk factor for RA. Other potential triggers may include exposure to certain environmental toxins or infections.

Who is At Risk from Rheumatoid Arthritis?

While anyone can develop RA, certain factors increase your risk:

Women: Women are two to three times more likely than men to develop RA.
Age: RA can occur at any age, but it most commonly develops between the ages of 40 and 60.
Family history: Having a close relative with RA increases your risk.
Smoking: Smoking is a significant risk factor for RA.
Obesity: Excess weight can put additional stress on your joints and increase inflammation throughout the body, potentially worsening RA symptoms.

Symptoms

The symptoms of RA can vary from person to person and may develop gradually over time. Some common symptoms include:

Joint pain: This is the most common symptom of RA, typically affecting multiple joints, often symmetrically (both sides of the body affected equally). The pain may be worse in the morning and improve with activity.
Joint stiffness: Stiffness in the joints, especially upon waking or after periods of inactivity, is a hallmark symptom of RA. This stiffness can last for more than 30 minutes and may improve with movement.
Joint swelling: Inflammation in the joints can cause them to appear swollen and puffy.
Joint tenderness: Joints affected by RA may be tender to the touch.
Loss of function: As the disease progresses, damage to the joints can lead to a gradual loss of function and difficulty performing daily activities, such as dressing, grooming, or climbing stairs.
Fatigue: Many people with RA experience chronic fatigue and a general lack of energy, which can significantly impact their daily lives.
Low-grade fever: A low-grade fever may accompany other symptoms, especially during flares (periods of worsened RA activity).

Diagnosing Rheumatoid Arthritis

Diagnosing RA can involve a combination of tests and evaluations:

Medical history and physical exam: Your doctor will ask about your symptoms, medical history, and family history. They will also perform a physical exam to assess joint tenderness, swelling, range of motion, and other potential signs of inflammation.
Blood tests: Blood tests can help identify markers of inflammation, such as elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Additionally, blood tests can check for specific antibodies associated with RA, like rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA). While positive tests can be suggestive of RA, they are not always definitive and should be interpreted in conjunction with other findings.
Imaging tests: X-rays can help assess joint damage, while MRI scans can provide more detailed images of the joints and soft tissues to detect inflammation and potential damage even in the early stages. Ultrasounds may also be used to assess joint inflammation and identify fluid buildup.

Living with Rheumatoid Arthritis: Reclaiming Your Mobility

While there’s no cure for RA, there are effective strategies to manage the disease, control symptoms, slow progression, and improve your quality of life. Here’s a look at some key approaches:

Medications: Several medications can help manage RA, including:

Disease-modifying antirheumatic drugs (DMARDs): These medications are the mainstay of RA treatment and work to slow disease progression and reduce inflammation. Different types of DMARDs work in various ways, and your doctor will determine the most appropriate option for you, considering factors like your disease severity, response to previous treatments, and potential side effects.
Corticosteroids: These powerful anti-inflammatory medications can provide quick relief from pain and inflammation, but they are typically used short-term due to potential side effects with long-term use, such as weight gain, high blood pressure, and osteoporosis. They may be injected directly into inflamed joints for targeted relief or taken orally in low doses to manage overall inflammation.

Biologic response modifiers: These newer medications target specific molecules involved in the inflammatory process of RA. Biologics can be highly effective in managing RA, especially in individuals who don’t respond adequately to DMARDs. However, biologics are typically more expensive medications and may require injection or infusion.
Pain relievers: Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage pain and inflammation. Topical pain relievers like creams, gels, or patches may also be used for localized pain relief.
Physical therapy: Physical therapy plays a crucial role in maintaining joint mobility, strengthening muscles around the joints, and improving flexibility. A physical therapist can design a personalized exercise program to help you manage pain, improve function, and prevent further joint damage. This may include exercises to improve range of motion, strengthen muscles, and increase flexibility. Physical therapists can also teach you proper joint protection techniques to minimize stress on your joints during daily activities.
Occupational therapy: Occupational therapists can help you learn techniques and strategies to perform daily activities with greater ease despite joint limitations. This may involve using assistive devices, modifying your workspace or home environment to accommodate your limitations, and developing joint-protection strategies to minimize stress on your joints during everyday tasks. Occupational therapists can help you find ways to maintain your independence and perform daily activities of living safely and efficiently.
Lifestyle modifications: Making certain lifestyle changes can significantly improve your overall well-being and potentially reduce RA symptoms. These include:
- Maintaining a healthy weight: Excess weight puts extra stress on your joints. Losing weight, even a moderate amount, can significantly improve your symptoms and joint function.
- Eating a healthy diet: A balanced diet rich in fruits, vegetables, whole grains, and lean protein can provide essential nutrients to support your overall health and potentially reduce inflammation. Some studies suggest incorporating omega-3 fatty acids found in oily fish like salmon, tuna, and sardines may offer benefits for RA due to their anti-inflammatory properties. While there’s no single RA diet, focusing on a balanced and anti-inflammatory approach can be helpful. Consult a registered dietitian or nutritionist for personalized dietary guidance.
- Exercising regularly: Regular exercise, even low-impact activities like walking, swimming, or yoga, can help maintain joint health, improve flexibility, and reduce stiffness. Aim for at least 30 minutes of moderate-intensity exercise most days of the week. Water exercises are particularly beneficial for people with RA as they provide gentle movement without putting excessive stress on the joints.
- Getting enough sleep: Adequate sleep is essential for overall health and can help manage pain and fatigue associated with RA. Most adults need around 7-8 hours of sleep per night. Develop a relaxing bedtime routine and practice good sleep hygiene to promote quality sleep.
- Stress management: Chronic stress can worsen RA symptoms. Relaxation techniques like deep breathing exercises, meditation, or yoga can help manage stress and potentially improve your overall well-being. Mindfulness practices can also be helpful in managing chronic pain and improving emotional well-being.
- Smoking cessation: If you smoke, quitting is one of the most important lifestyle changes you can make. Smoking significantly worsens RA symptoms and accelerates disease progression. Smoking cessation can improve your overall health and lung function, and is crucial for managing RA effectively.

Additional Tips for Managing Rheumatoid Arthritis

Heat and cold therapy: Applying heat or cold packs to affected joints can help manage pain and inflammation. Heat can be especially helpful in the morning to loosen stiff joints, while cold therapy can be beneficial for reducing inflammation and swelling after activity.
Assistive devices: Using canes, walkers, braces, or other assistive devices can help reduce stress on your joints and improve your ability to perform daily activities. A healthcare professional can help you choose the appropriate assistive devices to meet your specific needs.
Support groups: Connecting with others who understand the challenges of RA can be a source of encouragement, information, and shared experiences. Support groups can provide a safe space to discuss your concerns, learn coping mechanisms from others, and feel less alone in managing your condition. There are online and in-person support groups available, allowing you to connect with others facing similar challenges.

Arranging To Visit A Private GP

To discuss any symptoms that could be an indication of rheumatoid arthritis make an appointment with one of our private GPs. Appointments are available to everyone and can often be booked for the same day. There is no need to be registered with our Buckinghamshire hospital, or live locally.

If you have insurance which covers a GP visit, we can in most cases invoice the insurer directly. Where you are paying directly, the cost for a 30 minute consultation is £125.

Any additional costs will always be discussed. They could apply if you are referred for an MRI scan, or to a consultant, or for other agreed decisions to support your health.

Our Resident Private GP

Dr Chamali is welcoming and highly experienced. He offers his patients sound diagnosis and treatment, along with individual care focused on their future health.