Overview

Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes pain, stiffness, swelling and limited motion and function in many joints. More than 1.3 million U.S. adults have RA and about 75 percent of them are women. While there is no cure for RA, remission is possible. Treatment seeks to lessen symptoms and improve function.

Symptoms

RA symptoms can begin slowly with achy joints or morning stiffness. Your WellStar rheumatologist will help assess the presence of signs of the disease including:

• Anemia (low blood count)
• Loss of energy or appetite
• Low fevers
• Dry eyes and mouth
• Firm lumps (rheumatoid nodules) that grow under the skin in areas like elbows and hands

Risk Factors

Risk factors for developing rheumatoid arthritis include:

• Being female
• Onset of symptoms between age 40 and 60
• A family history of RA
• Smoking cigarettes can be a risk factor for some people

Prevention

Although researchers continue to study the subject, there is no known way to prevent RA. For those who have it, the following can help prevent worsening joint damage:

• Lose weight if needed, which will reduce stress on your joints.
• Stop smoking.
• Use larger, stronger joints instead of smaller, fragile ones. For example carry a shoulder bag instead of a handbag.
• Use assistive devices like a cane or tools with thicker handles.
• Get regular exercise of a type that places the least body weight on your joints.

Diagnosis

No single test definitively confirms an RA diagnosis. Your doctor will carefully review symptoms, the results of a physical exam, X-rays and lab and blood tests.

Tools and Tests

WellStar physicians use a variety of diagnostic tools and tests to assess the presence of rheumatoid arthritis. They will look for:

• Anemia (low red blood cell count)
• Rheumatoid factor (an antibody, or blood protein) and other antibodies
• Elevated inflammation in the joints

Treatment

RA has no cure, but therapy has improved greatly over the years. The right medications and other steps can relieve symptoms and keep patients functioning at or near normal levels. Many people achieve remission, which means no signs of active disease. Positive outcomes are tied to early treatment before joint damage progresses.

Options

Medical treatment options include:

• Disease-modifying antirheumatic drugs (DMARDs). These relieve symptoms and slow progression of the disease
• DMARDS are often prescribed with nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose corticosteroids (steroids) to reduce swelling, pain and fever
• Biologic agents (biologic response modifiers) for patients with more serious disease
• Nonmedical treatments also play an important role. Examples are:
  • Staying physically active as appropriate
  • Pursuing less active exercise, like stretching, during flares
  • Patient education to learn about the disease and how to manage it
  • Regular visits to your WellStar rheumatologist who will coordinate your care. He or she will track your disease and look for any side effects of medications

For some people surgery is an option to reduce pain, help a joint function better and regain the ability to perform everyday tasks.

Alternative therapies help some patients. Discuss the possibilities with your physician.

Ongoing Care

People with rheumatoid arthritis play an important role in keeping their disease under control and reducing the symptoms and stress that come from having a chronic disease. Partner with your rheumatologist to create a plan that works for you.

Smoking Cessation

WellStar offers smoking cessation programs that educate people about smoking risks, encourage behavior modification to help minimize smoking urges and offer numerous coping strategies. Several different methods for changing smoking behavior are explored so that individuals learn approaches that work best for them.