What is rheumatoid arthritis? 

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Rheumatoid arthritis (RA) is an inflammatory disease that can affect multiple joints in the body. RA is an autoimmune disease where the body’s immune system—which normally functions to protect us against infections—mistakenly attacks the lining of the joints.  The cause of this malfunctioning immune system is still unknown and while there is no cure for RA, there are some very effective medications and therapies to control the symptoms and results of the inflammation.  

Inflammation in the joints causes pain, stiffness and swelling.  If this inflammation continues, it can lead to damage of the joint. The inflammation can affect other organs, such as the nerves, eyes, skin, lungs or heart. 

The symptoms of RA vary widely from person to person. In many cases, RA starts in a few joints then spreads to other joints over a few weeks to months. RA can also progress extremely quickly; some people report that one morning they just could not get out of bed. 

The earliest symptoms of RA can be non-specific, including feeling unwell or tired, soreness around joints and muscles, low-grade fever, and weight loss/poor appetite. As time goes on, RA can involve more and more joints on both sides of the body, often in a “symmetrical” pattern. 

About one out of every 100 adult Canadians has RA. That’s about 300,000 Canadians. Anyone can get RA and at any age. RA affects women two to three times more often than men.  

There is no cure for RA. However, people who are diagnosed and treated early can avoid pain and damage to their joints, and lead active and productive lives. 

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What are early signs of RA? 

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RA usually starts over a period of weeks to months, with more joints becoming affected over time. You should see your doctor if you experience one or more of the following symptoms for more than six weeks: 

• Pain or stiffness, of multiple joints  

• “Gelling” or stiffness of joints, especially in the morning, that lasts an hour or more 

• Warmth or redness over joints 

• Reduced ability to move the joints (such as difficulty making a fist, twisting objects, opening objects, climbing stairs) 

• Fever, fatigue, weight loss or decreased appetite 

• Lumpy growths that form under your skin, most commonly on the elbows, hands or feet 

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How is RA diagnosed? 

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An accurate diagnosis is very important because there are many ways to treat and manage RA. Early diagnosis and treatment can reduce the pain and disability associated with this disease.  

There are no “perfect” tests to make the diagnosis of RA. If you have signs and symptoms of RA, your doctor will examine your joints and take your medical history. If indicated, he or she may order blood tests that detect inflammation that may help confirm the diagnosis. Your health-care provider may also order X-rays to look for any signs of joint damage. If your family doctor suspects you have RA, you will be referred to a specialist. 

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What are the risk factors for RA? 

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The exact causes of RA are unknown, but research has shown that several things that may contribute: 

• Family history:  Some people who develop RA have specific genes that are linked to RA. However, having genes linked to RA does not necessarily mean you will develop RA 

• Sex: RA affects women two to three times more often than men 

• Hormones: Some hormonal changes appear to be linked to RA.  Hormone changes during and after pregnancy, during breastfeeding and even oral contraception use may be linked to the development of RA or may relieve or trigger RA symptoms.   

• Age: Anyone can get RA at any age, but the risk does increase with age, commonly developing between 40 and 60 years of age 

• Environment: Infection can trigger RA in people who are have genetic links to RA. However, it is important to remember that you cannot catch or spread RA. 

• Smoking: Numerous studies have shown that cigarette smoking is the strongest environmental risk for the development of RA and for having a more severe form of RA.     

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What are the joints that can be affected by RA? 

Any joint can be affected in RA but the joints most commonly involved include: 

• Small joints of the hand and feet 

• Wrists

• Elbows 

• Shoulders 

• Knees 

• Ankles 

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Why is treatment for RA so important? 

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RA causes inflammation of the lining of certain joints. This inflammation leads to swelling, stiffness and increased warmth of the affected joint(s). It can also affect other parts of the body like the eyes, nerves, skin heart or lungs.  You can think of this inflammation like a “fire” burning in the joints. If the fire of inflammation is left “burning,” it can permanently damage the joint. Once a joint is damaged, it cannot be fixed other than through surgery. Just as you would try to put out a fire in your home with a fire extinguisher before it spreads, you want to put out the inflammation of RA as quickly and as safely as possible.  

RA is best managed by a specialist doctor, known as a rheumatologist, who is trained in dealing with inflammation of the joints.

It is important to treat RA as early as possible as research has confirmed that this improves the long-term outcomes and quality of life of people living with RA.

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Work Cited: https://arthritis.ca/about-arthritis/arthritis-types-(a-z)/types/rheumatoid-arthritis