Rheumatoid arthritis (A) is a chronic disease of the joint that damages the joints. The damage is a result of inflammation of the joint lining tissue.
The actual cause of rheumatoid arthritis is not identified. The activity of the immune system is abnormal in rheumatoid arthritis. In RA the factors that alter the activity of the immune system include:
- Genetics (heredity),
- Hormones (explaining why the disease is more common in women than men),
- Possibly infection by a bacterium or virus
The usual joint symptoms of RA besides pain include the following:
- Pain: Joint pain in rheumatoid arthritis is caused due to inflammation or swelling of the joint and surrounding tissues or from overuse of the joint. The severity of pain is variable.
- Stiffness: Stiffness reduces the range of motion of a joint and it is most noticeable in the morning which improves later in the day.
- Inflammation: Redness, tenderness, and warmth are the characteristics features of inflammation in RA.
- Swelling: The area surrounding the affected joint can become swollen and puffy.
- Nodules: Small hard bumps or nodules can appear on or near the joint. They occur most commonly near the elbows.
Tests and diagnosis
A comprehensive history regarding your signs and symptoms like pain, stiffness and physical examination can help to diagnose the cause of your symptoms. The diagnosis of rheumatoid arthritis cannot be confirmed by any single test. Your doctor will usually ask for lab tests and imaging studies such as X-rays to verify if you have rheumatoid arthritis.
Your doctor may suggest blood tests such as
- Complete blood count to measure how many of each type of blood cell are in your blood.
- Markers of inflammation such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). These are usually high in rheumatoid arthritis and are good indicators of disease activity.
- Other blood tests such as electrolytes (such as calcium, magnesium, and potassium), kidney and liver functions.
Your doctor may suggest imaging studies such as
- X-ray to detect damage to the joints. In early stages of the disease X-ray may be normal
- MRI may allow earlier detection of bone erosion than X-rays.
- Ultrasound to detect joint effusion (abnormal collection of fluid in the joint).
- Bone scanning to detect inflammatory changes in bone.
- Densitometry to detect changes in the thickness of bone that may indicate osteoporosis.
- Arthroscopy to examine the inside of the joint. This can help to detect signs of rheumatoid arthritis or other joint disease.
Both medications and nondrug approaches are important for treatment of pain in rheumatoid arthritis.
Nondrug approaches for rheumatoid arthritis include the following:
- Physical therapy: This can preserve and improve range of motion, increase muscle strength, and significantly decrease pain.
- Hydrotherapy: Exercising or relaxing in warm water relaxes your muscles and helps relieve pain.
- Heat and cold treatments: These can relieve pain and reduce inflammation. Some people benefit with heat application where as others may benefit from ice application.
- Occupational therapy: This teaches you how to use your body efficiently to reduce stress on your joints.
Medications: The ...