What is rheumatoid arthritis?

People of all ages get rheumatoid arthritis, which is a type of arthritis. This inflammatory joint disease can be compared to a fire: learn how to put it out before it causes real damage.

What is rheumatoid arthritis?

Arthritis is a general term that includes over a hundred disorders, and rheumatoid arthritis is one of them. This disease causes chronic inflammation of the membrane around a joint.

All body joints can be affected, but at first the disease more commonly affects the hands, wrists, elbows, feet, ankles, knees and shoulders. Joints are often affected bilaterally (e.g., both knees or both wrists). A number of joints can be affected at the same time. Over the long term, chronic inflammation can destroy or deform the joints. This damage is permanent.

Rheumatoid arthritis is an autoimmune disease. This means that the inflammation is triggered by the immune system, which no longer recognizes its own cells and attacks the joints. More rarely, rheumatoid arthritis can also attack other organs, such as the lungs and heart. 

The exact cause of rheumatoid arthritis is still unknown, but some risk factors are known and include:

• Smoking.
• Family history.
• Sex: 2 to 3 times more women get the condition.
• Age: The risk of rheumatoid arthritis increases with age, although people at any age can develop the condition.

Although less common than osteoarthritis, rheumatoid arthritis is one of the most common forms of arthritis. It is estimated that 1 out of 100 Canadian adults has the disease.

Rheumatoid arthritis symptoms

The symptoms and progression of rheumatoid arthritis vary greatly from person to person. People generally get pain and stiffness in the affected joint, which can also swell. The stiffness often lasts for at least an hour upon waking, and symptoms are worst after a period of rest. Conversely, symptoms decrease in intensity during movement.

Symptoms are felt not just at the affected site, as people with rheumatoid arthritis often feel generalized fatigue. They can also have a fever or experience loss of appetite.

A rheumatologist (a doctor who specializes in diseases of the joints) is often the one who confirms a diagnosis and establishes treatment. It’s important to quickly detect and treat the disease to limit permanent damage to the joint.

Rheumatoid arthritis treatment

Although rheumatoid arthritis can't be cured, treatment can relieve pain, reduce inflammation, improve joint mobility and stop the disease from progressing. The goal is to achieve remission, or a period between two   flares  when you can function as normally possible and feel almost no symptoms.

It’s important to start treatment as soon as possible after diagnosis to prevent the disease from causing irreversible damage.

Lifestyle

A healthy lifestyle is an essential part of treatment.

• Achieve or maintain a healthy weight.
• Get regular physical activity to strengthen the muscles around the weakened joint and helps control pain. While convincing yourself to get moving when you're in pain may be hard, the benefits will no doubt motivate you to continue. Avoid overtaxing your joints. A health care professional (doctor, occupational therapist, physiotherapist or kinesiologist) can help create an activity program that is best for you.
• Eat a healthy and balanced diet to give your body the nutrients it needs to function. In combination with physical activity, a good diet will help you achieve and maintain a healthy weight.

Heat and cold therapies

Applying hot or cold compresses to your painful joint can help decrease pain, swelling and stiffness. This treatment is safe and can be applied on a regular basis. Consult your pharmacist or doctor to find out which type of compress you should apply to your joint. To avoid chilblains, never put a cold compress directly on the skin.

Medication

To achieve remission as quickly as possible, you’ll need to immediately start an aggressive drug regimen that combines several medications, each of which play a specific role.

To decrease joint pain and inflammation, you can take nonsteroidal anti-inflammatory drugs (NSAIDs). These medications may only be taken as needed, as they don’t prevent damage to joints. You can also take corticosteroids (also known as cortisone) to reduce inflammation. Corticosteroids can be injected directly into the joint or taken orally. Corticosteroids are often suggested at the beginning of treatment as you wait for other drugs to take effect or whenever your rheumatoid arthritis flares up. These drugs are typically used for a short period because of their many long-term side effects.

To slow the progression of the disease, specific medication is used at the start of treatment to prevent the immune system from attacking the joints. When taken early on, these medications can control rheumatoid arthritis before damage occurs. They can also relieve the inflammation and pain caused by the condition. Combinations of drugs may be needed to control the disease. You need to be patient, because they can take a few weeks to a few months from the start of treatment to take effect. Also, these drugs usually require close monitoring by your doctor. Some of these drugs may reduce the production of white blood cells or platelets, while others can affect liver or kidney function. You must follow all of your doctor’s and pharmacist’s recommendations, go to your medical appointments, and get the tests recommended by your doctor.

Biologics are another drug class that is now part of rheumatoid arthritis treatment. These injectable drugs modify the biological reactions responsible for inflammation and therefore help reduce the damage  caused by prolonged inflammation. However, these drugs are very expensive and can cause a number of side effects, some of which can be serious. They are used only if usual medications fail to control the disease. These drugs also require close monitoring.

Even if your disease is under control, you’ll need to keep taking your medications as prescribed to prevent flares. Never stop taking them without talking to your pharmacist or doctor first.

Surgery

If your disease is debilitating or if your joints have become very deformed, you may want to consider surgery. However, this is a last resort.

What about “miracle” remedies?

Many companies advertise “miracle” remedies, such as bracelets, diets or natural health products, to ease the pain of joint disease. Although some natural health products may bring some relief, the best way to control rheumatoid arthritis is to take medication and adopt a healthy lifestyle.

How to manage rheumatoid arthritis

Play an active role in your treatment and participate in the decisions that affect you. When you suffer from arthritis, many simple, everyday actions become painful, difficult  or even impossible. Set realistic goals. Make the most of the expertise of your health care professionals, such as your doctor, pharmacist, nurse, physiotherapist, occupational therapist, and psychologist. They can help you adapt to your condition and achieve your goals so that you can maintain your quality of life and your independence. They are also there to support you. Don’t hesitate to also get support from your family and friends or other people who suffer from arthritis.

Resource:
The Arthritis Society