The truth about the symptoms, causes and diagnosis of rheumatoid arthritis.
Rheumatoid arthritis (RA) is an autoimmune disease that can cause pain, swelling, stiffness and even tissue destruction in your joints. It can cause problems for other organs as well.
Autoimmune simply means that your body is attacking itself. In rheumatoid arthritis, one of the places your immune system attacks is the synovium, a membrane that surrounds joints and produces lubricating fluid for them.
Over time, the synovium becomes inflamed and swollen, squeezing the nerves, which in turn send pain signals to your brain. That swollen synovium protrudes into the joint and releases digestive enzymes that eat away at the bone.
RA affects everyone differently. You may have periods when the symptoms get worse, called flare-ups, and then other times when you feel better. Early treatment of RA can limit the damage to your joints. This can preserve your range of movement and keep you active longer.
When RA first appears, it can feel a lot like the flu. You may have a fever, feel fatigued, develop rashes or even lose weight. Eventually you’ll feel stiffness and pain in your joints, especially in the morning.
The hands, wrists and feet are the most common targets for RA, but it can affect any joint in the body. Symptoms usually appear in a symmetric pattern, meaning that if a joint on your right side hurts, so will the one on your left side.
Because it stresses the entire body, uncontrolled RA can also make you more vulnerable to serious infections.
Unfortunately, no one yet clearly understands what causes RA. But there are some known risk factors that can increase your chance of developing the disease. Here are the five most important:
Establishing a clear-cut diagnosis of RA can be difficult, as no test works in every case and early symptoms can be similar to those of some other health problems.
For example, thyroid disease, kidney disease, fibromyalgia, diabetes and even hepatitis C can all do a good imitation of RA. So the first step your doctor should take is to do a thorough medical history and exam. Between doctor visits, you may find it helpful to keep track of your symptoms. When talking to your doctor, make certain you describe any pain, stiffness or movement problems that you have in as much detail as possible.
You may also undergo some blood tests that can help your doctor pin down a diagnosis.
One test looks for rheumatoid factor, a type of immune protein that appears in some—though not all—people with RA, and often indicates a more aggressive form of the disease. Other tests measure for white cell count, anemia (common in people with RA) and erythrocyte sedimentation rate, an indicator of inflammation in your body. Another common measure of inflammation often taken is the C-reactive protein test.
Finally, x-rays or other imaging techniques can be helpful in determining how much, if any, bone and joint damage has been done by the disease.