Rheumatoid arthritis (RA)
Introduction to Rheumatoid arthritis (RA)
Rheumatoid arthritis is a chronic (long term) condition that affects your joints and causes a triad of pain, stiffness and swelling.
What is Rheumatoid arthritis?
Rheumatoid arthritis is a chronic (long term) condition that affects your joints and causes a triad of pain, stiffness and swelling. It affects around 1 in 150 people in the UK and is three times more common in women than men. It affects adults of all ages, usually starting between the ages of 40-50 years. There is no cure for the condition, but there are several treatments available that limit flare ups and reduce the severity of the disease. If you think you may be experiencing symptoms of rheumatoid arthritis, please see a rheumatologist or GP.
What are the causes for Rheumatoid arthritis?
Rheumatoid arthritis is caused by the body’s own immune cells attacking the lining of joints. This results in damage and inflammation in the joints, causing chemicals to be released that damage nearby bones, cartilage, ligaments and tendons.
The reason why some people’s immune systems malfunction and attack their own body’s cells is not well understood. However, several genes have been identified that appear to increase your risk of developing the condition. Furthermore, smoking appears to increase your risk.
What are the symptoms of Rheumatoid arthritis?
Rheumatoid arthritis is characterised by joint problems. Often, the joints are affected symmetrically; the same joints on either side are affected to a similar degree. Joint pain is usually aching and throbbing in nature and tends to be worse in the morning or after periods of inactivity. Joints are often stiff and can become inflamed, warm and red. In some cases, inflammatory areas become firm, forming ‘rheumatoid nodules.’ In addition to joint problems, those affected may experience other systemic symptoms, including fever, tiredness, poor appetite and weight loss.
How is Rheumatoid arthritis treated?
Though there is no cure for rheumatoid arthritis, several treatments are available that can help reduce inflammation, alleviate symptoms and prevent worsening of the disease.
Medication aiming to limit progression of the disease include disease modifying drugs (DMARDs) and biological therapy. DMARDs block the action of chemicals released when you immune system attacks your joints. Several DMARDs exist, with methotrexate usually being the first drug prescribed. Biological therapies work by stopping certain chemicals in the blood from activating the immune system. Examples include etanercept, infliximab and rituximab, all of which are given through an injection.
Other treatment strategies used to tackle rheumatoid arthritis include painkillers, NSAIDs such as ibuprofen and corticosteroids. In addition, a range of supportive measures may be taken including physiotherapy. In some cases, despite medication, irreversible damage to the joints requires surgical interventions such as joint replacement. However, controlling the disease using medication can significantly reduce the risk of such complications.