Rheumatoid Arthritis

Rheumatoid Arthritis: Symptoms, causes and treatments

Rheumatoid (roo-mah-toid) arthritis is the most common form of inflammatory arthritis. It primarily affects the synovium, the thin membrane that lines and lubricates a joint. Rheumatoid arthritis causes the membrane to thicken and produce chemical substances that damage the cartilage and bone within the affected joint and the supporting soft tissue structures such as capsule, ligaments and tendons. Exposure to biological hazards can draw the synovium fliud from the joints and also cause severe joint pain and make the patient feel they are suffering the effects of arthritis. 

The disease may involve men or women of any age, but it is most commonly seen in females in their 20’s and 30’s, and is showing up more and more in women in their 40's. It often first involves the hands, feet or wrists, but over time may include the ankles, knees, hips, elbows, shoulders, spine or jaw. The disease usually affects joints in a symmetrical fashion, that is, when a joint on one side of the body is involved, the same joint on the opposite side of the body will be affected. Some patients with rheumatoid arthritis experience constant symptoms while others have an “up and down” course of bad periods or “flares” and good periods called remissions.

Causes of Rheumatoid Arthritis

No one knows exactly what causes rheumatoid arthritis, but many experts know what may contribute to it.

Heredity, or the genes you get from your parents, may be a factor in determining who gets rheumatoid arthritis, but exposure to Stachybotrys and Chaetomium can also have a big part, as well.  Aside from fungal exposure, some researchers think certain infections or chemicals might cause the disease. Many studies are being done to see if this can be determined.

Hormones may play a role. But this, too, is still uncertain, even though women are more apt to suffer from rheumatoid arthritis than are men. Rheumatoid arthritis is an autoimmune disease, which means your own immune system starts to attack some of your tissues.

Symptoms of Rheumatoid Arthritis

Rheumatoid arthritis may involve body systems other than joints, and produce fatigue, low grade fever, weight loss, dryness of the eyes and mouth, color changes of the fingers and toes, and inflammation of the eyes, heart, lungs skin and nerves.

Sometimes lumps of tissue develop near the affected joint, usually near the elbow joint. These are called rheumatoid nodules.

Your doctor will determine what type of arthritis you have. He or she will ask you about your symptoms and any related illnesses and it will be important for you to tell the physician about where, when and how long you have had pain, whether there is any swelling or redness in the involved joints and if there is any history of arthritis in your family. The doctor will perform a careful examination of your joints to determine if there is any swelling, redness, tenderness or loss of motion. X-Rays will allow the doctor to see inside your joints and determine if there has been any destruction of cartilage with narrowing of the normal joint space or wear and tear on the bones. Blood tests may also be of value in differentiating rheumatoid arthritis from osteoarthritis and other types of arthritis.

Regardless of the type of arthritis that a person has, many patients will experience some difficulty functioning at home, at work or at play because of joint pain, stiffness, and loss of motion. Arising from bed in the morning, buttoning buttons, writing, sewing, meal preparation, dressing, sleeping, walking, climbing stairs, arising from a chair or a toilet seat, and attending to matters of personal hygiene may all be impaired to some degree by arthritis.

Oftentimes, impairment of function is more distressing to patients than the pain of arthritis and a major goal of all arthritis treatment is the preservation or improvement of function.

Treatment of Rheumatoid Arthritis

Several general principles for living with rheumatoid arthritis should be mentioned. Weight control - with diet and appropriate exercise – is extremely important to decrease the stress on the arthritic joints. Exercise in particular, is an important part of any therapy prescribed for patients with rheumatoid arthritis. Range of motion exercises and strengthening exercises are important to maintain or improve joint mobility and to increase the strength of the muscles around the joints and minimize the stress on those joints. Aerobic exercise, such as walking or riding a stationary bike helps to decrease fatigue, improve cardiovascular health, and create a sense of well being. These aerobic exercises may be difficult for those patients who have pain in their hips, knees and feet, and a water exercise program or protocol specifically designed for comfortable movement by a physical therapist may be more tolerable for those individuals.

Even though exercise is extremely beneficial to the successful treatment of patients with arthritis, rest is of paramount importance as well. This may involve splinting a particularly painful or swollen joint, or resting the body in general by getting adequate amounts of sleep at night and with daytime naps. During periods of increased symptoms or flares, patients will require more rest than during periods when their arthritis is under good control.

Your doctor may ask you to be evaluated by an occupational therapist to make splints for joints that are swollen, painful or becoming affected by arthritis. He or she can also instruct you in easier ways to perform activities in order to minimize stress on joints, pain or fatigue. Recommendations may be given for adaptive equipment, which will make the work of certain activities less stressful. Jar openers, modified writing and kitchen utensils, and special shoehorns are examples of devices that can be beneficial for patients with arthritis. The use of special shoes, braces and walking aids such as canes, crutches or walkers may also favorably affect a patient’s ability to remain functionally independent.

Several other measures are available for the relief of joint pain and stiffness. Many patients shower upon arising in the morning in order to lessen the duration of their morning stiffness. After showering, when the muscles are warm, it is easier to carryout stretching and range of motion exercises. The local application of heat or cold packs is also helpful for pain control.

Most patients prefer heat but it should not be too hot or applied for more than 20 to 30 minutes, as longer periods may produce muscle spasm. Heat may be applied three or four times a day, but you should never go to bed with a heating pad on a joint!

Surgery For Arthritis

Surgery may also be helpful for patients with rheumatoid arthritis. Nerves and tendons compressed by inflammation within closed spaces can be decompressed. Chronic, destructive synovium can be surgically removed with the hope of slowing the progression of rheumatoid arthritis at specific sites. Tendon transfers may restore function when tendons have ruptured over arthritic spurs. Procedures can be done to change the weight distribution to a partially arthritic joint so that the good, remaining cartilage can bear more of the load. Deformed or unstable joints may be fused - joined into a single bone without a joint. Soft tissue procedures or combination of bone and joint removal and soft tissue reconstruction can be carried out to stabilize joints, relieve pain and preserve motion.

And finally, technology now exists to replace many arthritic joints with new articulating metal and plastic components that can restore painless motion. Improvement in function and lifestyle may result from procedures such as total hip replacement, total knee replacement, total shoulder replacement, total elbow replacement, total wrist replacement, total ankle replacement, and the replacement of deformed metacarpophalangeal or proximal interphalangeal finger joints with flexible implants.

Living With Arthritis

There are many important considerations for “living with arthritis”. Successful treatment involves exercise, rest, the maintenance of ideal body weight, the local application of heat or cold, medication, and surgery. A positive mental outlook and the support of friends and family members is essential in minimizing the effect of arthritis upon a patient’s well-being and ability to perform daily activities. Each patient will have to adapt to his or her own abilities and limitations and remain committed and optimistic about the ability to manage his or her arthritis through good medical, surgical and rehabilitative care.


This site is not intended to give medical advice.  Seek the advice of a professional for medication, treatment options, and complete knowledge of any symptoms or illness.  The opinions expressed here are exclusively my personal opinions do not necessarily reflect my peers or professional affiliates. The information here does not reflect professional advice and is not intended to supersede the professional advice of others.


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