Rheumatoid arthritis (RA) can be a very severe form of arthritis. It is a chronic, disabling disorder that can cause a multitude of physical woes, including inflammation and eventual destruction of the joints and cartilage throughout the body. It can also affect the lungs, muscles, blood vessels, skin and heart.
Fortunately, not everyone who has this disease is severely affected. Many people with RA experience only minor symptoms, and in some cases the disease simply ends, or "burns out."
Less common than osteoarthritis, rheumatoid arthritis affects upward of 2 percent of the population, with three times more women than men suffering its effects. Although the disease typically manifests itself in people between the ages of 20 and 40, it can start at any age.
Many doctors and researchers consider the disease an autoimmune disorder. Disorders of this nature result when the body initiates an immunological response to protect itself against something mistakenly recognized as foreign.
The joint damage caused by RA begins with inflammation of a layer of tissue called synovium that lines the joints. The inflammation leads to a thickened synovial membrane owing to an overgrowth of synovial cells and an accumulation of white blood cells. The release of enzymes and other substances by these cells can erode the cartilage that lines the ends of joints, as well as the bones, tendons, and ligaments within the joint capsule. As the disease progresses, the production of excess fibrous tissue limits joint motion. Inflammation of tissue surrounding affected joints can also contribute to joint damage.
Symptoms of Rheumatoid Arthritis
- Early symptoms (prior to obvious joint involvement) are generally nonspecific and include fatigue and weakness; low-grade fever; loss of appetite and weight loss.
- Red, swollen, painful joints, most often those of the fingers, wrists, knees, ankles, and toes on both sides of the body. (This symmetrical pattern and inflammation differentiates it from osteoarthritis. Also, rheumatoid arthritis, unlike osteoarthritis, usually spares the joints nearest the fingertips.)
- Tender joints, warm to the touch
- Dry mouth or eyes
- Stiffness, especially after awakening in the morning; usually improves during the day
- Red, painless skin lumps (rheumatoid nodules) on the elbows, ears, nose, knees, toes, or back of the scalp
- Inflammation in the lining of the lungs and spleen
- Bent and gnarled joints (with long-term rheumatoid arthritis)
- Chest pain, breathing difficulty (advanced cases)
- Fatigue, fever and weight loss
What Causes Rheumatoid Arthritis?
The exact cause of RA is unknown, but a susceptibility to develop it is inherited. Since the ratio of women to men with RA is three to one, some experts believe hormonal factors may play a role. The disease is generally progressive, and early treatment is important to slow or stop the progression and any accompanying disability.
What If You Do Nothing?
A small number of patients diagnosed with RA (about 10 percent ) experience a complete remission in one year, and roughly 40 percent go into remission within two years. But if the disease progresses and is not treated, it may severely restrict the range of motion of some joints, or worse, destroy the joints altogether.
Home Remedies for Rheumatoid Arthritis
There is no cure for RA at present. The best chance for relieving symptoms requires seeing your doctor to develop a treatment plan—and then taking an active role in your treatment. This means maintaining a medication schedule, exercise program, and other therapy recommended by your physician. Educating yourself about the disease is also very helpful. In addition, the following self-care measures can bring relief.
- Try hot or cold packs. Depending upon which temperature feels better, apply a hot or cold pack to a stiff or painful joint.
- Get plenty of rest. Sleeping 8 to 10 hours a night is optimal. Resting during the day is also helpful. When your joints feel warm, swollen, and painful, cut back on physical activity.
- Perform range-of-motion exercises. To maintain joint mobility, perform light exercises that will help preserve the mobility in the painful joint.
- Exercise gently and regularly. The gentle movement of regular exercise is an effective therapy for RA. Walking and swimming are excellent activities to help maintain joint flexibility and strengthen supporting muscles (but let your physician or physical therapist outline your program). Exercise will also help to maintain range of motion. The key to a successful program is to find a balance between exercise and adequate rest.
- Ease the strain on painful joints. Make use of devices (such as an electric can opener, larger pens, grab bars in the shower, and other assistive devices) that lend support and/or minimize joint involvement. A special splint for the hand or wrist can be useful in protecting an injured joint and relieving pain (check with your doctor).
At present, there is no known way to prevent rheumatoid arthritis.
Beyond Home Remedies: When To Call Your Doctor
Contact your physician if persistent joint pain or stiffness develops, especially if it begins to interfere with daily activities. Also contact your physician if you have RA and new symptoms develop.
What Your Doctor Will Do
There is no specific diagnostic test for rheumatoid arthritis. Your doctor will take a careful history and then perform a physical examination of the joints, heart, and lungs. Blood tests may be done and x-rays may also be taken; synovial fluid may be drawn from affected joints and analyzed. If your medical history or the tests are positive, treatment will begin immediately.
A range of medications is available that can slow the destructive aspects of RA. Aspirin to reduce pain and inflammation is the cornerstone of therapy for many patients—but to be effective, aspirin is taken in doses higher than commonly used, which can cause stomach problems. If aspirin is ineffective or causes serious side effects, your doctor may prescribe another nonsteroidal anti-inflammatory drug (NSAID).
If NSAIDs don't adequately control symptoms, other drugs can be tried, including corticosteroids and disease-modifying antirheumatic drugs (DMARDs).
Your doctor or a physical therapist will also advise you about an exercise program. For severe cases physical therapy may be prescribed, and surgery may be recommended for people with severe joint damage.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media