What is rheumatoid arthritis (RA)?
Rheumatoid arthritis, or RA, is an autoimmune and inflammatory disease, which means that your immune system attacks healthy cells in your body by mistake, causing inflammation (painful swelling) in the affected parts of the body.
RA mainly attacks the joints, usually many joints at once. RA commonly affects joints in the hands, wrists, and knees. In a joint with RA, the lining of the joint becomes inflamed, causing damage to joint tissue. This tissue damage can cause long-lasting or chronic pain, unsteadiness (lack of balance), and deformity.
RA can also affect other tissues throughout the body and cause problems in organs such as the lungs, heart, and eyes.
What are the signs and symptoms of Rheumatoid Arthritis?
Signs and symptoms of rheumatoid arthritis may include:
Tender, warm, swollen joints
Joint stiffness that is usually worse in the mornings and after inactivity
Fatigue, fever and loss of appetite
Early rheumatoid arthritis tends to affect your smaller joints first — particularly the joints that attach your fingers to your hands and your toes to your feet.
As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body.
About 40 percent of the people who have rheumatoid arthritis also experience signs and symptoms that don’t involve the joints. Rheumatoid arthritis can affect many non-joint structures, including:
- Salivary glands
- Nerve tissue
- Bone marrow
- Blood vessels
Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission — when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place.
As well as problems affecting the joints, some people with rheumatoid arthritis experience a range of more general symptoms, such as:
- tiredness and a lack of energy
- a high temperature (fever)
- a poor appetite
- weight loss
The inflammation associated with rheumatoid arthritis can also sometimes cause problems affecting other areas of the body, such as:
- dry eyes – if the eyes are affected
- chest pain – if the heart or lungs are affected
What Causes Rheumatoid Arthritis?
Nobody knows what causes the immune system to malfunction.
Some people appear to have genetic factors that make it more likely. One theory is that bacteria or a virus triggers RA in people who have this genetic feature.
In RA, the immune system’s antibodies attack the synovium, which is the smooth lining of a joint. When this happens, pain and inflammation result.
Inflammation causes the synovium to thicken. Eventually, if left untreated, it can invade and destroy cartilage — the connective tissue that cushions the ends of the bones.
The tendons and ligaments that hold the joint together can also weaken and stretch. The joint eventually loses its shape and configuration. The damage can be severe.
What are the risk factors for RA?
Researchers have studied a number of genetic and environmental factors to determine if they change person’s risk of developing RA.
Characteristics that increase risk
Age. RA can begin at any age, but the likelihood increases with age. The onset of RA is highest among adults in their sixties.
Sex. New cases of RA are typically two-to-three times higher in women than men.
Genetics/inherited traits. People born with specific genes are more likely to develop RA. These genes, called HLA (human leukocyte antigen) class II genotypes, can also make your arthritis worse. The risk of RA may be highest when people with these genes are exposed to environmental factors like smoking or when a person is obese.
Smoking. Multiple studies show that cigarette smoking increases a person’s risk of developing RA and can make the disease worse.
History of live births. Women who have never given birth may be at greater risk of developing RA.
Early Life Exposures. Some early life exposures may increase risk of developing RA in adulthood. For example, one study found that children whose mothers smoked had double the risk of developing RA as adults. Children of lower income parents are at increased risk of developing RA as adults.
Obesity. Being obese can increase the risk of developing RA. Studies examining the role of obesity also found that the more overweight a person was, the higher his or her risk of developing RA became.
Characteristics that can decrease risk
Unlike the risk factors above which may increase risk of developing RA, at least one characteristic may decrease risk of developing RA.
Breastfeeding. Women who have breastfed their infants have a decreased risk of developing RA.
What are the complications of RA?
Rheumatoid arthritis (RA) has many physical and social consequences and can lower quality of life. It can cause pain, disability, and premature death.
Premature heart disease. People with RA are also at a higher risk for developing other chronic diseases such as heart disease and diabetes. To prevent people with RA from developing heart disease, treatment of RA also focuses on reducing heart disease risk factors. For example, doctors will advise patients with RA to stop smoking and lose weight.
Obesity. People with RA who are obese have an increased risk of developing heart disease risk factors such as high blood pressure and high cholesterol. Being obese also increases risk of developing chronic conditions such as heart disease and diabetes. Finally, people with RA who are obese experience fewer benefits from their medical treatment compared with those with RA who are not obese.
Employment. RA can make work difficult. Adults with RA are less likely to be employed than those who do not have RA. As the disease gets worse, many people with RA find they cannot do as much as they used to. Work loss among people with RA is highest among people whose jobs are physically demanding. Work loss is lower among those in jobs with few physical demands, or in jobs where they have influence over the job pace and activities.
In summary, Rheumatoid Arthritis is caused by the body itself, though the cause is unknown, there are treatments for rheumatoid arthritis. If you don’t have rheumatoid arthritis, but runs in the family or have a predisposition to one of the risk factors, then you can prevent rheumatoid arthritis.