Rheumatoid arthritis, or RA, is an autoimmune disease. An autoimmune disease occurs when the body’s immune system attacks healthy tissue. Autoimmune diseases can be very challenging because the body is working against itself. RA results in inflammation of the joints and adjacent areas, but it can also affect internal organs.

What you should know about RA

• About 1% of the world’s population has RA.
• Women are three times more likely to have RA than men.
• Smokers are four times more likely than nonsmokers to get RA.
• RA can affect people of all ages, but RA most commonly starts when a person is between 40 and 50 years of age.
• RA may go away on its own or it may come and go. For many people, RA is a chronic condition that worsens over time.

Understanding RA

In a healthy person, the joints of the body are enclosed in a “joint capsule” that is filled with a lubricating liquid called synovial fluid. The ends of the bones are covered in a thick elastic tissue called cartilage that allows them to move against each other smoothly. The synovial fluid nourishes the cartilage and bones inside the joint capsule.

In a person with RA, the body’s white blood cells attack the synovium (the tissue that produces the synovial fluid) and cause inflammation, heat, swelling, redness and pain. As RA progresses, the inflamed synovium and synovial fluid destroy the cartilage and bone they were meant to protect.

The symptoms of RA

University Spine Center recognizes that RA is a complex disease that will affect different people in different ways. Early detection is important to prevent RA from damaging joints. Here are some symptoms of RA:

• RA usually causes warm, tender, swollen joints.
• RA often affects joints symmetrically, that is, if you have it in the right elbow you are likely to develop it in the left elbow, too.
• Wrist and finger joints are often affected.
• Fatigue with occasional fever and a general sense of not being well are frequent.
• There is pain and stiffness upon arising that lasts at least 30 minutes.
• There may be feelings of depression, anxiety and helplessness. This is not emotional weakness; they are associated with the disease.

Diagnosis and treatment

There is no simple definitive diagnostic test for RA. There are blood tests that can look for certain antibodies associated with RA. Other blood tests may look for white blood cell count or other measures looking for increased inflammation. In some cases, X-rays or other images may be required.

University Spine Center recommends several concurrent treatments for managing RA, including:

• Medications
• Lifestyle changes (rest, diet, exercise)
• Ongoing care
• Possibly surgery

There are many new and promising medications to treat RA. One group is called disease-modifying antirheumatic drugs (DMARDs), which can help slow RA by changing or modifying the nature of the disease process. Biologic response modifiers, or “biologics,” are another new type of drug for RA. They are genetically engineered medications to reduce inflammation.