The Most Important Things You Need to Know About Rheumatoid Arthritis
Just diagnosed with rheumatoid arthritis (RA)? You’re not alone. About 1.5 million people in the U.S. have RA, an autoimmune disease that can lead to symptoms like achy or locked joints, numb hands, and even eye pain that can impair vision. Granted, it’s scary stuff. But know this: “While it is a chronic disease, meaning something we cannot cure, we have great medications now that can keep patients pain- and damage-free,” says Rebecca Haberman, MD, a clinical instructor of rheumatology at NYU Langone Health in New York City. Here’s what you need to know.
It’s not your grandmother’s arthritis
Hearing the word “arthritis,” you may automatically think of the pain and stiffness people experience in their joints as they grow older. That’s osteoarthritis. Rheumatoid arthritis (RA)—altogether different—isn’t caused by wear and tear of the joints. It’s an autoimmune disease driven by inflammation, as Dr. Haberman explains.
“The immune system is designed to fight bacteria, viruses, and other ‘foreign invaders’ to keep us healthy,” she says. “However, in some people, the immune system begins to attack itself instead of those invaders. In the case of rheumatoid arthritis, the immune system is attacking the joints and tissue around the joints, causing pain and swelling.”
It commonly affects joints in the hands, wrists, and knees. Other symptoms include weight loss, fever, fatigue, and weakness.
Rheumatoid arthritis can strike anyone
The disease is three times more common in women than men and the likelihood of developing RA increases with age—in fact, the onset of RA is highest among adults in their sixties—but anyone can develop the disease at any age, cautions Dr. Haberman. “[Younger people with joint pain] may think, ‘I’m too young to have arthritis,’ when it could be rheumatoid arthritis,” she says.
Experts don’t know what causes RA
Rheumatoid arthritis is the result of an autoimmune system gone awry. But what specifically causes that to happen, no one knows for sure. Experts think a mix of genes, environmental factors, and sex hormones may play a role.
“It can be difficult to diagnose RA because it can present with nonspecific symptoms such as overall stiffness and fatigue—instead of one big swollen knee, for example,” says Dr. Haberman. “Sometimes people think they have a virus, thyroid problems, depression, or even just mechanical trauma.”
Take, for example, the person who experiences pain in a joint and attributes it to something like a recent accident. One clue it may be RA: The pain continues over the next several months and begins to spread to other joints. “It’s important to get checked by a rheumatologist who can ask the right questions and, if needed, get the right blood tests and X-rays to determine if you do have rheumatoid arthritis,” adds Dr. Haberman.
There’s no cure for RA but remission is possible
With RA, there are periods when symptoms get worse, known as flares, and periods when symptoms get better, known as remission. The goal is remission, meaning no more than one joint is affected and levels of inflammation are low.
To that end, early, aggressive treatment—within six months of the first sign of symptoms—is everything. “Joint damage can occur as early as the first two years of disease, which is why it is so important to see a doctor if you are having any symptoms of rheumatoid arthritis such as joint pain and swelling, stiffness, and fatigue,” says Dr. Habermen. “Studies show that early, tight treatment is more effective at preventing disability and permanent joint damage. Most patients achieve remission, but sometimes it can take time and trial of different medications before it is achieved. Not everyone responds to every medication.” The good news, she says, is there are a lot of quality options for the treatment of RA.
A healthy lifestyle is part of the Rx for RA
Diet and exercise play a big role. Why? Excess weight may exacerbate the disease and render medications less effective, says Dr. Haberman. Plus, “patients with RA have higher rates of conditions such as heart disease and diabetes; therefore, maintaining a heart-healthy routine can be lifesaving.”
Specifically: If you smoke, talk to your doctor about quitting. And lower risk factors like high blood pressure and high cholesterol by eating a nutritious, low-fat diet and adding cardio to your workout regimen. The Arthritis Foundation suggests at least 30 minutes of low- or no-impact aerobic exercise (like walking, swimming, or cycling) five days a week; as well as strength-training exercises to help support your joints and flexibility exercises to boost your range of motion. If you’re just starting an exercise program, be sure to get the green light from your doctor first.
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