What is Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is a chronic, inflammatory condition that primarily targets the joints, causing joint stiffness, swelling, and pain. An autoimmune disorder, RA occurs when your immune system — which typically protects your body by fending off viruses, bacteria, and other foreign substances — mistakenly launches an attack on your joints. This inflammatory attack causes damage to the synovial tissues and cells lining the joints, making your joints severely painful, swollen, and stiff. Joints of the ankles, knees, elbows, wrists, feet, and hands often bear the biggest brunt of rheumatoid arthritis.
Interestingly, the joint damage frequently occurs on either side of the body. This means if one wrist or elbow is affected, the other wrist or elbow will most likely be affected as well.
It’s this symmetrical impact that helps clinicians initially tell rheumatoid arthritis from other forms of arthritis, such as gout, fibromyalgia, psoriatic arthritis (PsA), and osteoarthritis (OA).
If left untreated or uncontrolled, rheumatoid arthritis can destroy not only the joints but also the cartilage (tissue that encloses the bones at the joints), and adjoining bones.
Over time, long-term damage can lead to instability (lack of balance) and joint deformity, as well as a partial or total loss of mobility.
As a systemic condition — a medical term for a disease that affects the whole body — RA can also impact the nervous system, blood, eyes, ligaments, muscles, skin, respiratory, or cardiovascular system.
Even though it’s not the most common form of arthritis, RA isn’t a rare disorder, either.
According to the Arthritis Foundation, around 1.5 million Americans currently have physician-diagnosed rheumatoid arthritis, which translates to nearly 0.5 percent of the US population.
What’s more, 41 out of every 100,000 people in the U.S. are diagnosed with RA annually.
Women are three times more likely to develop RA than men, with a lifetime risk of 3.6 percent, according to a 2011 study.
In women, the onset of the disease is usually between the ages of 30 and 60, whereas in men it can start developing a little later in life.
Because the damage to the joints is usually irreversible, the key is to get diagnosed early when it can still be treated much more effectively.
Keep reading to learn everything you need to know about rheumatoid arthritis, including:
● The signs and symptoms
● Causes and risk factors
● Diagnostic options
● Treatment options
● And when to call a doctor
Symptoms and Causes
What Happens When You Have Rheumatoid Arthritis?
Rheumatoid arthritis symptoms are usually different from patient to patient and can vary from one day to another.
At the onset, the person may experience mild symptoms like pain, warmth, or tenderness at the joints. Signs of severe inflammations like swelling, severe pain, and redness will appear somewhat later.
As with any autoimmune disease, RA is a long-term condition characterized by symptoms of pain and inflammation which typically come and go before appearing again.
These symptoms and signs may appear or worsen during periods called flares and flare-ups before disappearing again.
At other times, the symptoms are mild, unnoticeable, or inactive, and these periods are called remission.
As we’ve mentioned, early diagnosis is the key to preventing or minimizing joint damage over the long haul. But here are 10 early signs and symptoms of rheumatoid arthritis that you need to watch out for:
(1) Joint Stiffness
Inflamed joints will gradually become stiff, making them immovable, inflexible, and difficult to use. This affects their function.
For instance, if your elbow joints are affected, you may not be able to completely fold, bend, or flex your arms.
Stiffness normally starts in smaller joints, particularly in your hands, before advancing elsewhere. The progression can be gradual or sudden, affecting several joints at the same in a span of one to two days.
When you have rheumatoid arthritis, joint stiffness can happen at any time, regardless of whether you’re at rest or active.
(2) Morning Stiffness
Joint stiffness is typically much worse after a lengthy period of inactivity, which is mostly in the morning or after naps.
This is often referred to as morning stiffness.
Morning stiffness is one of the earliest signs of any autoimmune or inflammatory arthritis. That’s why it is very common in people with rheumatoid arthritis.
Although it is a shared symptom across all forms of arthritis, morning joint stiffness often lasts longer in RA. In the early days, however, it can last for a few minutes but worsens over time.
When your condition becomes chronic, you can expect morning stiffness to take up to 1 hour or even longer to wear off.
In osteoarthritis, on the other hand, it usually takes no more than 30 minutes for joints to become flexible and feel loose again in the morning.
(3) Joint Swelling
Early on, RA creates mild inflammation on the lining of your joints. This makes your joints look and feel larger than usual.
At first, you will experience bouts of joint swelling that lasts for a few days before subsiding. The swelling usually happens at the same joints before spreading to others.
Over time, these flare-ups can last for weeks or even longer, worsening with time as the inflammation becomes more severe.
Swelling is usually accompanied by tenderness, warmth, redness, and pain at the affected joints.
(4) Joint Pain
Mild to severe joint pain is the primary symptom of all forms of arthritis, but it is more prominent in rheumatoid arthritis.
Inflammation inside or around the joints makes them painful whether you are engaging them or resting. Frequently, this follows joint stiffness and occurs alongside tenderness and redness.
The type of pain linked to RA is often an aching and throbbing pain that’s typically more severe in the mornings, after naps, and following a spell of inactivity.
Unsurprisingly, your wrists and fingers are the most common spots of pain in the early stages of rheumatoid arthritis. However, you may also feel pain in the joints of your shoulders, ankles, feet, and knees.
Joint pain associated with RA is symmetrical (sometimes called bilateral), which means it equally affects the same joints or limbs on both sides of your body. For example, if you experience joint pain in one of your wrists, the other wrist will probably be painful, too.
In a chronic case of RA, you can experience pain in your joints for six weeks in a row or even longer, depending on the severity and medication.
(5) Joint Warmth and Redness
Inflammation generates a significant amount of heat and puffiness.
As a result, inflamed joints usually become warm (or even hot) to the touch and will change in color. In many cases, the joints develop redness around the site of inflammation.
Joint redness and warmth typically happen alongside swelling and pain. The affected joints may also become tender and somewhat soft to touch.
If you feel abnormally tired and weak, these could be an early giveaway of rheumatoid arthritis. As a rule of thumb, you should never ignore any tiredness that lasts unusually long.
Did you know that fatigue is one of the earliest signs of RA? You may start to feel unusually fatigued several weeks if not months before additional symptoms appear.
Fatigue associated with rheumatoid arthritis vacillates, coming and going from day to day, week to week, or month to month.
Generally, this feeling of tiredness or exhaustion can come alongside depression, anxiety, stress, and other signs that indicate you are unwell.
However, keep in mind that there are many other potential causes of fatigue, including anemia, thyroid problems, depression, and chronic infection.
(7) Low-Grade Fever
A low-grade fever might appear alongside other early symptoms of rheumatoid arthritis, most notably inflammation, swelling, and pain.
If you are genetically predisposed to develop rheumatoid arthritis, this is usually one of the earliest warnings to keep an eye on.
It is worth noting that if you run a high fever (any fever 38°C/100°F or higher), the odds are greater that you have an infection or some other type of illness, such as pneumonia.
Heatstroke, reaction to certain medications, sunburn, and extreme dehydration could also be to blame for a fever.
(8) Reduced Range of Motion
Reduced range of motion is directly related to joint stiffness, pain, swelling, and inflammation.
More often than not, prolonged joint inflammation causes your ligaments, tendons, muscles, and surrounding tissue to become deformed, inflamed, and unstable.
This becomes worse as the condition progresses.
Over time, you may find it hard to straighten, bend, or flex some of your joints. This is especially true for the joints of your feet, hands, and shoulders.
Ultimately, inflexibility, joint pain, and stiffness will reduce your range of motion. Besides using medication, the best course of action is to exercise them gently and regularly.
(9) Tingling and Numbness (Carpal Tunnel Syndrome)
The tendons and tissue on your joints are surrounded or connected to a network of nerves and blood vessels that help nourish your muscles.
When your tendons are inflamed, they can put undue pressure on the surrounding nerves. Often, this will lead to carpal tunnel syndrome, a condition in which you experience a burning sensation, tingling, or numbness in your hands and feet.
Extensive damage to tendons, ligaments, and cartilage can make your feet or hands generate a crackling noise or squeaking when you move the joints.
(10) Other Symptoms
In the early stages of the disease, you may experience symptoms in other parts of your body.
For instance, you may feel weak, fatigued, or generally ill. Your mouth may feel dry, and the eyes may become itchy, dry, and inflamed. In some cases, the eyes of a person with RA may produce excess discharge.
In the early days, you may lose appetite and later have more severe weight loss.
Chest pain/discomfort when breathing, difficult in falling asleep, and bumpy skin are other early signs of rheumatoid arthritis.
If Rheumatoid Arthritis is Left Untreated…
If left uncontrolled, rheumatoid arthritis can have far-reaching health consequences.
That is why you should get tested and treated as soon as possible to avoid further damage to joints, cartilage, and other dangers of untreated RA.
Remember, this is an autoimmune condition that can strike at any age, regardless of your race, gender, or ethnicity.
Unfortunately, many people with rheumatoid arthritis are undiagnosed and therefore untreated because they don’t know they have the disease. Others downplay their symptoms.
But if you think an RA diagnosis should wait, think again. Here are long-term effects, dangers, and complications of untreated rheumatoid arthritis:
1) Heart Problems
Researchers have shown that having untreated rheumatoid arthritis increases your risk of developing a variety of cardiovascular problems. It’s not hard to understand why.
If not controlled or treated, RA inflammation can spread to the heart, kidneys, blood vessels, and other associated organs. More specifically, inflammation creates clots and blockages in smaller blood vessels and arteries, forcing them to become narrower and narrower.
The most possible site of damage is the endothelium, the innermost layer of arteries. Inflammation not only damages this layer but also causes an accumulation of plaque or fatty deposits.
This plaque narrows the blood vessels, reducing blood flow to the heart and elevating blood pressure
Eventually, clots, blockages, and narrowing of the blood vessels may increase your chances of suffering from a stroke or a heart attack by twofold, according to many extensive studies.
For instance, in a 2015 study, researchers noted that rheumatoid arthritis patients can develop atherosclerosis much more quickly than the general population.
Atherosclerosis is a condition that causes a rapid build-up of cholesterol, fats, and other plaque in and on the walls of the arteries. If uncontrolled, it will lead to a stroke or heart attack.
Inflammation can cause damage to veins too. In a 2012 study, Mayo Clinic investigators found that people with RA are four times more likely to develop a life-threatening pulmonary embolism.
The same study confirmed that individuals with rheumatoid arthritis are at a three times greater risk of developing deep vein thrombosis (or what’s called venous thromboembolism in the medical community). This a potentially chronic condition that causes blood clots and potential blockages in the veins.
Inflammation can also affect how the heart fills and pumps blood, causing conditions like atrial fibrillation (AFib) which is characterized by an irregular heartbeat.
Accordingly, in another 2015 study, scientists found that people with RA are at higher risk of AFib.
Rheumatoid arthritis can also cause inflammation of the membrane surrounding the heart, leading to a condition called pericarditis.
The bottom line is that untreated rheumatoid arthritis can affect your heart’s health in more than one way.
Having untreated rheumatoid arthritis increases your risk of developing osteoporosis, a condition that’s typified by thinning of bones.
This makes your bones not only lose their strength and density but also become porous and unable to sustain your weight. As a result, any tumble, tripping, or slip can lead to a painful fracture or crack. The most susceptible bones are in your wrists, spine, and hips.
Many reasons may explain the link between osteoporosis and RA:
The first possible explanation has to do with inflammation. You see, your body is continuously replacing worn-out or lost bones. Unfortunately, inflammation breaks down the joints and interferes with this cycle.
Repeated inflammation increases the pace at which bones are broken down, as well as reduces the speed at which they are being replaced. Eventually, this can lead to osteoporosis.
Also, inflammation can make it hard for the body to absorb much-need nutrients like vitamin D, B vitamins, and calcium that help keep your bones healthy and strong.
As we’ve mentioned before, RA can lead to fatigue, joint swelling, stiffness, and pain, all of which can make it very difficult for you to stay active. You need physical activity to maintain strong, robust bones, and without it, your bones may weaken further.
RA inflammation doesn’t just affect the joints; it can also damage the nervous system and some areas of your brain. This can lead to neurodegenerative disorders and neuropsychiatric symptoms, including anxiety and depression.
This can lead to spinal cord compression, peripheral nerve complication, behavior dysfunction, and cognitive decline.
Interestingly, the connection between rheumatoid arthritis and depression goes both ways. On the one hand, uncontrolled depression can make it difficult to treat and manage rheumatoid arthritis.
According to a 2017 study published in the journal Psychosomatic Medicine, researchers found that untreated RA increases one’s risk of developing clinical depression.
And sadly, the pain and discomfort resulting from rheumatoid arthritis make depression symptoms worse.
Most RA patients usually suffer from anemia, a condition that is characterized by low levels of red blood cells. This greatly reduces the body’s capacity to transport enough oxygen to where it’s needed.
There’s also an overlap in the symptoms of anemia and RA, including fatigue, weakness, and osteoporosis.
Inflammation is perhaps the biggest route to anemia. In untreated RA, chronic inflammation destroys the bones around the joints and possibly the bone marrow, reducing their ability to produce healthy red blood cells.
Also, extensive inflammation in the blood may render your body unable to absorb or ship important minerals like folate, folic acid, and iron. This will ultimately cause iron-deficiency anemia.
5) Joint Damage and Deformity
In RA, the immune system instigates an immune war against the cells and tissue within the synovium.
It first creates antibodies (the foot soldiers) and then sends them to the lining of the joints, causing extensive damage to the synovium tissue, cartilage, tendons, and surrounding bones.
If left uncontrolled, this rapid inflammatory attack will eventually cause irreversible damage to the joints. This will lead to permanent joint deformity and destruction.
The most effective way to prevent and even reverse part of the damage in the joints of your toes, feet, fingers, hands, and ankles is through early detection and treatment.
6) Instability, Disability, and Loss of Mobility
The first site of inflammatory damage is in the joints, but inflammation can also affect surrounding cells and tissue, including muscles, ligaments, and tendons. These three are needed for mobility, flexibility, and stability in joints.
When the tendons, ligaments, and muscles are destroyed, the joints become either too loose, stiff or unable to function. However you look at it, untreated rheumatoid arthritis will cause disability, loss of balance, and impact joint functions, such as flexing, mobility, etc.
7) Respiratory Problems – It Can Affect your Lungs
If left untreated, the condition can spread to other parts of the body, including your lungs. Untreated RA can cause lung problems in many ways.
Lung scarring: Better known as interstitial lung disease, lung scarring is a respiratory condition that affects 10 percent of people with rheumatoid arthritis — and for good reason.
When RA is not treated, inflammation starts affecting lung cells and tissue, causing some forms of scars. This causes breathing difficulties, as well as weakness, sudden weight loss, appetite loss, excessive fatigue, dry cough, and shortness of breath.
As you might expect, this has a domino effect on the body, as the oxygen can’t reach every organ and part of the body. Chronic inflammation in the lungs can lead to pneumonia and infections.
Lung pulmonary nodules: these are non-cancerous small lumps that develop in the lungs. Although they aren’t very dangerous, they can hamper respiration.
Pleural disease: This is a condition that is characterized by the inflammation of the soft tissue, lining, and membrane surrounding the lungs.
It is usually accompanied by a buildup of fluids in the chest cavity (pleural space). The pleural disease can sometimes cause shortness of breath, fever, and pain during breathing.
Obstruction of the small airways: your lungs are made up of tissue and billions of air sacs and airways that help facilitate respiration. Uncontrolled RA inflammation can cause these small airways to develop mucus, become narrow, and blocked.
Small airway obstruction can lead to unease, discomfort, wheezing, and sometimes pain when you breathe. Broncho dilators and inhalers can be used to remove the obstruction, but it can be treated much more thoroughly by treating the underlying cause: rheumatoid arthritis.
8) Early Mortality
Untreated rheumatoid arthritis opens a floodgate to numerous conditions and complications that can eventually cause death. After all, without treatment, excessive inflammation, disability, and chronic pain can take a toll on your health and well-being.
According to a report by John Hopkins Arthritis Center, people with untreated rheumatoid arthritis are two times more likely to die early than their age-mates without the disorder.
As per the same report, heart disease is the leading cause of death in people with rheumatoid arthritis, contributing about 33 to 50 percent of the RA-related mortalities.
Infections associated with RA are responsible for approximately 25 percent of deaths, leaving other causes like depression, osteoporosis, lymphoma, and anemia to share the spoils.
9) Eye Problems
An immune attack as a result of RA can also affect the patient’s eyes.
Sjogren’s syndrome is a well-known autoimmune disorder that develops alongside rheumatoid arthritis. The condition is marked by the eye’s inability to produce enough moisture and tears to protect itself.
It makes your eyes feel dry, itchy, with burning or gritty sensation as if something is lodged in your eyes. Other symptoms of Sjogren’s syndrome include fever, fatigue, mouth sores, hoarse voice, difficulty swallowing, etc.
Another eye problem associated with RA is corneal damage. It is caused when the cornea of the eye becomes ulcerated, scarred, or scratched. RA inflammation can cause both scarring and ulceration, alongside other factors like Sjogren’s, uveitis, scleritis, and dry eyes.
In fact, dry eyes, or what’s medically known as keratoconjunctivitis sicca, affects more than 25 percent of patients with rheumatoid arthritis. This is a condition primarily defined by dry eyes as a result of the lacrimal gland’s inability to produce tears.
Other symptoms of the disease include a feeling of grittiness in the eyes, blurred vision, and eye redness.
Redness in the eyes has been found to affect about 0.17 percent of people with RA. Scientists think inflammation of the white of the eye and scleritis may be responsible for redness. It can also lead to vision reduction, light sensitivity, and pain in the eyes.
Uveitis is another eye complication that has been linked to RA, especially in juvenile rheumatic arthritis. This is a condition that occurs when the layer between the white part and the retina (uvea) becomes inflamed.
Blurred vision, pain, light sensitivity, and redness are some common symptoms of uveitis. If untreated, it can lead to loss of vision.
10) Skin Problems
RA inflammation can have adverse effects on your skin tissue and cells, especially in areas close to the affected joints.
First of all, uncontrolled inflammation can cause rheumatoid nodules to develop in your skin. These are tiny lumps or nodules that develop under the skin in bony areas or where the joints are.
RA is also strongly linked to another form of arthritis called psoriatic arthritis. It leads to painful joints, joint swelling, and creates skin plaques.
Causes and Risk Factors of Rheumatoid Arthritis
As noted throughout, rheumatoid arthritis is an autoimmune disease.
For reasons not yet known, the body’s own immune system initiates an attack on healthy cells and tissue. It’s this rapid immune response that causes inflammation and damage to the lining of the joints.
What causes the immune system to misbehave and go haywire still puzzles the medical community. However, what scientists know is that there must be a trigger.
Extensive scientific research and clinical trials have been conducted to establish some of these triggers. Even though more research is still needed, scientists believe that there are some specific factors that trigger or play a role in the development of RA:
(a) Genetic Factors
There’s a growing body of research and clinical evidence that family history and genetic predisposition may play a significant role.
Even though the risk of inheriting the condition is minimal, rheumatoid arthritis tends to run in families, which shows genes are responsible to some extent.
So if anyone in your family or your blood relatives (especially your parents) have RA, your chances of developing the disorder are high. And there are several medical studies to this effect.
In one study involving sets of twins, British investigators noted that rheumatoid arthritis occurred in 15 percent of the sets of identical twins, as opposed to 4 percent of non-identical sets of twins. These results are nearly identical to another 2013 Danish twins study.
Researchers didn’t stop there.
As of this date, scientists have discovered more than 100 genetic alterations that happen more prominently in people with rheumatoid arthritis.
For instance, in a 2011 study, researchers have found that people with gene variants called HLA-DRB1 are five times more likely to develop RA than the general population.
Other major genes suspected to predispose people to RA include:
● PTPN22, a gene that has been linked to both progression and triggering of RA.
● STAT4, a gene that’s known to play a critical role in activating and regulating the immune system.
● C5 and TRAF1, a set of genes that have been noted to play an important role in chronic inflammation. They are present in other inflammatory conditions, including SLE and type 1 diabetes.
Note, however, that not all patients with RA have these genes. And the opposite is also true – not everyone with these genes eventually gets rheumatoid arthritis.
(b) Gender and Parity
Traditionally, women are at a two to three times greater risk of developing RA than men. This has led scientists to believe that feminine hormones like estrogen might be linked to rheumatoid arthritis.
Parity — the number of liveborn children a woman has given birth to — may also play a part in the development of rheumatoid arthritis.
The research findings, however, are conflicting. On the one hand, some studies seem to suggest that RA is more likely in women who have never carried a pregnancy to term than those who have recently delivered.
On the other hand, certain findings show that parity may actually play in disfavor of some women. For instance, in a recent study, researchers noticed that women who have had two or more kids are 2.8 times more likely to get RA.
(c) Other Factors
Environmental – Scientists believe that overexposure to certain infections like viruses or bacteria, as well as toxic chemicals, can increase your chances of getting the condition. An infect of Epstein-Barr virus, for one, has been established to trigger the condition.
Age – Even though rheumatoid arthritis can start at any age, the onset is most common between the ages of 40 and 60. This is so despite the fact that RA is not part of a normal aging process.
Obesity – Having significant extra weight has been found to up your odds of developing RA, especially in women under the age of 55.
Smoking – Smoking alone doesn’t cause or trigger the onset of rheumatoid arthritis. However, if you are already genetically predisposed to get the condition, smoking can increase the probability that you’ll develop RA.
Similarly, if you are already struggling with RA, smoking can speed up the progress and make your symptoms worse.
Physical injury or trauma – If you already have the genes for the disorder, having a damaged ligament, dislocated joint, fractured bone or broken joint can raise your odds of developing RA.
Diagnosing rheumatoid arthritis can be quite challenging, and it’s easy to understand why.
Most symptoms of rheumatoid arthritis are non-specific and often vary from person to person.
In the early stages of the disease, for instance, many RA symptoms mimic those of other conditions, including Osteoarthritis, Lyme arthritis, Psoriatic arthritis, Sjogren’s syndrome, lupus, and SLE.
They may even resemble the side effects of certain medications and signs of an infection.
Even still, you shouldn’t ignore them. If you suspect that you have any of the above symptoms, get in touch with your physician immediately so you can get a proper diagnosis.
Because no single examination is enough to diagnose RA, your doctor will likely request a battery of lab tests, as well as do a physical checkup.
(1) Physical Examination
During your initial visit, your doctor will most likely perform a physical examination, making sure to check for obvious signs of rheumatoid arthritis.
Your physician will ask a serious of questions particularly about your family history, personal clinical history, and other risk factors. A physical checkup may include:
● Touch your joints for signs of tenderness or warmth.
● Check for a low-grade fever
● Look for redness and swelling in your joints
● Test your muscle strength, reflexes, etc.
Additionally, he or she may check for joint stiffness, pain, and discomfort (your doctor may ask if it has lasted for over six months).
(2) Joint Scans and Imaging Tests
Before moving on to the next step of diagnosis, your doctor may also order a series of images tests, especially those that will scan your joints for damage, inflammation, and deformity.
Though image scans may not conclusively diagnose RA, they can help your doctor tell your condition from other forms of arthritis. It can also help your doctor track the progress of the disease.
The most common image tests that can aid your physician in gauging the severity of the disease, and monitor the progress over time include:
MRI test – This test helps provide a clearer picture of the affected joints. An MRI scan isn’t usually used to confirm a diagnosis, but rather help with an early diagnosis
Ultrasound test – Like an MRI scan, an ultrasound test can help the doctor detect the condition early.
X-ray exam – An X-ray test will help show (if any) deformities, erosion, and damage in your joints.
However, if the joint damage is not visible via imaging tests, this doesn’t rule out rheumatoid arthritis. It could mean that the disease is in its early stages.
(3) Blood Tests
Once the physical examination and imaging tests are done, what follows is mostly like one or several blood tests. These blood tests are designed to either:
● Check for biomarkers associated with rheumatoid arthritis, such as antibodies (blood proteins created by the immune system), or
● Look for signs of inflammation and/or measure the levels of inflammation in your blood
Generally, if you show high inflammation levels and test positive for antibodies linked to RA, then it’s very likely that you have rheumatoid arthritis.
At imaware™, this is where we bring our A-game. Our at-home rheumatoid arthritis screening kit is an all-in-one blood testing solution backed by years of experience and solid science.
The best news is that you can save yourself a trip to the doctor’s office by taking these blood tests from the comfort of your own home. Thanks to cutting-edge technology, our kit is simple, painless, and easy to use, and makes it possible to screen for rheumatoid arthritis in under five minutes!
Note, however, that imaware test doesn’t actually diagnose you with a disease. However, imaware tests for specific biomarkers which tells you that you may have the disease!
With that being said, here are common blood tests for RA:
Antibody Blood Tests
As the name suggests, these are blood tests that screen for the presence of antibodies linked to rheumatoid arthritis. There are two key tests of this kind: anti-CCP and RF, but your doctor may request others.
(i) Rheumatoid factor (RF) test – This test screens for an antibody called rheumatoid factor, a blood protein that’s found in approximately 80 percent of patients with TA.
Even so, the rheumatoid factor can be present in other inflammatory conditions, so it’s not a sure-fire test for diagnosing RA. High levels of RF (usually higher than 2.2 u/mL) is a sign of having an autoimmune disease and not just rheumatoid arthritis.
(ii) Anti-CCP test – This is a more specific test that screens for anti-cyclic citrullinated peptide, an antibody that’s present primarily in people with rheumatoid arthritis. As such, if you get a positive anti-CCP result, your chances of having RA are substantial.
Nonetheless, anti-CCP antibodies are present in just 60-70 percent of patients with RA. That means a false negative can be read in the other 30 to 40 percent of people with the condition.
(iii) Antinuclear antibody test (ANA) – This may be requested as an initial test. This is a panel test that investigates your immune system to check if it’s putting out antibodies. A positive antinuclear antibody test is often a sign of a variety of autoimmune disorders, including rheumatoid arthritis.
Inflammation Blood Tests
These tests check for the presence of inflammation, as well as determine the inflammation levels. There are two major blood tests of this type:
(i) Erythrocyte sedimentation rate: Better known as ESR or sed rate, these tests measure the speed at which red blood cells clump and drop to the bottom of a testing tube in an hour.
In men under 50, a sed rate between 0 and 15 mm/hr is considered normal. In men older than 50, anything higher than 0-20 mm/hr is a sign of inflammation. For women under 50, the normal range is 0-20 mm/hr, while that for women older than 50 ranges from 0 to 30 mm/hr.
While a positive test is an indication of inflammation, an ESR doesn’t tell what caused the inflammation. A sed rate test isn’t enough to diagnose RA on its own, which is why it is often combined with an imaging test and an antibody test.
(ii) C-reactive protein test – this measures the level of C-reactive protein which is produced by your liver as a result of an inflammatory attack or in response to a serious infection. A high reading (usually higher than 1.0) is often linked to RA.
Complete Blood Count
A complete blood count (CBC) is often ordered to establish if you have anemia, which is common in people with rheumatoid arthritis.
It looks at five aspects of your blood, including hematocrit (total blood volume), white blood cells, red blood cells, hemoglobin, hematocrit, and platelets.
The bottom line is that none of these tests can singly confirm an RA diagnosis. However, when used in combination, they can help make an accurate diagnosis.
There’s no known cure for rheumatoid arthritis; however, there are numerous treatment options that can help you manage the condition better, and live a fuller and happier life.
As such, the aims of most RA treatments are:
● Prevent further damage to joints and harm to organs or parts of the body
● Stop inflammation and ultimately put RA in remission
● Relieve symptoms of rheumatoid arthritis, such as pain, swelling, redness, fatigue, and so forth.
● Improve overall health, well-being, and quality of life
● Reduce disability and other long-term complications
Medications for RA
There are several medications geared towards rheumatoid arthritis. Some of them help reduce inflammation, while others slow down or prevent joint damage. You may also find RA drugs that increase physical activity or reduce disability.
(i) Medications that relieve the symptoms
Corticosteroids, acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs) are the most available OTC (over-the-counter) meds for relieving symptoms such as inflammation and pain.
You may need a prescription for other NSAIDs. In most cases, these are taken orally, but they can also be applied transdermally. Here think of naproxen sodium, ketoprofen, and ibuprofen.
Your doctor may also prescribe steroids to ease joint stiffness, swelling, and pain.
(ii) Medications that reduce or slow down RA damage
Drugs shown below are commonly prescribed to help slow down or prevent damage caused by rheumatoid arthritis:
DMARDs: Short for disease-modifying antirheumatic drugs, DMARDs help “modify” the course of your condition. As such, these medications help stop or slow down rheumatoid. They work by blocking the response of your immune system, stopping RA right at the gate.
Methotrexate is the most commonly prescribed DMARD, but others like leflunomide, hydroxychloroquine, and sulfasalazine can also do the trick.
Biologics: They belong to the same group as DMARDs, but act faster. They can be administered via infusion or injection for even quicker action.
The special thing about biologics is that they tackle inflammation at a specific step, which means they don’t eliminate the entire immune system response.
Janus kinase (JAK) inhibitors: These are last-resort drugs that are usually prescribed when biologics and DMARDs don’t get the job done. They help block specific immune responses, meaning they are hyper-targeting.
In most patients with RA, JAK inhibitors can help stop joint damage and prevent inflammation.
Surgery is a corrective treatment option that is recommended if your joints are seriously damaged or the inflammation is unbearable.
In a lot of cases, your doctor may recommend the replacement of one or more of your affected joints. You can also have your knees and hips replaced, and even the shoulders.
Ideally, surgery should help improve mobility, reduce pain, and eliminate inflammation. A number of patients don’t get surgery until they are 50 or older.
Supportive Treatment Options
Your physician may recommend that you work with an occupational therapist and/or physiotherapist to help you deal with your RA symptoms. In some instances, you may have to see a cognitive therapist or podiatrist.
Occupational therapy: RA and its symptoms can impact your daily life, and seeing an occupational therapist can come in handy. Occupational therapy will help you train and learn how to protect your joints, both while at work, on the commute, and at home. Using supportive devices may also help you.
Podiatry: If your RA has affected your feet, ankles, or toes, podiatry may be what the doctor prescribed. You may be prescribed a device that will support your feet joints and relieve pain.
Physical therapy: when you have RA, it is important to stay on top for your muscle strength, fitness, joint flexibility, and overall well-being. A physical therapist can help you every step of the way.
Psychotherapy: RA can subject you to immense pain, discomfort, and emotional stress. A psychotherapist will help you improve your psychological and emotional well-being so you can pace yourself, relax, and better deal with stress.
When you’re experiencing intense joint pain, inflammation, and stiffness, exercise may not jump to your mind. However, it could be the answer to improving your flexibility, getting rid of pain, increasing mobility, and helping your joints regain their range of motion.
Low-impact workouts and exercises can also help you build muscle strength, and reduce the impact on your joints. Mindful exercises like yoga, shiatsu, and meditation can help you reinforce your mental and emotional strength.
You may also need to get in touch with a good dietician or nutritionist. No matter who you work with, you will need to embrace an anti-inflammatory diet.
Here are three pillars of an anti-inflammatory diet for someone with RA:
Omega-3 fatty acid-rich foods, including oily fish (mackerel, herring, tuna, river trout, and salmon), walnuts, flax seeds, and chia seeds.
Flavonoid-containing foods, such as grapes, green tea, broccoli, berries, and products made from soy.
Foods that contain antioxidants, including artichokes, pecans, kidney beans, spinach, and dark chocolate. They are loaded with selenium, as well as vitamins A, C, and E.
It’s also important to load up on fiber-rich foods. These include fresh veggies, fresh fruits, and whole-grain foods.
When to Call a Doctor
Pain, swelling, and stiffness in your joints can all be signs of rheumatoid arthritis. However, they can be symptoms of a whole range of conditions.
The only way to be sure is to get a conclusive diagnosis. Early diagnosis and treatment can make a huge difference.
That’s why you need to see your doctor right away if you suspect you have symptoms of rheumatoid arthritis, especially persistent pain and swelling in your joints.
Remember, diagnosing RA quickly is crucial because early treatment can help reduce the risk of further joint damage, deformity, and disability, as well as prevent symptoms from getting worse.