Rheumatoid Arthritis
What Is Rheumatoid Arthritis?
Rheumatoid arthritis is an autoimmune disease that can cause pain and stiffness in multiple joints. Rheumatoid arthritis is one type of inflammatory arthritis that most often starts in the small joints of the hands and feet and often will affect joints on both sides of the body—both hands or both feet.
The exact cause of rheumatoid arthritis is unknown, but it is not an inherited disease. Women are 2 to 3 times more likely to develop rheumatoid arthritis than men, and although symptoms usually develop between the ages of 30 and 60, children may also be affected. In children, the disease may appear similar, but it is caused by an autoimmune disorder and is now known as juvenile idiopathic arthritis (JIA).
Rheumatoid arthritis is the result of immune cells releasing substances that inflame the synovium, causing thickening and swelling. What causes the immune cells to behave this way is unknown, but doctors suspect a chemical or environmental trigger causing an incorrect immune system response. Instead of protecting the body, the immune system attacks healthy tissue. Infection and smoking are two likely triggers.
Symptoms of rheumatoid arthritis are different in different people and range from mild to severe. Many patients have chronic mild symptoms with occasional painful flare-ups of their symptoms.
The most common symptoms of rheumatoid arthritis are:
- Pain
- Fatigue
- Stiffness, especially morning stiffness, which may last hours
- Swelling in more than one joint; the joints can ache even at rest
Other rheumatoid arthritis symptoms include:
- A feeling of warmth around the joint
- Symptoms throughout the body, such as fever, loss of appetite, and decreased energy
- Weakness due to a low red blood cell count (anemia)
- Nodules, or lumps, especially around the elbow
- Deformities and contractures of the joint (with long-lasting disease)
- Foot pain, bunions, and hammer toes (with long-lasting disease)
If left untreated, over time rheumatoid arthritis causes joint damage that can result in serious disability.
While there is no cure, new medications can modify the course of the disease, frequently preventing the progression of joint damage, so early detection and treatment can help prevent joint destruction and other complications.
Nonsurgical Treatments
Many joint and musculoskeletal conditions can be effectively managed without surgery. Our doctors offer a range of nonsurgical treatments to help relieve pain, improve mobility, and protect long-term joint health.
Medications & Injections
- Non-steroidal anti-inflammatory drugs (NSAIDs) reduce pain and inflammation
- Corticosteroids such as prednisone are potent anti-inflammatories, which can be taken orally in pill form or injected directly into the affected area(s)
- Disease-modifying anti-rheumatic drugs (DMARDs) help slow the progression of rheumatoid arthritis by decreasing the body's overactive immune response. They reduce inflammation, joint damage, and other painful symptoms. DMARDs carry significant risk of side effects, including high blood pressure, liver damage, nausea, and an increased risk of serious infection.
Physical & Occupational Therapy
Physical therapy is an important part of any rheumatoid arthritis treatment program. Balanced exercise guided by a physical therapist and your doctor will help strengthen muscles around affected joints without stressing the joints.
Supportive & Assistive Devices
You may benefit from braces or splints to help reduce the stress on your joints and help prevent joint deformity.
Surgical Treatments
When nonsurgical options are no longer effective, surgery may offer lasting pain relief and improved function. The right surgical approach depends on your age, activity level, joint condition, and how far the condition has progressed. Depending on the extent of joint damage and your response to nonsurgical treatments, your doctor may recommend orthopedic surgery.
Synovectomy
Synovectomy is the removal of damaged synovial joint lining to reduce pain and swelling.
Tendon Surgery
Tendon surgery repairs ruptured tendons to restore function.
Joint Rebalancing
Joint rebalancing can be effective in early stages of rheumatoid arthritis as small joints may become loose and unbalanced, causing deformities and contractures. A surgeon may release tight structures or tighten loose joints to correct deformities and restore function.
Fusion
Fusion is a common surgery performed for rheumatoid arthritis. Fusing the bones that form a joint makes one bone that is no longer mobile. Fusions are mainly performed in the joints of the hand and foot because they can relieve symptoms while still allowing excellent function.
Joint Replacement Surgery
Joint replacement surgery is used for the larger joints required for mobility, such as the shoulder, hip, and knee. The damaged bone ends are removed and replaced by metal and plastic components. Joint replacement surgery can mean the difference between disability and an active life.