Causes of rheumatoid arthritisRheumatoid arthritis is an autoimmune disease in which the body's defence mechanisms go into action when there's no threat. In this case, the immune system attacks the joints and sometimes other parts of the body. It's not yet known why the immune system acts in this way in some people.
Rheumatoid arthritis is a common disease affecting about one in 100 people. People of all ages have the condition, but it most commonly starts between the ages of 30 and 50. Three times as many women are affected as men.
Symptoms of rheumatoid arthritisThe joints become inflamed, particularly:
The synovial membrane
The tendon sheaths
The bags of fluid that allow muscles and tendons to move smoothly over one another (bursae)
Inflammation sometimes becomes far worse - known as a 'flare-up' - when the joints become warm and red as blood flow to the area increases. The synovial membrane produces extra fluid, causing swelling and a stretching of the ligaments around the joint. The result is a stiff, swollen and painful joint.
In one in five cases, rheumatoid arthritis develops very rapidly but more often the symptoms develop over several months. For about one in 20 people with the disease the cycles of inflammation cause severe damage in many joints, but others have little or no damage. Treating inflammation as quickly as possible is vital because once joint damage has occurred it can't be reversed.
In a few cases, symptoms typical of rheumatoid arthritis come and go. These patients may have a different, but probably related, condition called palindromic rheumatism, which may be mistaken for rheumatoid arthritis. (There may also be other symptoms, such as certain skin rashes, which are not seen in rheumatoid arthritis.) Most importantly, the damage to bones or joints that occurs in rheumatoid arthritis is not seen in this condition. However, over time, as many as 50 per cent of patients will go on to develop rheumatoid arthritis.
Most people get fluctuating pain and stiffness that gets worse during flare-ups. Whereas in osteoarthritis morning stiffness wears off quickly, in rheumatoid and other forms of inflammatory arthritis it usually lasts more than 45 minutes. Many people find that the condition gives them flu-like symptoms and makes them tired, irritable or depressed.
What are the symptoms?In rheumatoid arthritis the affected joints are stiff (particularly in the morning), painful, tender and swollen. Usually more than one joint is affected, in a symmetrical distribution.
Rheumatoid arthritis can affect any joint, but the most commonly affected are those of the wrist, hands and fingers, toes, ankles and knees. The elbows and shoulders are often affected too.
Joint damage causes deformities to develop, which means many people also suffer disability, embarrassment and depression.
Weight loss, fatigue and anaemia may also be experienced.
Who's affected?About one in 100 people has rheumatoid arthritis, with women affected two to three times more often than men. It can occur at any age but commonly affects women between the ages of 20 and 50.
Some people are genetically susceptible to rheumatoid arthritis. In these cases stress, infection or trauma may trigger its development.
What's the treatment?It isn't possible to prevent rheumatoid arthritis or to cure it, but painkillers and anti-inflammatory medication can be used to relieve the symptoms.
Disease-modifying drugs are also used, including penicillamine and TNF (tumour necrosis factor) blockers, as is gold. Using these early can help slow the progress of rheumatoid arthritis. Sometimes steroids will be recommended.
Joint replacement is often needed. Physiotherapy, home aids and emotional and financial support are also important.
You can also treat your rheumatism yourself using the following techniques:
Local heat, using heat lamps, heated pads and hot water bottles
Wearing extra clothes when outdoors to avoid the cold
Taking warm baths
Local massage - but go slowly on particularly tender joints
Applying anti-inflammatory creams
Following a balanced diet, including supplements such as zinc and plenty of water
