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Rheumatoid Arthritis: How To Identify The Symptoms And Seek Effective Treatment
Rheumatoid arthritis, also known as RA, affects an estimated 1.3 million people in the United States.
Beyond this staggering statistic lies a complex reality: each person's experience with RA is uniquely their own.
Symptoms of the disease can widely differ among patients, and they can sometimes be challenging to identify.
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Whether you are seeking information for yourself or a loved one, read on to learn more about the disease and how to better understand its signs and symptoms.
What is rheumatoid arthritis?Rheumatoid arthritis is an inflammatory autoimmune disease that causes the immune system to mistakenly attack its own healthy cells, according to Dr. Jason Liebowitz, assistant professor of medicine in the Division of Rheumatology at Columbia University.
The immune system is meant to fight invaders, such as outside bacteria and viruses. However, with RA, the immune system misidentifies the body's own cells for foreign entities and releases inflammatory chemicals to target them.
Signs of rheumatoid arthritis are visible indications such as joint swelling, redness and warmth, an assistant professor of medicine in the Division of Rheumatology at Columbia University told Fox News Digital. (BSIP/Universal Images Group via Getty Images)
This often causes painful swelling in the affected parts of the body. RA commonly impacts the hands, knees or ankles, but the disease can also cause problems in the eyes, heart, circulatory system or lungs, Liebowitz said.
RA has a tendency to be mistaken for a different, more common type of arthritis, and he said it's crucial to differentiate the two.
"People colloquially use the term rheumatoid arthritis, but they often mean osteoarthritis," Liebowitz told Fox News Digital.
"That's a very important distinction. The way you can try to separate that, is nowadays, most people with rheumatoid arthritis are seeing a rheumatologist, and they're on specific immunosuppressant medications."
In contrast, osteoarthritis is a degenerative joint disease caused by the breakdown of cartilage.
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RA can lead to joint deformity and disability if not managed effectively, whereas osteoarthritis may cause similar symptoms of joint stiffness and pain but generally does not lead to systemic complications.
What are the signs of rheumatoid arthritis?Signs of rheumatoid arthritis are visible indications such as joint swelling, redness and warmth, Liebowitz said.
RA causes the body's immune system to attack the body's own cells, leading to inflammation. This causes the production of excess fluid, which accumulates in the joint cavity and swells.
Inflammation results in increased blood flow to the area, causing the skin to appear red or flushed.
Rheumatoid arthritis typically affects small joints such as the wrists and those in the hands and feet. (American College of Rheumatology)
Joint warmth is also a sign of active inflammation. When the immune system attacks, it triggers an inflammatory response, leading to increased blood flow to that area.
This increased blood flow can cause the joint to feel warm to the touch.
What are the symptoms of rheumatoid arthritis?Symptoms that may act as indicators of RA are joint pain, tenderness, swelling or stiffness that lasts for six weeks or longer. Another indicator is feeling stiff for at least 30 minutes in the morning, Liebowitz said.
"Rheumatoid arthritis is when your immune system mistakenly attacks your own body," Liebowitz said. "It causes those symptoms: stiffness, pain, swelling, and it affects specific joints. The most common would be small joints in the hands, like the first and second row of knuckles, wrists, ankles and toes."
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The disease typically affects small joints such as the wrists and those in the hands and feet.
In addition, it often affects the same joints on both sides of the body. If someone with RA experiences pain and swelling in their right wrist, they are likely to feel similar symptoms in their left wrist as well. The symmetry is a common characteristic of the condition.
Many people with RA also experience fatigue or low grade fevers on a regular basis.
Is rheumatoid arthritis genetic?While genetics play a role in the development of rheumatoid arthritis, it is not necessarily caused by a genetic mutation, Liebowitz said.
"It's not genetic in that sense," Liebowitz told Fox News Digital. "It varies, but data shows that people with a first-degree relative, meaning a parent or sibling with rheumatoid arthritis, may have about a four times increased risk of developing rheumatoid arthritis themselves."
Although it increases susceptibility, having a genetic predisposition does not guarantee that someone will develop RA.
There is currently no definitive cure for rheumatoid arthritis. As a result, treatment strategies primarily focus on achieving remission. (BSIP/Universal Images Group via Getty Images)
People who have a family history of the disease but no symptoms or signs do not need to get tested, Liebowitz said.
How is rheumatoid arthritis diagnosed?A doctor with specialized training in treating rheumatoid arthritis, called a rheumatologist, is the best person to make a correct diagnosis using medical history, a physical exam and lab tests.
Rheumatologists are specialized physicians in internal medicine with experience treating various conditions affecting the joints, muscles and bones. This includes inflammatory and autoimmune diseases like RA.
During a physical exam, the doctor will look for joint tenderness, swelling, warmth, painful or limited movement, bumps under the skin or a low-grade fever.
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A rheumatologist would most likely conduct blood tests for inflammation and blood antibodies linked to RA, in addition to taking X-ray scans.
"There is testing that often involves lab work," Liebowitz told Fox News Digital.
"There are two antibodies. One is called rheumatoid factor, and another one called CCP. That's the type of testing that we would get, as well as two inflammatory markers. One is called ESR, and one is called CRP. Those are some of the basic tests that look specifically for rheumatoid arthritis. We also do X-rays frequently."
Liebowitz said other inflammatory diseases such as psoriatic arthritis and lupus can mimic RA, which is why it is essential to have a trained medical professional differentiate between them.
How is rheumatoid arthritis treated?There is currently no definitive cure for rheumatoid arthritis. As a result, treatment strategies primarily focus on achieving remission.
Liebowitz said he would advise someone who suspects that they might have RA, as well as those who have been diagnosed, to seek care with a rheumatologist.
"Different treatment options include a wide range of medications that have been around for several decades," Liebowitz said. "Starting in the 1980s and '90s, and then more recently, since the early 2000s, biologics have emerged, which are also used to treat rheumatoid arthritis."
An X-ray of a patient's hand is displayed at Perry Memorial Hospital on Sept. 1, 2017, in Princeton, Illinois. A rheumatologist would most likely take X-ray scans in addition to conducting blood tests for inflammation and blood antibodies linked to rheumatoid arthritis. (Daniel Acker/Bloomberg via Getty Images)
The first targeted biologic for RA, which is a drug that targets specific parts of the immune system to treat diseases, was approved by the U.S. Food and Drug Administration in 1998, according to the National Library of Medicine.
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Since then, several biologic medications have become commercially available, which have been designed to reduce the signs and symptoms of RA, Liebowitz told Fox News.
Scientists have maintained this momentum, continually working toward treatments and potential cures, fueled by a growing understanding of the disease's complexities.
With each breakthrough, there is renewed optimism for improved outcomes and a better quality of living for those with RA.
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RA: Exercises That Are Easy On Your Joints
Having rheumatoid arthritis doesn't give you a pass to escape working out. In fact, regular exercise can keep your joints and muscles strong. It can also improve your heart health. That'll make you better equipped to deal with complications that may crop up.
Other benefits of regular exercise include:
To ease joint stiffness and widen your range of motion, you need to stretch your muscles. Morning is a good time for gentle stretching or yoga. It's also a good idea any time before exercise.
Leg/hamstring stretch: While standing, lean forward as far as you comfortably can and reach toward your toes. Make sure you bend your knees a little to keep your legs soft. Hold it for 10-20 seconds.
Finger/wrist stretch: Bend your fingers forward, then backward, holding each stretch for 10–20 seconds each time. Then do the same with your hand to stretch your wrist muscles.
Cross-body arm stretch: Put your arm across the front of your body and gently hold it for 10-20 seconds, then switch to the other arm. Next, reach up to the sky with one arm and then the other, tilting each arm slightly over your head to stretch your shoulders.
Neck stretches: Drop your head forward gently, and then roll it slowly toward one shoulder and back toward the other.
Cobra: Lie face-down on the floor, keeping your toes pointed away from you. Press your palms into the floor and slowly raise your upper body. Keep your elbows close to your side.
Extended leg balance: While standing, put all your weight on one foot. Use a chair or table for support and slowly lift your leg and hold it with one leg on the outside of your knee. For an even better stretch, rotate your leg out to the side from that position and hold.
Seated spinal twist: Sit up tall in a chair and put your hand on the outside of the opposite thigh. Gently twist in the direction of your arm and hold. Then, switch to the other side.
RA can slowly take away muscle mass. So, it's important to work out your muscles to help them stay strong.
If you have swollen joints, you can do isometric exercises. They hold your muscles in one place. They also don't make you move your joints.
If your joints aren't swollen, isotonic exercises (movements that work against resistance, like weightlifting) are good for building up muscles.
Talk to your doctor before you start any kind of strength training.
Abdominal contractions: To do this isometric exercise, lie on your back and put your hands on your stomach muscles. Lift your head and hold it. You can continue this exercise by squeezing the muscles that lifted your head without actually picking it up, too.
Palm press: This is isometric, too. Hold your hands so they face each other. One hand should have fingertips up and the other should have fingertips down. Press your palms together and hold.
Bicep lifts: While you sit in a chair with your arms resting on your thighs palms up, hold light weights in your hands. Then, raise them toward your shoulders, bending at the elbow.
Seated knee lift: With a resistance band over your legs in a seated position, raise one leg slowly, then switch sides.
Your heart muscle needs a workout just like your biceps or quads do. Aerobic exercises raise your breathing and heart rates. Your best bets are exercises that get your blood pumping and are easy on your joints.
Walking: Daily walks are an easy way to get into the exercise groove. Start with slow and short strolls if you're new to regular exercise. Then work up to longer, faster walks as you get stronger. Be sure to stretch before you start and after you finish. Drink plenty of water, too.
Cycling: A stationary bike takes away your risk of a fall. Again, start slowly if you're a beginner, and go faster as you get better.
Swimming: Water workouts are great when you have RA. They take weight off your joints. They also raise your heart rate. Water also acts as resistance against your muscles. That can make you stronger.
You can swim laps or join a water aerobics class. Use water weights for some more muscle work.
Understanding Rheumatoid Arthritis Symptoms In Young Women
Rheumatoid arthritis (RA) is more than three times as common in women as in men — but it's still rare in younger women. Learn the symptoms and seek care early if you think you may have RA.
Rheumatoid arthritis (RA), an autoimmune disease that primarily affects your joints, is far more common in older women. But younger women can have it too. Around 5% of people ages 18–44 years have any type of arthritis, and most of those people are women.
Younger women with RA may have unique symptoms, associated conditions, and other considerations. Effective treatment options are available. Recognizing symptoms and seeking treatment early can help create a more positive outcome for young women with RA.
Read on for more information about the symptoms of RA in younger women, how RA affects younger women, and what you can do about it if you're a young woman with RA.
Younger people with RA, 75% of whom are women, may experience more severe symptoms earlier than older people with RA. These symptoms may include:
Research suggests that younger people with RA are more likely to receive vigorous treatment. They are likely to begin this treatment earlier, have better outcomes, and receive prescriptions for disease-modifying antirheumatic drugs such as:
These treatments are designed to help protect your joints.
RA doesn't generally limit your ability to become pregnant, but it's important to plan for your pregnancy if possible. If you have RA, you may want to use birth control until you choose to become pregnant.
Some medications can affect your developing baby. For example, methotrexate, a medication commonly used to treat RA, can cause injury to a developing baby's head, face, arms, legs, and bones.
Your rheumatologist can help you prepare for pregnancy and manage your medications and treatment during pregnancy.
RA is often thought to be related to old age, but according to the Arthritis Foundation, the onset of RA happens between the ages of 30 and 60 years, on average. Children can get RA too. When people less than 18 years old develop RA, it's called juvenile RA.
Women tend to receive a diagnosis slightly earlier than men, potentially due to hormonal changes that occur in their mid-30s and again after their mid-40s.
In severe cases of RA, persistent inflammation may affect other areas of your body, such as your eyes, lungs, heart, and blood vessels.
Long-term inflammation may cause:
Not only do more women than men get RA, but women also tend to experience symptoms at a younger age, which may be more severe.
The reproductive hormones estrogen and progesterone seem to have a potential protective effect against symptoms of RA.
The levels of various hormones in your body change throughout your lifetime. Factors that can affect these levels include:
Hormones used in in vitro fertilization (IVF) treatment could also be a trigger.
In a study from 2008, a small group of middle-aged women with RA reported fewer joint symptoms after ovulation in their menstrual cycles and during pregnancy. Levels of estrogen and progesterone are higher during these time periods.
Research suggests that the effect of sex hormones combined with environmental and genetic factors could explain the higher prevalence of RA in women.
Researchers continue to seek more answers.
RA is a chronic condition, and there is no cure. But for some people, remission is possible with medication.
Since younger people may receive more intensive treatment, they may have better outcomes than older people. Effective treatment may protect your joints and delay or prevent joint damage.
The exact outlook is difficult to predict since RA may put you at risk for other conditions, including:
RA is not common in younger women. According to the Centers for Disease Control and Prevention (CDC), adults ages 18–44 have the lowest rate of RA: 5.4%. However, women are nearly three times more likely than men to have RA.
Is it common to get rheumatoid arthritis in your 20s?No, it's not. Only 5.4% of people with arthritis are within the age range of 18–44 years, and people in their 20s are only a part of that age group.
What were your first signs of rheumatoid arthritis?Early symptoms of RA include:
RA in women is not uncommon, and an increased prevalence seems to be linked to hormonal, genetic, and environmental factors. But medical experts' understanding of the disease continues to evolve.
Other sex-related factors, such as pain severity and lag time in diagnosis in women, are also being researched.
If you're experiencing any symptoms of RA, especially if you're a woman, talk with your doctor.
They may refer you to a rheumatologist, a doctor who specializes in diseases that affect the joints and connective tissues, as well as a range of autoimmune diseases.
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