Rheumatoid arthritis (RA) is an inflammatory disease most commonly impacting joints and connected tissues. While similar to other forms of arthritis, rheumatoid arthritis is distinguished in that it affects smaller joints including knuckles, hands, wrists, feet and ankles, while osteoarthritis is more pronounced in hips and knees.
RA is considered an autoimmune disease because the body's natural defenses turn against the connective joint tissues. The disease can strike at any age, but onset is frequently between 40 and 50. While men get RA, it affects women two to three times as often. A severe form of early onset RA that affects children is called juvenile rheumatoid arthritis. Families with histories of the disease should be checked for the presence of blood rheumatoid factor and the citrulline antibody. Joint stiffness that lasts more than one hour in the morning can be a sign of the disease; talking over symptoms with a doctor who understands a patient's complete medical history is the best way to decide if X-ray tests for rheumatoid nodules or other changes are necessary. Recent advancements suggest that joint fluid analysis, ultrasound and MRI tests can help identify RA.
Treatments for RA are similar as any other chronic pain condition, generally requiring lifelong therapy once identified. Physical therapy, diet, exercise and lifestyle changes are all promising treatments that do not require medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin, naproxen sodium, ibuprofen, acetaminophen and meloxicam are all effective treatments; however, long term use of these medications can cause ulcers and stomach bleeding. COX-2 inhibitors are a more recent advancement in NSAIDs, but should only be used in patients who do not have other risk factors for heart disease or stroke such as obesity or a history of smoking. Some research suggests that allergies to foods or inadequate absorption of certain minerals (particularly omega-3 fatty acids) could increase the inflammation.
Severely damaged joints can sometimes be corrected with surgery. Replacement of deteriorated joints is also an option for sufferers of RA.