ARTHRITIS, RHEUMATOID

BAsic information

description

A chronic, inflammatory disease that mainly affects the joints. It often begins between ages 25 and 50, and is more common in women.

frequent signs and symptoms

• Redness, pain, warmth, and tenderness in the affected joints. They may be in the hands and wrists (most often), elbows, shoulders, feet, and ankles.
• Morning stiffness.
• Muscle aches, weakness, fever, weight loss.
• Feeling generally unwell.
• Nodules (bumps) under the skin (sometimes).

causes

Unknown. It is probably caused by an autoimmune disorder in which the body's immune system attacks its own normal tissues. Infection may also be a factor.

risk increases with

• Family history of rheumatoid arthritis or other autoimmune disorders.
• Genetic factors.
• Women.
• Native Americans (prevalence is higher in this group).

preventive measures

No specific preventive measures.

expected outcomes

The outcome varies. The disease course may be short and limited, or progressive and severe. It is presently incurable. Pain relief, prevention of disability, and an active, normal life span are often possible.

POSsible complications

• About 5% to 10% of patients are eventually disabled.
• Drugs used in treatment can cause adverse affects.
• Heart, lung, blood vessel, or eye problems.
• Anemia.

diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about the symptoms. No one test is available to diagnose arthritis. Medical tests may include blood and joint fluid studies. CT, MRI, or x-rays of the involved joints are usually done.
• Treatment involves steps to relieve symptoms, to preserve joint function, to prevent complications, and help the person live as normal a life as possible.
• Treatment steps include drug therapy, physical therapy, occupational therapy, surgery, and lifestyle changes. A treatment plan is based on your special needs.
• Be sure to educate yourself about the disorder.
• Occupational therapy helps with activities of daily life
• Help the morning stiffness with a warm bath or shower, doing range-of-motion exercises, or a heating pad or cold pack (if it feels better).
• Options for treatment (to help symptoms such as pain) include relaxation techniques, counseling, meditation, stress reduction, biofeedback, and support groups. Flare-ups may be triggered by emotional stress.
• Surgery may be recommended for joint problems. It may involve joint replacement, tendon reconstruction, joint realignment, or removing inflamed tissue.
• To learn more: Arthritis Foundation, P.O. Box 7669, Atlanta, GA 30357; (800) 283-7800; website: www.arthritis.org.

medications

• Nonsteroidal anti-inflammatory drugs, including aspirin and others, will be prescribed.
• Disease-modifying drugs and biologic response modifiers are two classes of drugs that are often prescribed.

activity

• Physical therapy will help maintain strength and joint mobility. Follow instructions for home exercising.
• Exercising in a heated pool is good for stiff joints.
• Activity options include low impact aerobics, flexibility exercises, yoga, tai chi, or hydrotherapy.
• Mobility aids and splints may be recommended.

diet

Eat a normal, well-balanced diet. Avoid arthritis diet fads, which are common. Lose weight if you are overweight. Being overweight stresses the joints.

notify our office if

• You or a family member has symptoms of rheumatoid arthritis.
• The following occur during treatment:

Symptoms appear in different joints or other symptoms get worse.

New, unexplained symptoms develop. Drugs in treatment may produce side effects.