What is Rheumatoid Arthritis?

If you are on this website, you either have Rheumatoid Arthritis, think you may have Rheumatoid Arthritis, or someone close to you does.  So lets cover the basics.

Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints.  It usually affects the small joints (hands and feet) but any joint in the body can be affected.  The disease is usually symmetrical, (that is, if your right wrist is inflamed, your left wrist will be also) but this is not always the case.  Joints may appear red, hot and swollen, or they may be no visible signs at all.  Rheumatoid arthritis affects the synovium, or the fluid lining the joints.  This fluid becomes inflamed, and can cause severe pain.  The tissue surrounding the joints can also become inflamed, including the tendons, ligaments and muscles.

The severity of Rheumatoid Arthritis varies considerably.  Some people have mild disease, experiencing pain in their hands and feet from time to time.  This tends to be the public perception of RA.  This perception is very wrong, however, when it comes to people with moderate to severe disease.

For those with moderate to severe disease, the disease is devastating.  While inflammation of the tissue around the joints is characteristic of rheumatoid arthritis, the disease can also cause inflammation and injury in other organs in the body.  The heart, kidneys, the lungs, the eyes…all of these can become inflamed and damaged from the effects of RA.  Because it affects multiple organs, RA is referred to as a systemic illness, and is sometimes called Rheumatoid Disease.

People with severe disease often suffer irreversible damage to their joints, although studies have shown that the level of pain and stiffness a patient experiences doesn’t necessarily correlate to the amount of  damage visible on scans.  So a patient may have little damage, but intense pain.  Or a lot of damage, and not very much pain.

Pain is generally the limiting feature, and many people with moderate to severe RA are unable to work within five years of onset.  People with RA also experience severe fatigue, particularly during disease flares.  Some people are in a permanent state of flare, meaning that they are always in pain.

Around 30% of people do not respond to current treatments and must learn to live with crippling pain.

RA is a chronic disease, and there is no cure.  The condition can be managed to varying degrees with medication and lifestyle changes, but only the mildest cases continue to have a ‘normal’ life. People with moderate to severe RA experience considerable pain and disability, often made worse by the fact that the disease is often completely invisible.  And because many people claim to have arthritis, or call any ache or pain in their body ‘arthritis’ the disease is often not taken seriously.

Without a rheumatologists diagnosis (read the diagnostic criteria here), it is extremely ignorant and insensitive to claim to have rheumatoid arthritis, when so many people’s lives are completely altered and devastated by what is a very serious and painful disease.

Some people have periods of remission, where they are symptom free.  This is the aim of RA treatments, but many people never achieve this.  The public perception is that taking an advil or nurofen is all that’s necessary to relieve the pain, when in fact most people with active RA take low dose chemotherapy and biological drugs that have severe side effects, and only a moderate  success rate.

About 1 in a 100 people are affected by Rheumatoid Arthritis.  Women are two to three times more likely to get RA, and it affects all races equally.  It can begin at any age, even children suffer.  It most commonly hits around 35-55 years of age.  In some families, many members are affected, suggesting a genetic component to the disease, however others develop RA ‘out of the blue’ with no family history.

If you think you may have Rheumatoid Arthritis, the first step is to see your primary care physician, or general practioner and get a referal to a Rheumatologist.  Early diagnosis is key to preventing damage and provides the best treatment outcomes.