Rheumatoid arthritis

Rheumatoid arthritis is an inflammatory disease, mainly affecting joints and tendons. An inflamed joint looks swollen and red, and appears warm to the touch. The disease usually starts in the wrists, hands or feet, and can spread to other joints and other parts of the body.

There is no cure for rheumatoid arthritis, but treatment to relieve the symptoms is effective.

What causes it?

It is not known why rheumatoid arthritis occurs. People of any age can develop it, but it is most common between the ages of 30 and 50 years, and among women. Certain genes may trigger the development of rheumatoid arthritis.

What happens?

Usually, inflammation is the body’s way of healing. In rheumatoid arthritis, however, the immune system starts to attack the body instead of defending it.

The inflammation affects:

• the thin synovial membrane that lines the joint capsule
• the tendon sheaths (tubes in which the tendons move)
• the bursae (sacs of fluid that allow the muscles and tendons to move smoothly over each other)

The joints and inflamed tissues then become stiff, painful and swollen.

How will it affect me?

Rheumatoid arthritis affects everyone differently and is, therefore, hard to diagnose. There may be times when your disease is active (a flare up) and other times when it is inactive.

However badly and however long you have rheumatoid arthritis, there are some common difficulties during a flare up:

• pain and loss of strength and movement in inflamed joints
• feeling generally unwell and tired
• stiffness can be bad, especially first thing in the morning, or after sitting still for a long time

Although you may feel frustrated at times, particularly during a flare up, most people should be able to carry on as normal, with some adjustments to their lifestyle.

How is it treated?

The main aim of treatment is to reduce the inflammation. A rheumatologist will monitor the effects of any medications on your body regularly. There are different kinds of drugs that will be used to treat your disease:

• disease modifying anti-rheumatic drugs (DMARDs) are given soon after diagnosis to slow down the disease process
• non-steroidal anti-inflammatory drugs may be given alongside DMARD to tackle the inflammation and pain
• anti-TNFs also fight inflammation
• steroids are used in case of severe inflammation
  

Joint replacement surgery will only be considered if the joint is very painful or if there is a risk that you will lose overall function.

What can you do?

There is plenty you can do to manage your own arthritis. This will become easier over time as you learn which tasks are difficult for you and to pace yourself.

Special equipment such as splints and gadgets can help make carrying out simple everyday tasks easier. Your doctor can refer you to an occupational therapist who will advise you on how to make the most efficient use of your joints without causing further damage.

A physiotherapist can help you prepare exercises to keep your muscles strong and retain a good range of movement in your joints.

The Arthritis Care self-management programme Challenging Arthritis is designed to teach you skills to live life to the full and to help you get the most out of your healthcare team. It allows you to meet other people with your condition.

The Arthritis Care Helpline is available to answer any specific questions you may have on all aspects of arthritis.