Approximately 1.5 million people in the United States have rheumatoid arthritis (RA), including several patients whom I see regularly in my practice. Somewhat different from “regular” arthritis, rheumatoid arthritis is an autoimmune disease in which the body’s immune system, which normally attacks foreign agents like bacteria and viruses, mistakenly attacks the joints. This creates chronic inflammation that causes the tissue that lines the inside of joints to thicken, resulting in noticeable swelling and sometimes excruciating pain in and around the joints.

Although we don’t know exactly what causes rheumatoid arthritis, many experts feel that a person with RA could be genetically predisposed to react to a triggering event (such as an infection) that starts the chronic inflammation. If you’re worried that you might be susceptible to rheumatoid arthritis, this blog explains what might put you at risk, and also lists a number of treatment options you should know about.

How does rheumatoid arthritis affect your body?

If the chronic inflammation caused by rheumatoid arthritis goes unchecked, it can damage the body’s cartilage, the elastic tissue that covers the ends of bones in a joint, as well as the bones themselves. Over time, people with rheumatoid arthritis can actually lose cartilage. Their joints can then become loose, unstable, painful, lose their mobility and become deformed. This kind of joint damage cannot be reversed.

The joints most commonly affected by rheumatoid arthritis are in the hands, feet, wrists, elbows, knees and ankles. Unfortunately, if one knee or hand is affected, usually the other one is too. RA can also damage the skin, eyes, lungs, heart, blood and nerves. Because it can affect whole systems of the body, such as the cardiovascular or respiratory system, RA is called a systemic, or entire body, disease.

Who is most commonly affected by rheumatoid arthritis?

• Nearly three times as many women have the disease as men.
• In women, RA most commonly begins between ages 30 and 60.
• RA tends to improve with pregnancy but it may get worse after the baby is born.
• In men, RA tends to occur later in life.
• Having a family member with RA increases the odds of having RA. However, the majority of people with RA have no family history of the disease.

Symptoms to look out for that might indicate you’re developing RA

• Joint pain, tenderness, swelling or stiffness for six weeks or longer
• Morning stiffness for 30 minutes or longer
• More than one joint is affected
• Small joints (wrists, certain joints of the hands and feet) are affected
• The same joints on both sides of the body are affected
• Misshapen finger joints.
• Along with pain, many people experience fatigue, loss of appetite and a low-grade fever
• The knee joint becomes tender, warm and swollen. Although knee osteoarthritis causes pain and stiffness, joint pain from RA of the knee is more severe.

7 signs that you may be at high risk of developing rheumatoid arthritis

1. Three or more affected joints
2. High baseline level of systemic inflammation. Simple blood tests for erythrocyte sedimentation rate (ESR or “sed rate”) and/or C-reactive protein (CRP) measure body-wide inflammation.
3. Evidence of bone erosion on X-rays.
4. Immune system proteins in your blood, such as rheumatoid factor (RF) or anti-cyclic citrullinated peptides (anti-CCP) antibodies.
5. Difficulty climbing stairs, dressing and performing other activities of daily living.
6. Rheumatoid nodules (lumps of tissue) under the skin on the elbows and fingers.
7. One or more conditions related to RA. Having one or more of these arthritis-related conditions signals rheumatoid arthritis:

• vasculitis (blood vessel inflammation)
• Felty’s syndrome (enlarged spleen and very low white blood cell count)
• Sjögren’s syndrome (poor function of the glands that produce tears and saliva)

Recommended treatments for rheumatoid arthritis

For my patients with rheumatoid arthritis, I first evaluate the severity of their condition. Based on my findings, I then create a detailed treatment plan, including:

• Medications (some for pain and others to slow or stop the disease)
• Rest
• Exercise
• Splints and special arthritis aids to take pressure off of painful joints
• Managing stress
• Avoiding foods that trigger inflammation
• Eating foods that curb inflammation, such as omega-3 fatty acids found in fish and flax oil
• Regular medical checkups
• Physical therapy
• Surgery if joints are severely damaged, sometimes including joint replacement surgery

To learn more

An excellent resource for finding out more about rheumatoid arthritis, and arthritis in general, is The Arthritis Foundation.

Concerned that you’re at risk of developing rheumatoid arthritis? Come see us.

If you have rheumatoid arthritis or are worried that you may be developing it, and would like advice and guidance about managing this chronic disease, please make an appointment with Westchester Health, member of Northwell Health Physician Partners to see one of our rheumatologists. We’ll examine you, evaluate your condition and symptoms, and together, decide on the best course of treatment going forward. Whenever, wherever you need us, we’re here for you.

By Sharon Karp, MD, a Rheumatologist with Westchester Health, member of Northwell Health Physician Partners