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Rheumatoid Arthritis: Symptoms, types, causes, stages, and treatments

Team AckoDec 12, 2024

If you have been facing pain, swelling, and tenderness in joints, then you may be affected by Rheumatoid Arthritis (starting stage). However, early diagnosis and timely treatment of related signs may slow down the progression of this disease. Though it is an incurable disease, it can be managed with medications and lifestyle changes. This article will help you understand more about Rheumatoid Arthritis and its common signs, causes, types, stages, complications, and treatments.

Rheumatoid

Contents

What is Rheumatoid Arthritis?
Rheumatoid Arthritis symptoms
Types of Rheumatoid Arthritis
Different stages of Rheumatoid Arthritis
Causes and risk factors of Rheumatoid Arthritis
Early Warning Signs of Rheumatoid Arthritis: How to Recognise RA Before it Strikes Hard
What Causes Rheumatoid Arthritis: Genetics, Lifestyle, and Environmental Factors
The Role of the Immune System in Rheumatoid Arthritis
Complications of RA
How is Rheumatoid Arthritis screened and diagnosed?
- Blood tests
- Imaging tests
Rheumatoid Arthritis treatment options
How to manage Rheumatoid Arthritis
Conclusion
Frequently asked questions

What is Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is a chronic autoimmune disorder in which the body's immune system attacks the synovium, the lining of the membranes surrounding the joints. This results in inflammation, which can cause pain, swelling, and stiffness, often in joints such as the hands, wrists, knees, and feet. If left untreated, the persistent inflammation can lead to joint deformities and loss of function.

Beyond the joints, RA can affect various organs, including the lungs, heart, skin, eyes, and mouth, potentially leading to complications such as lung disease, heart problems, or dry eyes and mouth, often referred to as "sicca syndrome." While the exact cause of RA remains unclear, it is thought to be influenced by a combination of genetic factors and environmental triggers, such as infections or smoking.

RA is different from osteoarthritis, another common type of arthritis, in that it is systemic, meaning it can affect multiple areas of the body, not just the joints. The condition can range from mild to severe and often causes periods of flare-ups followed by remissions.

Early diagnosis and treatment are crucial for managing RA and preventing long-term damage. Treatment often includes medications such as disease-modifying antirheumatic drugs (DMARDs), biologics, and steroids, which help reduce inflammation and prevent joint damage. Lifestyle modifications, including physical therapy and a balanced diet, can also help manage symptoms and improve quality of life.

Rheumatoid Arthritis symptoms

The main signs and symptoms of RA include the following.

Joint pain and swelling
Tenderness and stiffness in more than one joint that worsens in the morning or after inactivity
Weight loss
Fever
Fatigue and weakness
Loss of appetite
Sweating

Sometimes signs get worse (flares), and other times symptoms get better (remission). So, RA affects individuals differently and over time. Moreover, some people may develop fleshy lumps under the skin around affected joints.

Types of Rheumatoid Arthritis

RA is classified into three types — Seropositive RA, Seronegative RA, and Juvenile RA.

Seropositive RA

If your RF (rheumatoid factor) blood test result is positive, then you have this type of arthritis. Those with a family history of positive RF are prone to developing it.

Seronegative RA

If you have negative RF and negative anti-CCP results, then you have mild RA, which may eventually develop into Seropositive RA.

Juvenile RA

It is also called Juvenile Idiopathic Arthritis, which occurs in children below 17 years. The symptoms are similar to RA, but this type of arthritis can lead to issues with the individual's physical development.

Different stages of Rheumatoid Arthritis

The four stages of RA are as follows.

Stage 1: Synovitis

This is the early stage where you may feel joint pain, swelling, and stiffness. During this stage, bones do not get damaged, but the immune system starts attacking the tissue around the joint, which causes inflammation.

Stage 2: Pannus

In this moderate stage, the continued inflammation starts damaging the cartilage in the joints. Cartilage acts as cushiony stuff for the bones, without which joint pain may worsen.

Stage 3: Fibrous Ankylosis

This is the severe stage where the damage extends from cartilage to bones. As the cushion between bones is no more, you will experience muscle weakness. You will also face more pain, swelling, loss of motion, and your joints may begin to appear crooked.

Stage 4: Bony Ankylosis

In this end stage, you may experience pain, stiffness, and swelling, but your joints will stop working. You won't be able to bend or flex the affected area. It is the time when you would need joint replacement surgery.

Causes and risk factors of Rheumatoid Arthritis

RA is an autoimmune disease, and the exact causes of this condition are not known. But the following factors may increase the risks of developing this health issue.

Age: It affects people between the ages of 40 and 60.
Diet: High intake of red meat increases the odds of developing RA.
Obesity: If you are overweight (your body mass index is above 25), you may develop this condition.
Gender: It is more common among women.
Family history: Those who have a family member with this disease are at higher risk of developing RA.
Smoking: It is one of the common risk factors for RA.

Early Warning Signs of Rheumatoid Arthritis: How to Recognise RA Before it Strikes Hard

Affecting the joints, the chronic inflammatory illness rheumatoid arthritis (RA) causes inflammation, discomfort, and stiffness. Although many people do not show obvious symptoms right away, identifying the early warning signs of RA can significantly help to start treatment early and stop more deterioration of the joints.

In its early stages, RA may not present the obvious swelling or severe pain typically associated with arthritis. Instead, it could start with more subdued symptoms that would be easy to ignore or discount. Early identification of these symptoms will enable one to catch the illness before it causes permanent damage.

1. Unexplained Joint Pain and Tenderness

Joint discomfort is among the initial RA symptoms. Usually beginning in the little joints of the hands, wrists, or feet, it progresses. The suffering could feel more like discomfort or soreness than the extreme pain that follows later in the disease. Finding the precise reason for this discomfort could prove difficult, and you could believe it is only a sign of ageing or general aches. But this sensation can come and go and usually shows up on both sides of the body, which suggests something else could be going on.

2. Morning Stiffness

One common early indication of RA is waking up with stiffness in your joints lasting an hour or longer. Many RA sufferers discover that, particularly in the hands, wrists, and knees, their joints seem tight and challenging to move in the morning. This stiffness may be severe after periods of inactivity—such as napping or extended periods of sitting. Should this stiffness not improve rapidly or last throughout the day, it may be the first sign of RA.

3. Fatigue

Another common early sign of RA is unusual tiredness or lack of energy even after a decent night's sleep. Often described as overwhelming, this tiredness can make even daily chores challenging. Although many other diseases can cause tiredness, it becomes more suggestive of RA when combined with joint pain or stiffness.

4. Mild Swelling in the Joints

Early on in RA, you could see modest joint swelling—often without skin redness or heat. This swelling can be minor and only apparent when moving the impacted joints. Though it may also come and go, the swelling is usually accompanied by numbness or pain. In the hands or feet especially, this is rather obvious.

5. Low-Grade Fever

Another early-stage symptom some persons with RA report is a low-grade fever. The fever is usually moderate and may only last a brief period; hence, this might be challenging to identify. If you have a mild temperature along with other symptoms, it is advisable to see a doctor to rule out RA or other inflammatory diseases.

6. Loss of Appetite or Weight Loss

Sometimes, RA results in loss of appetite or even inadvertent weight loss. This occurs because the body's immune system works nonstop to combat what it incorrectly perceives as a threat, impairing regular digestion ability. Though only some people with RA will have this, it can be a significant early warning indicator.

7. Numbness or Tingling in the Hands or Feet

Some RA sufferers find numbness or a tingling sensation in their hands or feet as the condition advances. Often, this results from inflammation surrounding the nerves. Early indicators of nerve involvement can be numbness in the fingers or toes, tingling, or trouble holding objects.

What to Do if You Notice These Signs?

See a healthcare physician immediately if you exhibit these early warning signs. Early diagnosis and treatment can help control RA and significantly stop joint deterioration. To aid in diagnosis, your doctor might do a physical exam, gather a thorough history, and request imaging or blood tests. Sometimes, blood tests such as the rheumatoid factor (RF) or anti-CCP antibody tests help detect RA even before significant joint damage occurs.

What Causes Rheumatoid Arthritis: Genetics, Lifestyle, and Environmental Factors

The complicated autoimmune disorder known as rheumatoid arthritis (RA) causes inflammation and pain due to the body's immune system's misdirected attack of the joints. Although the precise aetiology of RA is yet unknown, it is thought that lifestyle decisions, environmental triggers, and genetic elements all help to shape RA.

Genetic Factors

You run more chances of getting RA yourself if someone in your family suffers from it. Although no one gene causes RA, studies have connected some genes—especially one termed HLA-DRB1—to the condition. Though it's not a certainty, possessing this gene might make you more likely to get RA. Many people with RA lack this gene; thus, genetics alone cannot explain everything. Instead, it depends on how your genes interact with other elements of your existence.

Environmental Triggers

Besides hereditary elements, environmental triggers are also important in RA development. Among the most often occurring causes is smoking. Studies reveal that smoking raises RA risk, particularly in those with the genetic markers described before. If you already have a hereditary tendency to RA, smoking can cause your immune system to kick in and start fighting your joints, therefore aggravating the disease progression. Among the limited lifestyle choices that directly impact your risk of developing RA, you can influence some.

Yet another possible environmental trigger is infections. A few viruses, including the Epstein-Barr virus, have been connected to the RA starting point. These infections may set off your immune system to respond in a way that causes joint inflammation and RA development. Though their exact mechanism is yet unknown, it is abundantly evident that viruses might contribute to the emergence of the disease.

Lifestyle Factors: Diet and Weight

Your whole way of life and diet also count. For instance, obesity raises a risk of RA development. Being overweight strains your joints more than others, and it also increases systemic inflammation, which could aggravate or start RA symptoms. If you already have RA, keeping a good weight helps control symptoms and lower the risk of complications associated with it.

Your diet is also crucial. While a diet rich in fruits, vegetables, and omega-3 fatty acids—found in foods like fish—may help lower inflammation and improve joint health, some studies indicate that a diet high in processed foods and red meat can raise the risk of RA.

The Role of the Immune System in Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an immune system illness rather than only a condition of the joints. Our immune system guards the body against dangerous intruders such as viruses and bacteria. Something goes wrong, though, in those with RA. Rather than focusing on external invaders, the immune system mistakenly targets the body's tissues, particularly the joints. This process generates inflammation, discomfort, and, over time, joint degeneration.

What Happens in RA?

Special cells called T-cells enable a healthy immune system to identify and combat illnesses. In RA, though, these T-cells become hyperactive and begin to target the synovium—the joint lining. People with RA thus typically suffer from joint pain, stiffness, and oedema since this causes inflammation and swelling in the joints.

Other immune system components join in while the system keeps attacking, aggravating the problem. One important participant in this process is autoantibodies, a collection of proteins. Customarily used to target foreign invaders, these antibodies damage healthy body tissue in RA. Though other antibodies like anti-CCP can also be implicated, rheumatoid factor (RF) is the most well-known of these autoantibodies in RA. Targeting the synovium, these antibodies cause further inflammation. The effect is a vicious cycle of joint injury and immunological activation.

Why Does the Immune System Turn Against Itself?

Although the exact cause of the immune system targeting healthy tissue in RA remains unknown, scientists think environmental elements and genes interact to play a part. Those with specific genetic markers are more likely to get RA; factors including infections, smoking, and even stress can aggravate or cause the immune system to malfunction.

The immune system's attack on the joints results in synovium inflammation; with time, the inflammation can also affect cartilage and bone. Deformities and loss of function in the impacted joints might follow from this damage, which can be permanent without therapy.

The Consequences of the Immune Attack

The continuous attack on the synovium causes the joints to swell and hurt. However, its effects are not confined to the joints alone. Joint abnormalities could be one of the significant effects of the inflammation. Severe forms of RA can even affect other organs in the body, causing heart disease, lung problems, and possibly vision problems.

Despite these challenges, managing the immune system's attack is possible. Modern treatments focus on lowering inflammation and inhibiting the immunological response, therefore shielding the joints from more harm. Targeting particular immune system components, medications such as biologics and disease-modifying anti-rheumatic drugs (DMARDs) help to reduce the hyperactive response.

Complications of RA

People with RA are at greater risk of developing other health conditions, which are as follows.

Infections
Lung diseases
Osteoporosis
Heart problems
Carpal tunnel syndrome
Dry eyes and mouth
Lymphoma

It can affect your blood vessels and may lower the count of red blood cells. If you have RA due to being overweight, you may develop diabetes, high blood pressure, and high cholesterol.

How is Rheumatoid Arthritis screened and diagnosed?

A diagnosis of RA is based on a combination of several factors, as there is no single test that can show if you have this condition or not. Your doctor will ask about your medical history and the issues you have been facing. A physical examination will also be conducted to see the location and symmetry of painful joints. Apart from these, your doctor will order certain tests to help confirm a diagnosis.

Blood tests

Full blood count to check the number of red blood cells
C-reactive protein (CRP) to see the level of inflammation
Cyclic citrulline antibody test (anti-CCP), which, if comes positive, confirms you have RA
Erythrocyte sedimentation rate (ESR) to determine the degree of inflammation in your body
Rheumatoid factor (RF) test to see the levels of a protein called rheumatoid factor

Imaging tests

X-rays
Ultrasound scans
Magnetic Resonance Imaging (MRI) scans

Rheumatoid Arthritis treatment options

There is no cure for RA; however, signs can be treated by medications which can further help slow down the disease. Drugs that are known to treat RA are as follows.

1. Non-steroidal anti-inflammatory drugs (NSAIDs)

These medications can help control signs like pain, stiffness, and swelling in the joints.

2. Disease-modifying antirheumatic drugs (DMARDs)

These drugs can slow the progression of the disease.

3. Corticosteroids

These meds are called steroids, and they are known to help with pain and inflammation.

How to manage Rheumatoid Arthritis

People with RA can consider the following lifestyle changes to improve the quality of their life.

Get physically active: Perform low-impact exercises like yoga, biking, swimming, walking, and stretching. This will help you maintain a healthy weight.
Showers and packs: Warm showers may reduce stiffness in the joints, whereas ice packs may help reduce pain and inflammation.
Quit smoking: Cigarette smoking not only worsens the condition but can even invite other health issues.

Apart from these, it is crucial to take enough rest, eat a diet high in vegetables, fruits, and whole grains, and maintain good oral health.

Conclusion

Rheumatoid arthritis (RA) is a chronic autoimmune condition that affects joints and can impact overall health if left untreated. Recognising symptoms like joint pain, stiffness, and swelling is crucial for early diagnosis and management. Understanding its types, causes, and stages helps tailor effective treatment plans, which may include medications, physical therapy, and lifestyle adjustments. Early intervention can slow disease progression, relieve symptoms, and improve quality of life. While there is no cure, adopting healthy habits and staying proactive with medical care can significantly manage RA and minimise its long-term effects on daily life.

Frequently asked questions

Following are some of the commonly asked questions regarding Rheumatoid Arthritis symptoms and their answers.

What aggravates rheumatoid arthritis?

Infections, stress, and poor sleep can trigger this condition.

Can RA affect more than just joints?

Yes, RA not only affects more joints, but it can also damage other body parts, including the eyes, lungs, skin, heart, and blood vessels.

Does Rheumatoid Arthritis hurt all day?

This disease causes pain and stiffness in the joints. So you may face difficulty in getting out of your bed in the morning.

Which body part is most often affected by Rheumatoid Arthritis?

Usually, it affects the hands, elbows, shoulders, feet, wrists, knees, and ankles. It can cause pain and bumps over small joints and can also deform the affected joints.

What is the difference between RA and osteoarthritis?

RA is an autoimmune disease in which the immune system attacks the lining of joints. Osteoarthritis leads to the wearing away of the cartilage in the joints.

Does Rheumatoid Arthritis affect your teeth?

Yes, you are prone to developing serious oral conditions such as periodontitis (gum infection that leads to tooth loss) and gingivitis (gum disease that causes inflamed gums).

Can Rheumatoid Arthritis be cured?

It is incurable but manageable. You can consume medications and bring about lifestyle changes to lead a better life.

References:

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet. As this content piece is not vetted by a medical professional, please consult a doctor before making any health-related decisions.

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