What is Rheumatoid Arthritis?

Rheumatoid Arthritis, generally known as RA, is an autoimmune disease. This means it causes your immune system to malfunction and target healthy cells, causing severe inflammation and swelling in certain regions of the body. Rheumatoid arthritis most commonly impacts the joints of the knees, wrists, and hands.

Individuals with rheumatoid arthritis can sustain significant joint tissue damage — usually caused by the inflamed joint lining. The tissue damage can cause stability issues, chronic pain, and deformity. In severe cases, RA can also harm organs such as the eyes, lungs, and heart. [¹]

Types of Rheumatoid Arthritis

Scientists have divided rheumatoid arthritis into two subtypes: seronegative and seropositive. The type of RA you have is determined through a blood test, and you are diagnosed depending on the absence or presence of a protein or auto-antibody produced by the body, which attacks your healthy blood cells.

This protein is known as the Rheumatoid factor. The blood tests of patients with seropositive RA have incredibly high levels of anti-CCPs (anti-cyclic citrullinated peptides). In contrast, individuals with a seronegative test do not have the presence of RA in their bloodstream.

However, these individuals may still have RA. This is because medical health professionals don’t only rely on this test to offer a diagnosis. If your test result shows seronegative RA, your doctor may recommend getting other laboratory tests and X-rays and considering your clinical symptoms to make an accurate diagnosis. [²]

How is Rheumatoid Arthritis Diagnosed?

Since the beginning stages of Rheumatoid arthritis cause mild symptoms, diagnosing this disease in the early stages is difficult. Moreover, medical practitioners face even further challenges in diagnosing rheumatoid arthritis since its early stages may not appear in blood tests and X-rays.

If your doctor suspects you have Rheumatoid arthritis, they may conduct the following tests to rule out the disease [³]:

• Joint aspiration: A medical health professional will take a small fluid sample from your swollen joint during this test. This sample will then be sent to the lab for testing for signs of gout or infection.
• X-ray: An X-ray test utilizes electromagnetic waves to create clear images of the insides of your body. Doctors can get a clear picture of your bones, internal tissues, and organs through an X-ray.
• Blood tests: As discussed above, the doctor may run tests to find signs of rheumatoid arthritis. One major sign doctors are looking for is the presence of antibodies known as the rheumatoid factor.
• MRI (Magnetic resonance imaging): This test involves a medical imaging technique to create anatomy pictures. Doctors may be able to search for indications of RA and study your synovial membrane using an MRI to establish if you have RA or not. [⁴]
• Nodule biopsy: A medical health professional will examine a tissue sample from your body under a microscope for signs of abnormal cells or cancerous growth.

Rheumatoid Arthritis Staging

Scientists divide rheumatoid arthritis into four stages, including [⁵]:

• Stage 1: This is the early stage of RA, and its symptoms are minimal. People with stage 1 RA may experience modest swelling, stiffness, joint discomfort, and tenderness. Joint damage does not occur during this stage.
• Stage 2: When patients proceed to stage 2, their RA symptoms may worsen. This stage is also referred to as moderate RA. Synovial inflammation may develop at this stage, leading to joint cartilage degradation.
• Stage 3: Individuals with stage 3 RA have more severe symptoms, such as increased joint inflammation, swelling, and mobility issues. The inflammation at this phase can severely degrade cartilage and joint bones.
• Stage 4: This is the most severe stage of RA, which severely impacts an individual's ability to function and conduct day-to-day tasks. People with stage 4 RA may need mobility devices to perform everyday tasks and surgery to address joint damage.

Is Rheumatoid Arthritis Hereditary?

According to health experts, rheumatoid arthritis is a partially hereditary illness. Individuals with immediate family members having RA diagnoses are 2 to 5 times more susceptible to developing the disease. However, people that are most at risk of developing the condition are the ones that have specific genes associated with RA.

Moreover, individuals with risk factors like obesity or smoking are also suitable to develop the disease. For example, the findings of a study surrounding RA and its risks concluded that children with mothers with smoking habits had an almost double risk of developing the condition later on in their lives. [⁶]

Rheumatoid Arthritis Symptoms

People with rheumatoid arthritis may encounter a range of symptoms depending on the stage of the disease. Identifying RA symptoms and making an appointment with your medical health practitioner early on will help you get treatment before the symptoms worsen.

What Are the Symptoms of Rheumatoid Arthritis?

Individuals with RA may experience the following symptoms [⁷]:

• Joint tenderness, pain, stiffness, or swelling lasts over a month or more. Feeling stiffness right after waking up in the morning. This stiffness can last anywhere from half an hour to a few hours.
• Joint pain after inactivity.
• Discomfort in more than one joint (wrist, hands, or feet).
• Pain in similar joints on both sides of the body (both knees or both wrists).
• Sudden flare-ups accompanying severe inflammation of the joints last for several days and even months.
• Swelling and redness on the affected joints (Individuals in the beginning stages of RA may not experience redness).

What Are Some Signs of Rheumatoid Arthritis?

Detecting the early signs of RA can help you get treatment before the disease causes significant damage to your joints. Some early signs of RA include [8]:

• Joint warmth: RA can induce excessive joint inflammation, resulting in joint warmth. This is also common before symptoms such as swelling or redness develop. Joint warmth can also be a sign of several other illnesses like osteoarthritis or bursitis.
• Weight loss: RA symptoms, like fever and fatigue, can be severely draining for an individual. Therefore, a RA patient may lose weight due to weakness caused by other symptoms associated with the condition.
• Tingling and numbness: Numbness and tingling are common symptoms patients in the early stages of RA may experience. This is caused by inflammation in your joints, which causes nervous system compression and diminished sensation.
• A decline in the range of motion: In the beginning stages of RA, you may notice a drop in your ability to move your joints. For example, you may experience difficulty bending your knee back and forth. This usually occurs due to damage to the tendons and ligaments.
• Fatigue and low-grade fever: RA patients may feel unwell and slightly feverish due to the inflammation in their joints. This symptom is usually accompanied by fatigue — another early sign of RA.

It is not necessary for the symptoms and signs you are experiencing to be an indication of RA. The symptoms discussed above are also indicators of other diseases. Obtaining a health examination will help you establish whether the symptoms you are experiencing result from RA or if you are suffering from another ailment.

Symptoms of Rheumatoid Arthritis in Women vs. Symptoms of Rheumatoid Arthritis in Men

Although men and women experience comparable RA symptoms ranging from joint inflammation, pain, and swelling to tiredness and movement issues, RA symptoms tend to be more severe in women. This is evident in the outcomes of a 2015 research involving 70 women and 70 men.

The investigators aimed to evaluate the participants' disease severity, medical history, coping techniques, and disease and psychologically-related behaviors during the trial. They also used questionnaires to assess both groups' quality of life.

The research findings revealed that women with rheumatoid arthritis have greater rates of depression, pain, functional impairment, and anxiety than males. The women also experienced greater general and mental health impairments than men. [⁹]

Risk Factors for Rheumatoid Arthritis

Some traits raise a person's chances of having RA. Certain risk factors are inherent. These include genes, family history, age, and gender. Other risk factors, such as environmental variables, food, smoking, toxin exposure, or body weight, may be modifiable. However, it is important to note that individuals without these risk factors can also develop RA. [¹⁰]

Rheumatoid Arthritis Prevention

Following certain preventative measures may minimize your chances of developing rheumatoid arthritis. Some of these preventive measures include [¹¹]:

• Maintaining optimal oral hygiene.
• Consuming a healthy diet.
• Exercising regularly.
• Maintaining a healthy weight.
• Avoiding harmful habits like smoking.

Rheumatoid Arthritis Prognosis and Treatment

The prognosis of rheumatoid arthritis strongly depends on the disease's severity. If diagnosed early, the illness has a better outlook and management. However, disease management can become more difficult in the severe stages.

Rheumatoid Arthritis Survival Rate

Chronic pain, death, and disability are unpleasant consequences of untreated RA. Rheumatoid Arthritis can cause serious joint degeneration in over 80% of people within the first two years of the disease. If left untreated, the chance of death increases. Heart disease and infection are other significant causes of mortality in RA patients. [¹²]

Rheumatoid Arthritis Treatment Options

Some common treatment options for rheumatoid arthritis include:

• Medications: Your medical health professional may recommend NSAIDs, target synthetic DMARDs, steroids, and conventional DMARDs to help with symptom and disease management.
• Surgery: You may have to undergo a surgical procedure like total joint replacement, Synovectomy, tendon repair, or joint fusion to repair, prevent or slow down the disease's damage.
• Exercise and physical therapy: Your medical healthcare provider may refer you to a physiotherapist who can help exercise your joints and teach you exercises to strengthen your joints.

Note that a medical health professional may recommend more than one of these treatment options, depending on the severity of your disease. You may also have to experiment with several treatment options discussed above to find something that works for you. [¹³]

Conclusion

Takeaway

Rheumatoid arthritis can negatively influence a patient's overall quality of life and cause several unwanted symptoms. However, detecting RA symptoms early on and getting treatment can help you live a better life and effectively manage the disease.