What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is a condition in which the body's own immune system attacks the joints. This causes swollen, stiff, and painful (inflamed) joints, especially in the hands and feet.

Over time, RA can damage and deform joints. It makes it hard to open jars, write, and do other daily tasks. Sometimes it can also cause bumps to form under the skin.

Rheumatoid arthritis is more common in women than in men. It often starts between the ages of 40 and 60.

Symptoms of RA often develop slowly over weeks or months. Fatigue and stiffness are usually early symptoms.

Joint symptoms include:

• Pain, stiffness, and swelling in the joints of the hands, wrists, elbows, feet, ankles, knees, or neck. The disease usually affects both sides of the body at the same time.
• Morning stiffness. Joint stiffness may develop after long periods of sleeping or sitting. It usually lasts at least 1 hour and often up to several hours.
• Bumps (nodules). Rheumatoid nodules ranging in size from a pea to a mothball form in nearly one-third of people who have RA. Nodules usually form over pressure points in the body such as the elbows, knuckles, spine, and lower leg bones.

Rheumatoid arthritis can also cause symptoms throughout the body (systemic). These include:

• Fatigue.
• A loss of appetite.
• Weight loss.
• Mild fever.

No single lab test can diagnose RA. The doctor will ask you questions about your health and look at your joints for signs of swelling or tenderness. The pattern and nature of joint symptoms are the most important clues to the diagnosis. Your doctor will then rule out other diseases that can cause similar symptoms.

Diagnosis is based on a set of classification criteria. The criteria include the results of these blood tests:

• Anti-cyclic citrullinated peptide antibody (ACPA or anti-CCP) test. It helps confirm the diagnosis and may show your risk of having severe symptoms.
• C-reactive protein. This test may help show how the disease is affecting you.
• Erythrocyte sedimentation rate. It may also help show how the disease is affecting you.
• Rheumatoid factor. This blood test measures the amount of the RF antibody in the blood.

RA is most often treated with medicine. Some medicines help to control the symptoms. Other medicines, especially when used early, can help to prevent the disease from getting worse.

Many of the medicines used to treat rheumatoid arthritis have side effects. Have regular checkups. And talk with your doctor about any problems. This will help your doctor find a treatment that works for you.

Physical therapy and finding the best balance between rest and activity can also help your symptoms.

If your treatment doesn't help, surgery may be an option. The type of surgery you can have depends on which joints are causing problems. Sometimes surgery to replace a joint (such as a hip or knee) is an option. Other types of surgery can remove debris or inflamed tissue from a joint, or relieve pressure on nerves.

Living with RA often means making changes to your lifestyle. You can do things at home, such as staying active and taking medicines, to help relieve your symptoms and prevent the disease from getting worse.

Here are some ways that you can care for yourself:

• Rest as you need to. Build rest periods into your day.
• Protect your joints. Use assistive devices and wear shoes that fit well.
• Stay active. Swimming is a good activity if you have joint problems in your knees, ankles, or feet. Bicycling and walking are good activities if your joint problems are not in your legs or feet.
• Don't smoke.
• Eat healthy foods. Be sure to get enough calcium and vitamin D to protect your bones against osteoporosis. And try to stay at a healthy weight.