Rheumatoid arthritis (RA) is an autoimmune disease that mainly attacks the synovial tissues within the joints.
Autoimmune diseases occur when the body’s immune system mistakes its own tissues for foreign invaders, such as bacteria or viruses. The confused immune system develops antibodies to seek out and destroy the “invaders” in the synovium.
RAis a systemic disease, which means it can affect the whole body. It can attack organs, such as the heart, the lungs, or other tissues like muscles, cartilage, and ligaments. RA causes chronic swelling and pain that is sometimes severe, and it can cause permanent disability.
At the onset of RA, you might notice that small joints like your fingers and toes are warm, stiff, or swollen. These symptoms might come and go, and you may think it’s nothing. RA flare-ups can last just a few days or a few weeks before they disappear again.
Eventually, RA will affect larger joints, such as the hips, shoulders, and knees, and the period of remission will shorten. RA may damage joints within 3 to 6 months of onset.Sixty percentof people with inadequately treated RA are unable to work 10 years after onset.
Other symptoms associated with RA include:
- fatigue
- low-grade fevers
- pain and stiffness for longer than 30 minutes in
the morning or after sitting - anemia
- weight loss
- rheumatoid nodules, or firm lumps, beneath the
skin, primarily in the hands, elbows, or ankles
RA can be hard to diagnose because the types and severity of symptoms vary from person to person. They’re also similar to symptoms of other types of arthritis, which makes misdiagnosis possible.
The cause of RA is unknown, but a number of risk factors could contribute, that are:
- hereditary
- environmental
- lifestyle-related (for example, smoking)
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Women are about two to three times more likely to get RA than men. Hormones in both genders may play a role in either preventing or triggering it.
RA generally starts between the ages of 30 and 60 in women and somewhat later in life in men. The lifetime risk of developing RA for U.S. adults is
RA increases the risk of heart disease and stroke. It can also attack the pericardium, the lining of the heart, and cause inflammation throughout the body. According to a 2010 Swedish study, risk of heart attack is60 percent higherat 1 year following an RA diagnosis.
The damage RA can do is not limited to the joints. The disease also can affect your:
- heart
- lungs
- vascular system
- eyes
- skin
- blood
Infections may be responsible forone quarter of deathsin people with RA.
Although there is no cure for RA, there are many different treatment options designed to relieve symptoms and prevent long-term joint damage.
Doctors may prescribemedication, lifestyle changes, or a combination of both, with a goal of achieving a state of remission.
There are currently four different drug classes used to treat RA:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)are themildest class of medicationsand primarily work to reduce pain by reducing inflammation, but they do not affect the progression of RA.
- Corticosteroidsmore powerfully work to quickly decrease inflammation and are ideally for short-term use.
- Disease-modifying antirheumatic drugs (DMARDs)are considered the most standard RA treatment and work to slow down the progression of RA, but they may cause moderate to severe side effects.
- Biologic response modifiers (biologic DMARDs)are often used in combination with DMARDs, work tomodify immune systems that have trouble respondingto DMARDs.
A recent approach to treating RA suggests the use of aggressive treatment in the early stages of the onset of RA to prevent it from graduating to a more serious and long-lasting state.
Lifestyle changes
Living with RA can not only be physically taxing but also emotionally taxing as well.
It’s suggested for people with RA to find a balance between rest andexerciseto keep their inflammation down while continuing to maintain strength and flexibility.
Your doctor will generally recommend certain exercises beginning with stretching and then working up tostrength training, aerobic exercises, water therapy, and tai chi.
Experimenting withdietary changes, such as elimination diets, can help people with RA discover certain foods that may trigger or relieve RA symptoms.
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There are also many herbal remedies used for the treatment of RA, although the
Because many people living with RA often experience chronic pain, it can be very beneficial to learn stress management and relaxation techniques, such as guided meditation, mindfulness, breathing exercises, biofeedback, journaling, and other holistic coping modalities.
RA can make simple tasks like getting out of bed and getting dressed in the morning challenging, let alone holding down a regular job. People with RA are more likely to:
- change occupations
- 减少他们的工作时间
- lose their job
- retire early
- be unable to find a job (compared with people without RA)
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In addition to the financial costs of this disease, the quality-of-life cost is high. Compared with those who do not have arthritis, people with RA are more likely to:
- report fair or poor general health
- need help with personal care
- have health-related activity limitations
RA does not currently have a cure. However, many effective treatments have been developed over the last 30 years, that aim to lower inflammation and pain, prevent joint damage, and slow the progression and damage of the disease.