What is Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is one type of arthritis and it is a persistent inflammatory joint condition. RA is an autoimmune disease, which means the immune system misinterprets the joint linings for “foreign” objects, so it attacks and destroys them. This leads to inflammation and pain.
Around 1.3 million people in the U.S. live with rheumatoid arthritis (x). In fact, a 2017 report shows that between 2004 and 2014, the condition increased significantly in the U.S., affecting around 1.36 million people in 2014 (x). According to the Arthritis Foundation, women are 70 percent more likely to develop rheumatoid arthritis (x).
The most common symptom of rheumatoid arthritis is stiff joints, particularly after sitting down for a long time or upon waking up in the morning. Some individuals also often feel sick or fatigued and they may have a fever or loss of appetite.
Researchers have not discovered a specific cause for rheumatoid arthritis, but genes, hormones and environment can contribute. Treatment options include lifestyle changes, medication and surgery. These may stop or slow joint damage, as well as reduce swelling and pain.
Rheumatoid Arthritis vs. Osteoarthritis
Rheumatoid arthritis is different from osteoarthritis because it is an autoimmune disease, while osteoarthritis is progressive. RA develops from an overactive immune system that targets the joints and causes inflammation. The symptoms often appear quickly and worsen within a short amount of time. On the other hand, osteoarthritis is progressive, meaning it causes damage to the joints over time. It is caused by wear and tear on the joints and the symptoms usually only affect individual joints (x).
Symptoms of Rheumatoid Arthritis
RA symptoms can affect several different parts of the body and gradually wears away the bone. Although it may affect several different joints, they usually affect the hands (specifically the fingers and knuckles), wrists, shoulders, elbows, toes, knees, ankles and hips (x).
Joint Pain & Tenderness
Pain is an early defining symptom. It may affect any joint and usually it affects the body symmetrically. For example, the patient may notice pain in the joints of both feet, hands or wrists. The pain may be sharp, aching, shooting, tender or throbbing. Sometimes it may even feel like burning nerve pain. However, some patients may not feel pain specifically, but the joints may just feel tender to the touch. Bone and joint pain can be intermittent or constant, localized or widespread (x, x).
Swollen joints are also a common sign of rheumatoid arthritis, caused by inflammation. However, every patient is different and the amount of swelling may vary in different parts of the body. The swelling may make it more difficult for patients to perform everyday tasks like typing, cutting food or walking (x).
Redness & Warmth
In the initial stages, the patient may not notice any visible symptoms, such as redness or swelling. However, skin discoloration occurs when the inflammation widens the skin’s capillaries and they are more visible through the skin. It is usually more noticeable as the condition progresses, but subtle swelling or skin discoloration may also be an early sign. The joints may also feel warm to the touch, even if there is no visible redness (x, x).
Another common rheumatoid arthritis sign is stiffness. Specifically, patients feel stiff when the body is attacking the tissue in an active inflammatory state. The patient usually feels stiff for at least 30 minutes. Most patients feel stiff when they wake up, but the feeling may continue throughout the day. In other cases, the morning stiffness may ease throughout the day and then return at night (x).
There are also other progressive symptoms that may be a sign that the immune system is attacking the body. For example, patients may feel fatigue and loss of appetite. They may also have a slight fever (x).
Chronic conditions and psychological symptoms tend to coexist and rheumatoid arthritis isn’t an exception. Experts report that depression may be an early warning sign for rheumatoid arthritis. In fact, research suggests that depression is two to four times more common among people with rheumatoid arthritis than other people (x).
Another warning sign of rheumatoid arthritis is unexplained weight loss. Because the condition can cause a loss of appetite, patients may unintentionally lose weight. It can also cause diarrhea, nausea and vomiting, which can also lead to a decline in body weight. On the other hand, joint pain and stiffness can make it difficult to exercise, which may reduce muscle mass (x).
Complications from Rheumatoid Arthritis
This is a serious complication from rheumatoid arthritis. According to a study from the University of Pennsylvania, individuals with rheumatoid arthritis had substantial deficits in muscle density and muscle mass compared to subjects without it (x). In chronic cases and without treatment, RA can damage cartilage and bone, causing joint deformity (x). If patients notice a significant decrease in strength, it’s important to contact a physician.
Rheumatoid arthritis can also increase the risk for heart disease and diabetes. Similarly, patients with RA who are also obese have an increased risk for heart disease. It can also affect patient’s employment because it limits mobility (x).
Risk Factors for Rheumatoid Arthritis
Medical research has not identified a specific cause for rheumatoid arthritis. However, there are different risk factors that may play a role, both genetic and environmental.
Genetic Risk Factors
Researchers have identified a connection between RA and the human leukocyte antigen (HLA). Specifically, HLA is a collection of genes that experts associate with the condition. It does not cause RA, but it increases the likelihood. However, not everyone with the HLA genes has RA. There is only a connection between them (x).
Environmental Risk Factors
Environmental factors do not cause RA, but if a patient already has a genetic predisposition—such as HLA genes—they can increase the risk, such as second-hand smoke, air pollution, silica mineral, bacteria or viruses and exposure to chemicals and mineral oils (x).
Other risk factors include gender and age. Although the condition can affect anyone, it is more common in women than men. Researchers have noticed a connection between RA and biological changes, such as with contraception, pregnancy and breastfeeding. Rheumatoid arthritis also tends to affect patients between the ages of 40 and 60, but younger patients can experience it as well. Also, if an individual has a family history of RA, they may be more likely to develop it as well (x).
Treating Rheumatoid Arthritis
After a doctor makes a diagnosis, they can refer the patient to a specialist called a rheumatologist who will formulate a treatment plan. There is currently no cure for RA, but treatment aims to relieve pain and inflammation in the joints, prevent or slow down joint damage and minimize any dysfunction from pain, damage or deformity. Treatment options for rheumatoid arthritis may include medication, occupational therapy, surgery and lifestyle changes (x).
Some medications can help ease symptoms and slow down the disease’s progression. For example, non-steroidal anti-inflammatory drugs (NSAIDs) are available with or without a prescription in oral or topical forms. They help ease inflammation and pain. Corticosteroids are also powerful, fast-acting anti-inflammatory drugs that aim to slow progression. In addition, disease-modifying anti-rheumatic drugs (DMARDs) work to alter the course of rheumatoid arthritis (x).
Although medication may be effective, it cannot treat the pain and discomfort on its own. A doctor may also recommend physical therapy or exercise. With physical therapy, the patient can learn new, effective methods to perform daily tasks. This can ease stress on the joints. Low-risk exercises can also help reduce inflammation, even if exercise is painful (x).
Patients with rheumatoid arthritis typically do not need surgery, unless they have severe joint damage that limits mobility, daily function and independence. Joint replacement surgery may restore function and relieve pain. The procedure replaces parts of the damaged joints with prosthetics. Surgeons may also repair damaged tendons for improved mobility or realign the joints by fusing them together (x).
Rheumatoid arthritis affects many different components of everyday life, including work, social activities and leisure. Thankfully, there are many lifestyle changes to make that may help improve the quality of life in conjunction with other treatment methods (x).
Physicians recommend 30 minutes of physical activity per day, such as walking, swimming or biking. Because RA increases the risk of other chronic diseases, such as heart disease and diabetes, exercise can help lower it (x).
Keep a Healthy Weight
Obesity can cause complications for RA patients, potentially leading to high blood pressure and high cholesterol. It’s important to maintain a healthy body weight in order to stay healthy and better manage the symptoms (x).
Smoking makes RA even worse and it can also increase the risk of other diseases. It may also interfere with exercise and weight loss (x).
Supplements for Joint Pain and Arthritis
Supplements might help RA patients by reducing pain and inflammation in the joints. Although they do not cure the disease or completely eliminate the symptoms, patients can use supplements in conjunction with other forms of medical treatment. Consult a doctor before starting a supplement regimen. They are not an adequate medical treatment. Instead, they simply aim to improve overall health.
D-Glucosamine Sulfate Potassium
The body produces glucosamine naturally from the amino acids glutamine and glucose. It’s required to produce glycosaminoglycan, a molecule that helps repair and develop cartilage as well as other body tissues. Research claims that consuming glucosamine sulfate may raise glucosamine levels in the blood in order to repair or reverse joint damage. One study showed that glucosamine was as successful as acetaminophen in alleviating joint pain (x). However, the study did not clarify whether the supplement increased joint function on its own.
It is also available as a dietary supplement. Take 1,000 mg of D-glucosamine sulfate potassium powder one to three times daily, or according to a doctor’s directions. Pregnant or breastfeeding women should discuss intake with a doctor.
Boswellia serrata has anti-inflammatory effects that experts believe may help ease joint pain. In fact, one study shows that boswellia can help relieve pain, swelling and increase mobility in patients with osteoarthritis or arthritis. Some participants experienced a drastic decrease in joint pain, which means boswellia may be as effective as prescription medications in treating arthritis or osteoarthritis (x).
The recommended dosage for pure boswellia serrata extract powder is 450 mg once or twice daily with food, after consulting a physician.
Chondroitin sulfate helps support cartilage health. It also plays a role in preventing enzymes from damaging cartilage. A 2018 study even suggested that taking 800 mg of this supplement per day may be as effective in relieving joint pain as taking daily 200 mg doses of NSAIDs (x).
As a dietary supplement, take 750 to 1,500 mg of chondroitin sulfate powder per day, or based on a doctor’s directions.
Devil’s claw is a common treatment for skin diseases and it may contain anti-inflammatory properties. One study tested it on subjects with various rheumatic conditions and it appeared to significantly relieve pain in the subjects’ backs, knees, hips, shoulders, elbows, wrists and hands. In addition, most of the subjects in the study experienced an improved quality of life. In fact, 60 percent of the participants were able to reduce or stop using other pain medicines (x).
The recommended dosage for devil’s claw extract powder is 1,000 mg one to three times a day, unless a physician orders a different dosage.
The Bottom Line
Rheumatoid arthritis (RA) is a chronic, disabling and progressive autoimmune condition. It causes pain, swelling and inflammation in and around joints and other organs in the body. Unlike osteoarthritis, the symptoms can appear very suddenly and they may affect any joint in the body. Usually the pain is symmetrical and patients experience pain in joints on both sides of their bodies.
Common symptoms include pain, swelling, stiffness, muscle loss, mild fever and fatigue. Some people may experience depression and the condition also causes complications, such as an increased risk for heart disease and diabetes. Rheumatoid arthritis affects each patient differently.
There is no cure for rheumatoid arthritis, but treatments may help ease pain, reduce inflammation, slow down the disease’s progression and possibly prevent joint damage. Rheumatoid arthritis treatments include medications, occupational and physical therapy or surgery to prevent or repair damage to the joints. Physicians also recommend regular exercise to keep the joints strong and reduce inflammation. Supplements are also proven to help with bone strength and health. They may even help combat rheumatoid arthritis, in combination with other medical treatments.