Rheumatoid Arthritis

What is rheumatoid arthritis?

RA is a common autoimmune disease affecting more than 1 million Americans that results in inflammatory arthritis. Although it generally tends to affect the hands and feet in a symmetrical pattern, it can affect any joint. The majority of patients who have RA are women, and although it can develop at any age, RA most commonly afflicts people in their 30s and 40s.

Rarely RA can also cause problems with the eyes, lungs, and skin. Symptoms of RA include:

• Joint pain
• Joint and systemic stiffness
• Joint Swelling
• Reduced mobility in the joints
• Joint deformity
• Chronic fatigue
• Low-grade fevers
• Loss of appetite
• Dry eyes and mouth
• Rheumatoid nodules
• Raynaud’s phenomenon

What causes rheumatoid arthritis?

Rheumatoid arthritis is an autoimmune disorder. Autoimmunity is a general term that refers to the condition when the body's immune system, which generally fights infections,  becomes overactive and for unknown reasons attacks normal tissues in the body. With autoimmune diseases, the immune system mistakenly attacks the body and, depending on which organ is affected, results in a unique set of symptoms.  

Autoimmune diseases include a wide range of conditions and are generally treated by rheumatologists.

How is rheumatoid arthritis diagnosed?

There are a number of blood tests and imaging modalities like X-rays, ultrasound, or MRI’s that can aid in the diagnosis of RA. Dr. Schwartzman uses a combination of physical examinations, blood tests to check for signs of inflammation, and X-rays, MRI and/or ultrasound to aid in establishing a diagnosis. One of the defining characteristics of RA is that the joint stiffness is typically worse in the mornings, and can last for several hours or longer but ultimately improves with use or exercise. 

How is rheumatoid arthritis treated?

Research into this condition over the last three decades has resulted in the development of specific medications, known as “biological agents and targeted synthetics,” that can successfully manage this illness, and in some patients, affect the destructive course of this illness. They work by blocking the abnormal chemical messages sent by the immune system that causes inflammation and damage to the different tissues in the joints.

Medication plays a key part in the successful treatment of RA. The sooner initiated the more effective the results, but finding the best therapies can be challenging, as every patient responds differently.

There are a number of oral medications and biologic medications that can successfully treat RA. These medications include:

• Non-steroidal anti-inflammatory agents
• TNF (tumor necrosis factor) inhibitors
• Rituximab
• Sarilumab
• Tocilizumab
• Tofacitinib
• Upadacitinib
• Baricitinib
• Abatacept
• Steroids

These treatment methods are effective in improving mobility and reducing pain. Frequently, they can result in remission or low disease activity. Many people who have RA can lead normal or close to normal lives.

How do I live with rheumatoid arthritis?

Medication is important, but other therapies are also vital to the successful management of RA. Learning to cope with a chronic pain condition can make a massive difference to the quality of life. This includes learning pain management strategies and understanding how pain works. Exercise, diet, physical and occupational therapy are also important therapeutic modalities. 

If you think you have RA or need expert help managing your condition, call Sergio Schwartzman, MD, today.