About rheumatoid arthritis
Rheumatoid arthritis (RA) occurs when the body’s immune system mistakenly attacks healthy tissue. This affects the lining along the small joints in the body and causes pain in different body parts.
While the hands and feet are commonly impacted, larger joints such as the elbows and knees may also be affected. RA can produce a variety of other symptoms, including joint stiffness and difficulty breathing. Read on to see what people who have RA say about living with this condition.
What does RA feel like?
Pain in the joints
RA usually appears gradually, affecting small joints first and then spreading to larger joints. In most cases, the pain occurs on both sides of the body. Symmetric pain in multiple joints is what makes RA different from other types of arthritis. For example, you will feel pain in both left and right wrists, hands, and knees.
If you have RA, joint pain can range from mild to moderate or severe. Sometimes it can feel like a sprain or broken bone. Some areas of your body may even be painful to the touch.
Stiffness in the joints
In addition to pain, this disease causes stiffness in the affected joints. You may have difficulty getting out of bed or walking in the morning because of stiff and painful ankles, knees, or feet. This stiffness is usually worse in the mornings and can last for 45 minutes or more.
RA can also trigger swelling in the affected joints. Long-term inflammation can make you physically exhausted.
RA can cause low energy, especially when the pain gets in the way of sleeping. Even when you do get enough sleep, you may still feel tired, or fatigued. About 98 percent of people with RA say they feel fatigue. This number can increase if you have other conditions, such as obesity, depression, and headaches. You may feel tired or unwell earlier in the day.
Joint pain is the most common symptom of RA, but it’s not the only one. RA can also affect your lungs. This is because long-term inflammation can cause scarring in your lungs, which causes shortness of breath and a chronic dry cough.
Some people with RA develop lung nodules, or a spot on the lung, due to inflammation. These nodules are often benign. They can range in size from as small as a pea to as large as a walnut. Generally they don’t cause pain.
If RA affects your skin, you may develop nodules or lumps of tissue underneath the skin. You may also develop a rash due to inflammation around or in the blood vessels. If you have eye problems because of rheumatoid arthritis, eye inflammation causes pain, redness, light sensitivity, dry eyes, and blurry vision.
Complications and outlook for RA
Long-term inflammation can also affect other organs. Nearly 40 percent of people with RA also experience symptoms in other parts of the body, according to the Mayo Clinic. These parts include the:
- nervous system
RA can increase your risk for other diseases or complications. These may cause other symptoms that appear unrelated to RA, such as hearing loss or irregular heartbeats.
RA is a chronic condition that, if left untreated, could possibly result in deformed and knotted-looking joints. Small lumps, known as rheumatoid nodules, can develop under the skin at pressure points or other areas like the back of the scalp. RA also increases the risk of other conditions, such as:
- lung disease
- heart problems
- peripheral neuropathy
Although RA affects people differently, the outlook is generally good — as long as you seek treatment. Treatment may not alleviate 100 percent of swelling and flare-ups, but it can reduce the severity of symptoms and help you enjoy periods of remission.
Treatment for RA
There’s currently no cure for RA, but many treatments can help control symptoms, limit joint damage, and facilitate a clinical remission. The earlier your doctor diagnoses for RA, the more effective your treatment is. Current treatments help most people with RA continue a healthy, active, and functioning lifestyle.
In cases of mild RA, over-the-counter (OTC) pain relievers such as ibuprofen may provide relief. Your doctor will likely prescribe disease-modifying antirheumatic drugs (DMARDs) to prevent disease progression. DMARDs can help reduce swelling, pain, and fever. For more severe inflammation and pain, you may need biologic response modifiers. These medications target specific parts of the immune system and help inflammation and prevent joint and tissue damage.
Your doctor may recommend surgery if medication doesn’t help. During the surgical procedures, your doctor can remove inflamed lining of joints or repair tendon damage. Joint fusion helps stabilize damaged joints and relieve pain. In some cases, your doctor may recommend total joint replacement and replace damaged joints with a prosthetic.
Research shows that exercises that incorporate flexibility and strengthening can help relieve pain and improve daily functioning. Moderate exercises like walking, swimming, and yoga can help strengthen your joints. Aim for 30 minutes of physical activity at least three times a week.
Occupational and physical therapists can help you learn exercises to maintain flexibility in your joints and provide strategies to make daily tasks easier and protect your joints.
Alternative therapies don’t aim to cure RA but instead aim to relieve symptoms of pain, fatigue, and more. For example, fish oil supplements can help reduce inflammation. Adding other supplements may also benefit. These supplements include:
- black currant oil
- borage oil
- cat’s claw
A lot of research has gone into herbs and supplements for RA, but talk to your doctor before taking any of them. They may interact with medications you are already taking and cause unintended side effects.
When to see a doctor
Call your doctor if you have discomfort or swelling in your joints. Your doctor will examine you for RA and look for signs of stiffness, swelling, tenderness, pain, or even infection.
There’s no single test that determines whether you have RA. Your doctor may run several tests to help confirm an RA diagnosis. These tests include:
- taking your blood to check for specific antibodies, called rheumatoid factor or CCP (cyclic citrullinated peptide)
- taking samples of synovial fluid to look for inflammation or infection
- looking for inflammation (elevated erythrocytes sedimentation rate or C reactive protein)
- ordering imaging tests to look at your joints and bones
Sometimes, X-rays are ineffective in diagnosing the disease. An MRI or ultrasound can show abnormalities in your joints before X-ray changes appear.
Don’t be afraid to get a second opinion if you’re still experiencing discomfort from your condition. A doctor can prescribe new medications if the ones you’re taking aren’t working.
RA usually appears in people between the ages of 25 and 50. If you aren’t in this age range, you should still see a doctor if you think you’re experiencing symptoms of RA. In the case of RA, the earlier you receive your treatment, the better your outcome is.
Find ways to cope and support
Talk to those close to you about your condition. The more they know about what it’s like to have RA, the more they can help.
You can also join Healthline’s Facebook community Living with Rheumatoid Arthritis and share your story or ask for advice. Joining a support group is a good way to learn more about the disease, coping methods, and new treatments. You can also find local support groups through Arthritis Introspective or the Arthritis Foundation.