Aching joints is a common symptom of arthritis. But joints may ache for several reasons. If the lining of the joint becomes inflamed, you may have rheumatoid arthritis. If the cushioning cartilage in the joint becomes damaged or worn away, you may have osteoarthritis or "wear-and-tear" arthritis.
In rheumatoid arthritis (RA), the joint lining swells, invades surrounding tissues, and produces chemical substances that attack and destroy the joint surface. People of all ages may be affected, but the disease usually begins in middle age. RA usually affects joints on both sides of the body in the hands and feet, as well as the hips, knees, and elbows. Without proper treatment, RA can become a chronic, disabling condition.
Causes of rheumatoid arthritis
Rheumatoid arthritis is not an inherited disease, although researches believe that some people have genes that make them susceptible to the disease. People with these genes will not automatically develop RA. There is usually a "trigger," such as an infection or environmental factor, which activates the genes and leads to the development of RA. When the body is exposed to this trigger, the immune system responds inappropriately. Instead of protecting the joint, the immune system begins to produce substances that attack the joint.
Symptoms of rheumatoid arthritis
- Swelling, pain, and stiffness in the joint, even when it is not being used.
- A feeling of warmth around the joint.
- Joint deformities and contractures.
- Systemic symptoms, including fever, anemia (low red blood cell count) and loss of appetite and energy.
- Developing nodules, or lumps, particularly around the elbow.
- Foot pain, bunions and hammer toes with long-standing disease.
Diagnosing rheumatoid arthritis
To diagnose RA, your physician will take a medical history and perform a physical examination. Some of the conditions your doctor looks for include swelling and warmth around the joint, painful motion, lumps under the skin, joint deformities and joint contractures (inability to fully stretch or bend the joint).
Diagnostic tests include blood tests and X-rays. The blood test may reveal an antibody called rheumatoid factor that is an indicator of RA, and the X-ray can help show the progression of the disease.
Treatment options
Although there is no cure for RA, there are a number of treatment options that can help relieve joint pain and improve functioning. Your physician may refer you to an orthopaedic surgeon who can tailor a treatment plan to your needs and lifestyle.
Medications used to control RA fall into two categories: those that relieve symptoms and those that have the potential to modify the course of the disease. Often they are used together. For example, aspirin and ibuprofen can help reduce the pain and inflammation of RA. Treatment also may include disease-modifying drugs such as methotrexate and sulfasalazine and gold injections. Researchers are also working on biologic agents that can interrupt the progress of the disease. These agents target specific chemicals in the body to prevent them from acting on the joints.
Exercise is also an important part of a treatment program. Your physician and physical therapist may work with you to develop an exercise program that helps strengthen the joints without stressing them. In some cases, you may have to wear a splint or corrective footwear. Joint replacement surgery is also an option and is often effective in restoring function.
Information provided by American Association of Orthopaedic Surgeons
March 2001
|
