Rheumatoid arthritis or RA is an autoimmune disorder affecting the joints and organs. RA tends to alternate between symptom flare-ups and remission periods, making it a difficult disorder to predict and treat. A great deal of research into rheumatoid arthritis has identified many risk factors and potential treatments, although there is still no cure for arthritis.
Early symptoms of RA can easily mimic other diseases, but there are several symptoms that are indicative of rheumatoid disease. In general, tenderness and pain of the joints is common in the early stages of the disease. Swelling and redness are hallmarks of RA, but they may not appear right away.
Joint symptoms are, according to the Mayo Clinic, the most noticeable symptoms of RA and they include:
- Joint stiffness in the morning that lasts for 30 minutes or longer
- Joint inflammation, tenderness, pain, or swelling
- Small joints in the wrists, feet, and hands are affected
- Loss of range of motion of the affected joints
- The same joints on either side of the body are affected (symmetric)
- More than one joint is affected by symptoms (polyarthritis)
The joint symptoms of RA are caused by inflammation in the joints according to the Arthritis Foundation. The joint pain can occur during flare-ups when the disease is active and when the disease is inactive. During periods of active RA, the joints swell due to thickening of the joint lining (synovium) and excessive fluid in the joint. When the inflamed joint stretches and moves, it irritates the tissue surrounding the joint. This capsule around the joint has nerve endings that result in pain signals.
Rheumatoid arthritis symptoms can also spread beyond the joints. Many people with RA experience loss of appetite, fatigue, and a low-grade fever during flare-ups. Flare-ups are defined as periods of high disease activity and symptoms (including joint inflammation and pain). These flare-ups can last for many days or even months.
Because rheumatoid arthritis leads to widespread, high levels of inflammation, other areas of the body are affected. RA can, according to the Mayo Clinic, lead to symptoms in the:
- Lungs – Shortness of breath is commonly caused by inflammation and tissue scarring.
- Eyes – Many RA sufferers experience dryness, redness, pain, impaired vision, and sensitivity to light.
- Mouth – Some people with RA experience dryness of the mouth and gum problems.
- Skin – Many RA patients develop rheumatoid nodules, which are tiny lumps beneath the skin over bony areas like finger joints
- Blood and blood vessels – Some people develop anemia, or low red blood cells. Inflammation can also affect blood vessels and damage the cardiovascular system, nerves, and skin.
Aside from joint symptoms, fatigue is one of the most common and troublesome symptoms of RA that can come at any stage, the Arthritis Foundation writes, but is especially noticeable when inflammation is active during flare-ups. Fatigue in RA is usually the body’s way of responding to inflammation, anemia, poor sleep quality, and RA medications. Insomnia and trouble sleeping is also common due to the pain from tender joints. RA that is not well controlled will lead to permanent and painful damage of the joints.
Alleviating Rheumatoid Arthritis Symptoms
Reducing RA symptoms and flare-ups requires a three-prong approach: proper diagnosis, medical treatment, and self-management.
Rheumatoid Arthritis Diagnosis
The first step to seeking relief from your joint pain and stiffness is an accurate diagnosis. If your doctor suspects you have rheumatoid arthritis, you will likely be referred to a rheumatologist with the training necessary to diagnose and treat rheumatoid arthritis. There is no test to confirm RA, but a rheumatologist can base the diagnosis on your medical history, symptoms, a physical exam, and diagnostic tests.
Common tests used to diagnose RA include:
- Blood tests to measure inflammation and look for biomarkers associated with RA.
- Inflammation tests can check your ESR and CRP levels, which are markers of inflammation.
- Imaging tests such as ultrasounds and MRIs can check for joint damage to determine the stage of the disease.
RA Treatment Options
Several treatment options have been found to reduce RA flare-ups and reduce the progression of the disease. The goal of treatment is stopping the inflammation, relieving your symptoms, improving physical health, reducing complications, and preventing damage to your joints and organs.
There are several medications that can ease the symptoms of RA. As the Arthritis Foundation points out, over-the-counter and prescription NSAIDs are commonly used to reduce inflammation and pain. Corticosteroids like prednisone are fast-acting anti-inflammatory drugs that are used to reduce potentially joint-damaging inflammation quickly. Sometimes other medications are also prescribed like DMARDs that change the course of the disease, biologics that are faster acting, and JAK inhibitors, a new type of DMARD.
In severe cases, surgery may be necessary such as joint replacement surgery.
Self-Management of RA
There are several steps you can take to manage your RA and reduce the progression of the disease. The following lifestyle changes and self-care strategies can, the Arthritis Foundation writes, help combat rheumatoid arthritis.
- Heat and cold therapy – Heat is best for relieving stiff joints while cold can help numb joints and reduce inflammation.
- Physical therapy and exercise – Exercise is considered central to treating rheumatoid arthritis. Exercise should focus on low-impact aerobics, flexibility exercises, and strength training.
- Take frequent breaks throughout the day when you feel tired. Resting helps you reduce inflammation, conserve your energy, and protect your joints from damage.
- Meditation and guided imagery. Meditation has been found to reduce the pain of arthritis and improve joint function.
- Dietary changes – Learn more about diet and foods that can improve RA symptoms below.
Research has indicated that some foods high in antioxidants can help reduce inflammation, Harvard Health Publishing writes. The Mediterranean diet with an emphasis on fish, olive oil, vegetables, and fruits may help control RA. Studies have found that fish oil can relieve tender joints and improve morning joint stiffness, according to the Arthritis Foundation. Boost your intake of fiber from natural sources like vegetables and whole grains to help lower C-reactive protein (CRP) levels, an indicator of inflammation. Because studies, like one in the Scandinavian Journal of Rheumatology, have found that RA sufferers tend to have low selenium levels, you can supplement your diet with whole-grain products and shellfish like crab.
Alternatively, some foods have been linked to inflammation. It’s also important to dramatically reduce your intake of fast food that can increase inflammation. Hamburgers, chicken, and meats that have been fried or grilled at a high temperature increase the level of advanced glycation end products (AGEs) which have been found in RA sufferers per a study published in Arthritis Research and Therapy. Omega-6 fatty acids (not to be confused with the inflammation-fighting omega-3 fatty acids) are also linked to inflammation. These fatty acids are found in fried foods and many snacks.