Rheumatoid Arthritis (RA) is an autoimmune disease that occurs when your immune system malfunctions and starts to mistakenly attack healthy tissue, causing inflammation, pain, stiffness, swelling and loss of joint function.

As a result of the inappropriate immune response, white blood cells travel to the joint, producing certain cytokines (including tumor necrosis factor alpha (TNF-a), interleukin-1 (IL-1), and others), that overtime can signal cells to attack perfectly healthy tissue.  The attacks causes ongoing destruction of cartilage, bone and other joint-related tissues.

Causes

The exact cause of RA is unknown, but experts believe there is a combination of factors:

  • Genetics.  While your genes don’t actually cause the onset of RA, they can make you more susceptible to environmental factors that may trigger the disease.
  • Environment.  RA may be triggered by an infection with certain viruses and bacteria.
  • Other Factors.  Female hormones and the body’s response to stressful events may play a role in the development of RA.

Symptoms

Signs and symptoms of RA may include the following:

  • Joints that are tender, warm or swollen
  • Stiffness in the morning that can last for hours
  • Firm bumps of tissue under the skin on your arms (these are called rheumatoid nodules)
  • Fatigue, fever and weight loss

Early onset of rheumatoid arthritis usually affects your smaller joints first, such as the joints that attach your fingers to your hands and your toes to your feet.  As the disease progresses, symptoms often spread to your ankles, elbows, knees, hips and shoulders.  In most cases of RA, symptoms will occur in the same joints on both sides of your body.

The signs and symptoms of RA may vary in severity and come and go.  Flares are periods of increased activity.  Over time, your joints may become deformed and shift out of place.

Treatment

NSAIDs (nonsteroidal anti-inflammatory drugs) – NSAIDs are used to relieve pain and to reduce inflammation.  NSAIDs are available over the counter or can be prescribed by a doctor, such as COX-II inhibitors.

DMARDs (disease-modifying antirheumatic drugs) – Like NSAIDS, DMARDs reduce pain and inflammation, but can also slow further RA joint damage.  DMARDs are only available through prescription and may take anywhere from a few weeks to months to have an effect.

Biologics – Biologics are used for people with moderate to severe RA to reduce the signs and symptoms.  Biologics may also help slow or prevent the progression of joint damage.  Biologics work by blocking the part of the immune system that contributes to the inflammation seen in RA.