Rheumatoid arthritis

The cause of RA isn't fully understood. But it's an autoimmune disease. This means that the body's natural defense system attacks the joints.

Genes play a role, but experts don't know exactly what that role is. For most people with RA, the disease doesn't run in their families and they don't pass it along to their children. One or more genes may make it more likely that the body's immune system will attack the tissues of the joints. This immune response may also be triggered by bacteria, a virus, or some other foreign substance.

Symptoms of RA often develop slowly over weeks or months. Fatigue and stiffness are usually early symptoms.

Joint symptoms include:

• Pain, stiffness, and swelling in the joints of the hands, wrists, elbows, feet, ankles, knees, or neck. The disease usually affects both sides of the body at the same time.
• Morning stiffness. Joint stiffness may develop after long periods of sleeping or sitting. It usually lasts at least 1 hour and often up to several hours.
• Bumps (nodules). Rheumatoid nodules ranging in size from a pea to a mothball form in nearly one-third of people who have RA. Nodules usually form over pressure points in the body such as the elbows, knuckles, spine, and lower leg bones.

Rheumatoid arthritis can also cause symptoms throughout the body (systemic). These include:

• Fatigue.
• A loss of appetite.
• Weight loss.
• Mild fever.

RA is most often treated with medicine. Some medicines help to control the symptoms. Other medicines, especially when used early, can help to prevent the disease from getting worse.

Many of the medicines used to treat RA have side effects. Have regular checkups. And talk with your doctor about any problems. This will help your doctor find a treatment that works for you.

Physical therapy and finding the best balance between rest and activity can also help your symptoms.

If your treatment doesn't help, surgery may be an option. The type of surgery you can have depends on which joints are causing problems. Sometimes surgery to replace a joint (such as a hip or knee) is an option. Other types of surgery can remove debris or inflamed tissue from a joint, or relieve pressure on nerves.

• If your doctor recommends it, get more exercise. Walking is a good choice. If your knees or ankles hurt, try riding a stationary bike or swimming.
• Move each joint gently through its full range of motion once or twice a day.
• Rest joints when they are sore or overworked. Short rest breaks may help more than staying in bed.
• Reach and stay at a healthy weight. Regular exercise and a healthy diet will help you do this. Extra weight can strain the joints, especially the knees and hips, and make the pain worse. Losing even a few pounds may help.
• Get enough calcium and vitamin D to help prevent osteoporosis, which causes thin bones. Talk to your doctor about how much you should take.
• Protect your joints from injury. Do not overuse them. Try to limit or avoid activities that cause joint pain or swelling. Use special kitchen tools and other self-help devices as well as walkers, splints, or canes if needed.
• Use heat to ease pain. Take warm showers or baths. Use hot packs or a heating pad set on low. Sleep under a warm electric blanket.
• Put ice or a cold pack on the area for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• Take an active role in managing your condition. Set up a treatment plan with your doctor, and learn as much as you can about rheumatoid arthritis. This will help you control pain and stay active.

Call your doctor now or seek immediate medical care if:

• You have a fever or a rash along with joint pain.
• You have joint pain that is so severe that you cannot use the joint at all.
• You have sudden swelling, redness, or pain in one or more joints, and you do not know why.
• You have back or neck pain along with weakness in your arms or legs.
• You have a loss of bowel or bladder control.

Watch closely for changes in your health, and be sure to contact your doctor if:

• You have joint pain that lasts for more than 6 weeks.
• You have side effects from your arthritis medicines, such as stomach pain, nausea, heartburn, or dark and tarlike stools.