What is rheumatoid arthritis? — Rheumatoid arthritis is a disease that causes pain, swelling, and stiffness in the joints. It is one of many different types of arthritis. Doctors do not know what causes it. But they do know that it happens when the body's infection-fighting system, called the immune system, "attacks" the joints.
How can I tell whether I have rheumatoid arthritis or another type of arthritis? — You cannot tell. Only a doctor or nurse can tell you that. But there are some clues to look for. For instance, rheumatoid arthritis usually starts by affecting the small joints in the fingers (picture 1), the balls of the feet, and the wrists. It usually affects both the left and the right side at the same time. (Other types of arthritis tend to first affect larger joints, like the knees or hips. And they might affect one side much more than the other.)
What happens as rheumatoid arthritis gets worse? — Even though it might start in the fingers and toes, rheumatoid arthritis can affect any of the joints. Sometimes it damages the joints forever. Plus, rheumatoid arthritis can cause problems in other parts of the body, such as the heart, lungs, or eyes. Doctors and nurses have no way of knowing which people will get which symptoms or how bad the symptoms will get.
Get treated early for rheumatoid arthritis — If your doctor or nurse tells you that you have rheumatoid arthritis, start treatment right away. Do not wait until your symptoms get worse. Getting treated early can help prevent a lot of the damage the disease can do to your body.
What are the treatments for rheumatoid arthritis? — There are dozens of medicines for rheumatoid arthritis. The right one for you will depend on:
How bad your symptoms are
How many of your joints are affected
How your disease has changed over time
What side effects you feel with the medicines you try
What your X-rays look like
The results of certain blood tests
In general, the treatment options include:
Medicines called "nonsteroidal antiinflammatory drugs," also known as NSAIDs
Medicines called steroids (see "Oral steroid medicines")
Medicines called "disease modifying antirheumatic drugs," also known as "DMARDs"
People who have severe pain that does not get better with the medicines listed above sometimes get opioid pain medicines. But this is not usually necessary. Also, unlike the other medicines used for rheumatoid arthritis, opioids do not help with inflammation or joint damage.
Is there anything I can do on my own to feel better? — Yes. It is very important that you stay active. You might want to avoid being active because you are in pain. But that can make things worse. It will make your muscles weak and your joints stiffer than they already are. A physical therapist can help you figure out which exercises will do the most good. An occupational therapist can help you figure out how to keep doing the everyday tasks you need to do − even with arthritis.
Another thing you can do to on your own is to eat a healthy diet. People with rheumatoid arthritis are at risk for heart disease, so avoid fatty foods. Instead, eats lots of fruits and vegetables.
What if I want to get pregnant? — If you want to get pregnant, talk to your doctor or nurse about it before you start trying. Some of the medicines used to treat rheumatoid arthritis are not safe for a baby, so you might need to switch medicines before you get pregnant. Plus, there are things you should do to help prevent problems during the pregnancy. The symptoms of rheumatoid arthritis often get a lot better during pregnancy. But they can get worse again after the baby is born.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15445 Version 11.0
Release: 28.2.2 - C28.105
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