Rheumatoid arthritis (RA) is an autoimmune disease. It causes pain, swelling, stiffness, and loss of function in the joints. RA usually affects the same joint on both sides of the body. It occurs mostly in the:
As RA progresses, it may cause complications with the:
It is also linked to early cardiovascular disease and death.
There is no single test for RA. The doctor will ask about your symptoms and medical history. She will examine your joints, skin, reflexes, and muscle strength.
Rheumatoid factor (RF) level
in the blood
Erythrocyte sedimentation rate (ESR)
of the blood—to measure inflammation in the body
C-reactive protein (CRP)
—an indicator of active inflammation in the blood
White blood cell count
of affected joints (especially
<![CDATA]>dual energy x-ray absorptiometry<![CDATA]>
)—a test that uses radiation to take a picture of structures inside the body, especially bones
There is no cure for RA. The goals of treatment are to:
Slow down joint damage
Improve functional ability
There are a variety of medicines to treat the pain and inflammation of RA. In some cases, medicines may be used in combination.
Disease-modifying anti-rheumatic drugs (DMARDS)—to slow the course of the disease; used early in the course of the disease to prevent long-term damage:
Low-dose corticosteroids (eg,
) are often used first. They may be tapered when other drugs start working. Avoid long-term steroid use. Corticosteroid injections to inflamed joints may also be used.
Rest and Exercise
Rest reduces active joint inflammation and pain and fights fatigue. Exercise is important for maintaining muscle strength and flexibility. It also preserves joint mobility.
Splints applied to painful joints may reduce pain and swelling. Devices that help with daily activities can also reduce stress on joints. Devices include:
Specially designed kitchen tools
can ease the difficulties of living with a chronic, painful disease. Participating in an exercise program or joining a
are two strategies you can use to reduce stress.
<![CDATA]>Cognitive behavioral therapy<![CDATA]>
, a form of talk therapy, and
may also offer benefits in reducing your pain and improving your ability to cope with RA.
Joint replacement and tendon reconstruction help relieve severe joint damage.
These may relieve stiffness and weakness and reduce inflammation:
Maintain a balance between rest and exercise.
Attempt mild strength training.
Participate in aerobic exercise (eg, walking, swimming, dancing).
Tanaka E, Saito A, Kamitsuji S, et al. Impact of shoulder, elbow, and knee joint involvement on assessment of rheumatoid arthritis using the American College of Rheumatology Core Data Set.
Verstappen SM, Bijlsma JW, Verkleij H, et al. Overview of work disability in rheumatoid arthritis patients as observed in cross-sectional and longitudinal surveys.
4/16/2009 DynaMed's Systematic Literature Surveillance
: Zautra AJ, Davis MC, Reich JW, et al. Comparison of cognitive behavioral and mindfulness meditation interventions on adaptation to rheumatoid arthritis for patients with and without history of recurrent depression.
J Consult Clin Psychol.
12/31/2009 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed/what.php: Anis A, Zhang W, Emery P, et al. The effect of etanercept on work productivity in patients with early active rheumatoid arthritis: results from the COMET study. Rheumatology (Oxford). 2009;48:1283-1289.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a