Rheumatoid arthritis (RA) is an autoimmune disease. It causes pain, swelling, stiffness, and loss of function in the joints.
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RA is caused by a combination of genetic and environmental factors that trigger an abnormal immune response. Possible causes include:
RA is more common in women, and in people between the ages of 30 and 60. Other factors that may increase your chance of developing RA include:
RA causes many symptoms.
Joint symptoms include:
RA may also cause:
Conditions associated with RA include:
The doctor will ask about your symptoms and medical history. A physical exam will be done. To be diagnosed with RA, you must have at least one swollen or tender joint or a history of a swollen joint. How many joints, and which joints are involved, will help aid your doctor in the diagnosis. The doctor will also rule out other conditions that may have similar symptoms.
Tests may include:
There is no cure for RA. The goals of treatment are to:
There are a variety of medications to treat the pain and inflammation of RA. In some cases, medications may be used in combination. These may include:
Medication may be taken by mouth, applied to the skin, or injected into the joint.
Rest reduces active joint inflammation and pain and fights fatigue. Exercise is important for maintaining muscle strength and flexibility. It also preserves joint mobility.
These steps may help relieve stiffness, weakness, and reduce inflammation:
Splints applied to painful joints may reduce pain. Devices that help with daily activities can also reduce stress on joints. Devices include:
Stress reduction can ease the difficulties of living with a chronic, painful disease. Participating in an exercise program or joining a support group are two strategies you can use to reduce stress. Cognitive behavioral therapy , a form of talk therapy, and meditation 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.
American College of Rheumatology
Canadian Orthopaedic Association
Canadian Rheumatology Association
Rheumatoid arthritis. Arthritis Foundation website. Available at: http://www.arthritis.org/conditions-treatments/disease-center/rheumatoid-arthritis. Accessed August 21, 2013.
Rheumatoid arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Rheumatic_Disease/default.asp. Updated April 2009. Accessed August 21, 2013.
Rheumatoid arthritis (RA). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 2, 2013. Accessed August 21, 2013.
Who gets RA? Arthritis Foundation website. Available at: http://www.arthritistoday.org/about-arthritis/types-of-arthritis/rheumatoid-arthritis/who-gets-ra-and-why/who-gets-ra/how-do-you-get-ra.php. Accessed August 21, 2013.
Tanaka E, Saito A, et al. Impact of shoulder, elbow, and knee joint involvement on assessment of rheumatoid arthritis using the American College of Rheumatology Core Data Set. Arthritis Rheum. 2005;53:864-871.
Verstappen SM, Bijlsma JW, et al. Overview of work disability in rheumatoid arthritis patients as observed in cross-sectional and longitudinal surveys. Arthritis Rheum. 2004;51:488-497.
4/16/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed 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. 2008;76:408-421.
1/4/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: 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.
1/4/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Aletaha D, Neogi T, Silman AJ, Funovits J, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2010;69(9):1580-1588.
4/24/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Wise JN, Weissman BN, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/ChronicFootPain.pdf. Updated 2013. Accessed April 24, 2014.
Last reviewed June 2013 by Fahran Tahir, MD
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 medical condition.
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