To mark Rheumatoid Arthritis Week (13-19 September), we are focusing on this common form of arthritis including what it is, how its diagnosed and when to get treatment. We’ll also outline some of the key differences between rheumatoid arthritis and osteoarthritis.
What is rheumatoid arthritis?
Did you know there are more than 100 different types of arthritis and related diseases? Two of the most common are rheumatoid arthritis and osteoarthritis. The word ‘arthritis’ means inflammation or swelling of one or more joints in the body. Specific symptoms vary but normally joint pain and stiffness are common across all forms of arthritis.
Rheumatoid arthritis is a chronic autoimmune disease that causes your immune system to mistakenly attack your body’s own tissues. It causes inflammation that not only damages the lining of your joints but can also affect other systems in the body, including the major organs, blood vessels, eyes and skin. There is no known cure for rheumatoid arthritis which tends to progress to other joints in the body, causing worsening symptoms.
What are the symptoms?
In the early stages, rheumatoid arthritis tends to affect the smaller joints, such as the fingers and toes. As it spreads, it may affect all the joints in the body, with the larger joints tending to be affected last. The disease causes stiffness – which is often worse in the morning or after periods of inactivity – and swollen, warm, tender joints. It can also cause fatigue, fever and loss of appetite. In around 40% of people, other parts of the body may also be affected, including the heart, lungs, kidneys, nerve tissues, blood vessels, skin and eyes. Rheumatoid arthritis is characterised by a flare up in symptoms followed by periods of remission when the pain and swelling may reduce or even disappear. Over time, symptoms tend to worsen and may eventually lead to deformity of the joints and bone erosion.
Who is at risk?
Experts are not completely clear why some people develop rheumatoid arthritis. A normal healthy immune system protects your body from disease and infection but in people with rheumatoid arthritis, the immune system begins attacking the body’s healthy tissue. Having a family history of the condition increases your risk of developing rheumatoid arthritis, and although your genes cannot cause it, they may make you more likely to react to environmental triggers, such as certain viruses or bacteria. Other factors as well as your genes may also make you predisposed to the disease. Women are at greater risk than men and the disease is more common in middle age. Being overweight and smoking cigarettes are also risk factors.
How does it differ from osteoarthritis?
Rheumatoid arthritis and osteoarthritis share similar symptoms, however, while the former is an autoimmune disease, osteoarthritis is caused by the protective cartilage that cushions the joints starting to wear away, which can cause the bones to start rubbing together and may lead to the development of bony spurs. Osteoarthritis is sometimes referred to as wear and tear arthritis.
While both cause stiffness which tends to be worse in the morning, with osteoarthritis this normally eases within around 30 minutes whereas it tends to last longer with rheumatoid arthritis. Symptoms of osteoarthritis tend to develop more gradually than rheumatoid arthritis and whereas the former often only develops on one side, rheumatoid arthritis usually occurs in the same joints on both sides of the body.
How is rheumatoid arthritis diagnosed?
It can be challenging to obtain an accurate diagnosis as the symptoms of rheumatoid and osteoarthritis are very similar, particularly in the early stages. A blood test is used to check for signs of rheumatoid arthritis, including biomarkers such as cyclic citrullinated peptide antibody and rheumatoid factor, as well as levels of the C-reactive protein antibody which indicates inflammation. You may also be given a diagnostic imaging test, such as an X-ray, MRI or ultrasound scan to look for joint damage.
When to get treatment for rheumatoid arthritis
Unfortunately, there is no cure for either rheumatoid arthritis or osteoarthritis and both conditions will gradually worsen. Getting an early diagnosis can be helpful as there are treatments available that can help you to manage your symptoms, improve your quality of life and slow the progression of the disease. If you are experiencing persistent pain or stiffness in your joints, see a doctor who can perform a range of diagnostic tests. The earlier you begin treatment with medications known as disease-modifying antirheumatic drugs (DMARDs), the earlier you are likely to experience remission of symptoms.
How is it treated?
Treatment for rheumatoid arthritis will depend on the severity of your symptoms and how advanced the disease is. In the early stages you may be able to control your symptoms with anti-inflammatories and exercises recommended by a physiotherapist. Corticosteroids can reduce inflammation and joint damage and DMARDs can slow the progress of the disease. More advanced rheumatoid arthritis may require surgery to reduce pain and improve joint function. Common procedures include tendon repair, removal of the inflamed joint lining and total joint replacement.
If you are experiencing joint pain and stiffness, contact us for advice on diagnosis and treatment options.
