Rheumatoid Arthritis (RA)
Waking up to stiff and achy joints is the bane of all arthritis sufferers. But for about 2.1 million people in the United States, the pain is the result of rheumatoid arthritis (RA), an autoimmune disease in which the immune system mistakenly attacks the healthy lining of the joints.
Fact
Rheumatoid arthritis has afflicted some of history's most successful people, including the French impressionist painter August Renoir, who tied a paintbrush to his arthritic hand in order to continue painting. Other famous folks with RA include Christiaan Barnard, the first surgeon to perform a heart transplant, and actresses Lucille Ball and Kathleen Turner.
No one knows what causes the immune system to attack the joints. Although scientists have confirmed that RA is linked to a cluster of genes, not everyone who carries these genes will get the condition. At the same time, not everyone who gets RA carries these genes. That's why experts believe that it's probably a combination of genetic susceptibility and environmental triggers that causes RA. Possible triggers may include infections, stress, cigarette smoking, and occupational hazards. And since 70 percent of all people with RA are women, experts suspect hormones may play a role.
Rheumatoid arthritis can be extremely painful, and in severe cases, it can be disabling and life altering. The condition is chronic, but the pain can ebb and flow, depending on life circumstances, medications, and stress. It can also go into remission.
Symptoms and Diagnosis
People who have RA typically have morning stiffness in and around the joints. They may experience arthritis in three or more joint areas, and the arthritis may afflict the hands. In addition, the arthritis may occur symmetrically, meaning that if a joint on the right side hurts, the same joint on the left side will hurt, too. Some people will also feel lumps under their skin, called rheumatoid nodules.
Diagnosing RA is based on a doctor's examination, blood tests, and imaging studies. Blood tests may show the presence of certain substances in the blood, including rheumatoid factor, anti-cyclic citrulline-containing peptides (CCP) antibodies, and antinuclear antibodies (ANA). X-rays, CAT scans, and MRIs may reveal erosions or decalcifications in or around the affected joints. Usually, it's a combination of these measures and the patient's own self-reported symptoms that lead to a diagnosis of RA.
Treatment
Treating RA is an imprecise science that may require experimentation. Patients often wind up taking several drugs, including nonsteroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs, and biologic response modifiers. Some of the medications are very powerful and can have profound effects on your immune system.
How RA Differs from FMS
RA and fibromyalgia might feel similar, and the symptoms may be described in the same way. But the two conditions are really rather different. RA is primarily a disease of the joints, while FMS pain can occur anywhere. RA actually causes damage to the body, while FMS does not physically injure you. Blood tests and imaging scans can help pinpoint whether you are suffering from RA.
