Rheumatoid Arthritis
Long-term treatment to control autoimmune inflammation affecting the joints and other organs
What is rheumatoid arthritis?
Rheumatoid arthritis is an autoimmune disease in which the lining of the joints becomes inflamed. It typically affects the small joints of the hands and feet, on both sides, and causes stiffness that is worst in the morning and eases with use.
It is a disease of the whole body and not only the joints. Tiredness, low-grade fever and weight loss are part of it, and the lungs, eyes and blood vessels can be involved.
What you might notice
- Stiff joints for an hour or more each morning
- Several joints swollen and painful at once
How it is diagnosed
Your doctor counts which joints are swollen and tender and asks how long the morning stiffness lasts, since an hour or more points away from wear-and-tear arthritis.
Inflammatory markers, rheumatoid factor and anti-CCP antibodies are measured, with anti-CCP the more specific of the two. X-rays of the hands and feet set a baseline, and ultrasound can show inflammation before any change appears on an X-ray.
Recovery
The aim is remission, and reaching it usually takes two to three months from starting disease-modifying treatment. Symptoms are controlled in the meantime while that treatment takes effect.
Monitoring is regular and ongoing: joint counts, inflammatory markers, and blood tests for the effects of the medicines. Treatment continues once you feel well, because stopping is what lets erosion resume.
If it is left untreated
Untreated inflammation erodes cartilage and bone within the first two years, and those erosions are permanent. That is why treatment is started early instead of after a period of watching.
The deformities associated with this condition are the end result of that erosion. Rheumatoid arthritis also raises cardiovascular risk independently, so blood pressure and cholesterol are managed alongside the joints.
Questions about rheumatoid arthritis
How is it different from ordinary arthritis?
Rheumatoid arthritis is inflammation of the joint lining, affects small joints on both sides, causes stiffness lasting an hour or more in the morning, and eases with use. Osteoarthritis is wear, is often one-sided, stiffens for minutes, and worsens with use.
Do I have to take medication when I feel well?
Yes. The erosion of bone continues in joints that are inflamed but not painful, and stopping treatment in remission is the usual reason a flare returns with damage attached.
Does it affect anything besides my joints?
It can. The lungs, the eyes and the blood vessels are all involved in some people, and the condition raises cardiovascular risk on its own, so blood pressure and cholesterol are managed alongside.
Other rheumatology treatments
Management of joint pain and stiffness caused by cartilage wear and degenerative joint changes
Day CareTreatment and prevention of painful attacks caused by uric acid crystal deposits
Day CareTalk to a care coordinator about rheumatoid arthritis
Leave a number and a care coordinator calls you back with what the treatment involves and which hospital it would be at. They book a consult only if you want one