Rheumatoid arthritis is a chronic autoimmune disease that causes joint pain and inflammation. Learn about the symptoms, causes, and treatment.

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes joint inflammation, pain, and swelling. Unlike osteoarthritis, which occurs due to wear and tear, rheumatoid arthritis is associated with a mistaken attack by the immune system on the body's own tissues, especially the joints. This causes inflammation that can damage not only the joint structure, but also other organs such as the heart, lungs and skin. Rheumatoid arthritis can appear at any age, but it is most often diagnosed in middle age (usually between 40 and 60 years) and is about twice as common in women as in men.

RA is a progressive disease that can cause joint deformity and loss of function over time if not properly treated. In this article, we will look at the causes, symptoms, diagnosis, treatment options and ways to improve the quality of life with this disease.

Causes and risk factors of rheumatoid arthritis

The causes of rheumatoid arthritis are not fully understood, but several factors are known to increase the risk of developing the disease:

1. Genetics: There is a genetic predisposition to RA, and people with a family history of RA are at greater risk. Specific variants of the HLA-DRB1 gene are associated with an increased risk of developing RA.
2. Immune system dysfunction: RA is an autoimmune disease, which means the immune system mistakenly attacks the joints. This causes inflammation, which over time can damage joint tissue and other parts of the body.
3. Environmental factors: Environmental factors such as smoking can significantly increase the risk of developing RA, especially in people with a genetic predisposition. Certain viruses, such as the Epstein-Barr virus, and bacteria, such as Porphyromonas gingivalis, are also associated with an increased risk of developing the disease.
4. Gender: RA is more common in women than men, suggesting that hormones may play an important role in the development of the disease.
5. Age: RA can develop at any age, but it most often appears in middle age (usually between the ages of 40 and 60).

What are rheumatoid arthritis symptoms?

Symptoms of RA can vary and can develop gradually or suddenly. Some of the most common symptoms of RA include:

1. Joint pain and swelling: One of the main symptoms of RA is joint pain, swelling and stiffness. These symptoms usually occur symmetrically on both sides of the body and affect the hands, fingers, knees, elbows and ankles.
2. Morning stiffness: RA patients often experience morning stiffness that can last from 30 minutes to several hours. This is one of the defining symptoms that help distinguish RA from other types of arthritis.
3. Fatigue: RA can cause chronic fatigue, which can be related to long-term inflammation and disturbed sleep.
4. Small nodules under the skin: Some RA patients may develop small, painless nodules under the skin, most commonly near the elbows or other pressure points.
5. Weight loss and fever: Chronic inflammation can cause unwanted weight loss and low-grade fever.

If you have any of the mentioned symptoms of rheumatoid arthritis, it is very important to consult a rheumatologist or family doctor. Early diagnosis and treatment can help prevent disease progression and joint damage, and improve quality of life. Symptoms such as prolonged pain, morning stiffness, fatigue and nodules under the skin may indicate a serious inflammatory process that requires the attention of a specialist. Only a doctor can perform the necessary analyzes and examinations to establish an accurate diagnosis and initiate appropriate therapy.

Rheumatoid arthritis diagnostics

Diagnosing RA can be difficult because the symptoms can be similar to those of other diseases. To diagnose RA, your doctor may perform the following tests:

1. Blood tests: Several blood tests are used to diagnose RA. Rheumatoid factor (RF) and anti-citrulline antibody (anti-CCP) analysis is often performed. Rheumatoid factor (RF) is considered positive when it exceeds 20 IU/mL, and a positive result indicates possible RA, but it can also be positive for other diseases. The anti-CCP antibody assay is more specific for the diagnosis of RA, and a positive result (>20 U/mL) indicates a high probability that the patient has RA. Elevated levels of C-reactive protein (CRP) (>10 mg/L) and erythrocyte sedimentation rate (ESR) (>20 mm/h) indicate an active inflammatory process in the body.
2. Imaging of joints: X-ray, ultrasonography or magnetic resonance imaging can help determine joint damage and the degree of inflammation. Early images may show joint swelling before bone damage is visible.
3. Physical examination: Your doctor will perform a thorough physical exam to check for joint swelling, tenderness, and mobility. RA often affects symmetrical joints, and this feature is important in diagnosis.

Rheumatoid arthritis treatment

1. Physiotherapy: Physiotherapy can be very helpful in improving joint mobility and muscle strength. A physical therapist can recommend exercises that help keep joints moving and reduce stiffness.
2. Lifestyle changes:

   • Physical activities: Regular, moderate physical activity, such as walking, swimming, and yoga, can help reduce RA symptoms and improve joint function.
   • Nutrition: An anti-inflammatory diet rich in fruits, vegetables, omega-3 fatty acids (found in fish, walnuts and flaxseeds) can help reduce inflammation.
   • Smoking cessation: smoking is one of the biggest risk factors for the progression of RA, so it is important to quit smoking.
3. Surgery: in severe cases, when joint damage becomes irreversible and significantly reduces movement function, surgical intervention such as joint replacement or synovectomy (removal of the inflamed joint membrane) may be necessary.

What can be rheumatoid arthritis complications?

RA can cause several complications if not treated properly:

1. Joint damage: Inadequate treatment can cause severe joint damage and deformity that can interfere with daily activities.
2. Cardiovascular diseases: Chronic inflammation in rheumatoid arthritis can increase the risk of cardiovascular disease, such as developing atherosclerosis and heart attack. This is due to the fact that inflammatory processes in the body cause damage to the endothelial cells that cover blood vessels. Damaged endothelium becomes more susceptible to the accumulation of lipids and calcium, which contribute to the formation of plaques in the arteries (atherosclerosis). These spots can interfere with normal blood flow, which can lead to coronary heart disease or even a heart attack.
3. Lung problems: RA can cause inflammation of lung tissue (interstitial lung disease), which can cause shortness of breath and other breathing problems.

If any of the complications of rheumatoid arthritis appear, it is essential to consult a rheumatologist or family doctor to prevent serious health risks. For example, cardiovascular problems resulting from chronic inflammation can lead to serious consequences, such as heart attacks, if not diagnosed and treated in time. On the other hand, lung complications can cause breathing difficulties and significant disruption of oxygen supply in the body. A quick doctor's consultation can help to start the necessary therapy in time, reducing the risk of progression of complications and improving the general state of health.

New treatment approaches for rheumatoid arthritis

Researchers continue to find and develop new treatments for RA. Some of the more recent approaches include:

1. Vaccination against autoimmune reactions: Research is underway to develop vaccines that could modulate the immune system and reduce the intensity of autoimmune reactions.
2. Use of biomarkers in personalized therapy: Biomarkers are biological indicators such as specific antibodies, inflammatory proteins (such as C-reactive protein) or genetic markers that help determine the level of disease activity and predict the effectiveness of treatment. Research is moving in the direction of using these biomarkers to tailor the treatment plan to a specific patient, thereby improving the effectiveness of treatment and reducing unnecessary side effects.

Life with rheumatoid arthritis

Living with RA can be challenging, but with the right treatment and support, quality of life can be greatly improved. Here are some suggestions that can help manage RA:

1. Regular medical examinations: it is important to visit the doctor regularly and monitor the progress of the disease in order to adjust the treatment plan if necessary.
2. Support groups: Joining support groups can help you cope with the emotional challenges of RA, as well as share experiences and learn new management techniques from other patients.
3. Stress management: Stress can exacerbate inflammation, so practicing stress management techniques such as meditation, breathing exercises and yoga is recommended.
4. Adaptation in everyday life: at work or at home, it is important to use ergonomic solutions and adapt the work environment to reduce the load on the joints. Use assistive devices that help you perform daily activities with less effort.

Conclusion

Additional resources

• Rheumatoid arthritis. What affects the disease and how to improve the quality of life? (Source: Doctus)
• Current about rheumatoid arthritis (Source: Doctus)
• Rheumatoid arthritis (Source: Latvian Society of Adult Rheumatology)
• What tests should be done in case of arthritis (Source: Lærsts.lv)