Munson Health
 
Rheumatoid Arthritis

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by Chwistek M

(RA; Arthritis, Rheumatoid)

 

Symptoms

RA causes many symptoms.
Joint symptoms include:
  • Increased pain and stiffness in the morning and after inactivity
  • Morning stiffness and pain that lasts more than 30 minutes
  • Red, swollen, warm joints
  • Deformed, misshapen joints
RA may also cause:
  • Intense fatigue, decreased energy
  • Muscle aches
  • Decreased appetite
  • Weight loss
  • Fever and sweats
  • Insomnia
  • Small lumps or nodules under the skin
Conditions associated with RA include:
  • Sjogren's syndrome —an inflammatory condition involving the tear and salivary glands
  • Felty syndrome—three conditions marked by rheumatoid arthritis, enlarged spleen, and low levels of white blood cells
  • Caplan syndrome—marked by rheumatoid arthritis and pneumoconiosis (lung disease in people exposed to coal mining dust or asbestos)
  • Osteoporosis
  • Osteoarthritis
  • Raynaud's disease and phenomenon
  • Muscle inflammation
  • Muscle weakness
  • Kidney disease
 

Treatment

There is no cure for RA. The goals of treatment are to:
  • Relieve pain
  • Reduce inflammation
  • Slow down joint damage
  • Improve functional ability

Medications

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:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Cyclooxgenase-2 or COX-2 inhibitors
  • Nonbiologic disease-modifying antirheumatic drugs (DMARDs)
  • Biologic disease-modifying antirheumatic drugs (DMARDs)
  • Corticosteroids
Medication may be taken by mouth, applied to the skin, or injected into the joint.

Rest and Exercise

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:
  • Maintain a balance between rest and exercise
  • Attempt mild strength training
  • Participate in aerobic exercise, such as, walking, swimming, or dancing
  • Avoid heavy-impact exercise
  • Control weight
  • Participate in a physical therapy program

Joint Care

Splints applied to painful joints may reduce pain. Devices that help with daily activities can also reduce stress on joints. Devices include:
  • Zipper extenders
  • Long-handled shoehorns
  • Specially designed kitchen tools

Stress Reduction

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.

Surgery

Joint replacement and tendon reconstruction help relieve severe joint damage.
 

RESOURCES

American College of Rheumatology
http://www.rheumatology.org

Arthritis Foundation
http://www.arthritis.org

 

CANADIAN RESOURCES

Canadian Orthopaedic Association
http://www.coa-aco.org

Canadian Rheumatology Association
http://rheum.ca

 

References


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%5FInfo/Rheumatic%5FDisease/default.asp . Updated April 2009. Accessed August 21, 2013.


Rheumatoid arthritis (RA). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . 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/what.php : 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/what.php : 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/what.php : 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.

 

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