You've been waking up in the morning with stiff fingers that don't seem to relax until well after breakfast. You feel sluggish and you're losing weight. There is pain in your joints and they feel hot to the touch. These are signs that you could be suffering from rheumatoid arthritis.
"Rheumatoid arthritis is an autoimmune disorder that affects your joints, which are the connectors between your bones," says Steven L. Smith, MD, a family medicine physician with
St. Joseph Heritage Medical Group in Tustin. "The joints are encased in a tissue lining called synovium. With rheumatoid arthritis, the body's immune system attacks the synovium lining, causing it to swell and become painful. Left unchecked, it can damage the joint, as well as the bones and cartilage." About 1.5 million people in the United States have rheumatoid arthritis.
Generally, rheumatoid arthritis starts in the small joints in the hands or feet, before moving on to other spots such as the ankles, elbows, hips and wrists. It attacks symmetrically, meaning if you have rheumatoid arthritis in one elbow, you'll have it in the other, too.
"Rheumatoid arthritis can be debilitating, causing pain as well as fatigue, fever and swollen or stiff joints," Dr. Smith says. "What's even more frustrating for patients is that these symptoms can come on suddenly—those are called flares—and then ebb away."
In addition to weakening the joints, bones and cartilage, rheumatoid arthritis can affect the body in other ways. Other side effects could include anemia, dry mouth and eyes, neck pain and, in extreme cases, damage to organs such as the heart and lungs, Dr. Smith says. "There can also be a mental toll, as some patients report low self-esteem or depression." Rheumatoid arthritis can also put you at higher risk for other health problems, such as carpal tunnel syndrome and osteoporosis.
The Riddle of Rheumatoid Arthritis
There's no specific known cause of rheumatoid arthritis. "Genetic history can be a factor, and some people are more susceptible to infections or other environmental issues that could be triggers," Dr. Smith says. "There is also some thought that hormones can play a role, which could help explain why three times more women than men have the disorder."
While anyone can get the disease, it comes on primarily between ages 40 and 60 for women, and can occur even later for men.
Just as there is no definitive cause for rheumatoid arthritis, there is also no cure. "Because bone damage can start within the first couple of years, it's imperative to get an early diagnosis and treatment," Dr. Smith says.
Your doctor will conduct an exam and run tests to determine if you have rheumatoid arthritis and may refer you to a specialist called a rheumatologist. "The goal is to manage the disease and reduce inflammation as much as possible," Dr. Smith says. "That could occupational and physical therapy, medications such as steroids or anti-inflammatory drugs or surgery, including joint replacement or tendon repair."
You will also be monitored regularly with blood tests and exams. "Your doctor should tell you how to manage the disorder through lifestyle changes," Dr. Smith says. "Strive for a balance of activity and rest—you'll need regular exercise to help with joint flexibility but your body also needs downtime, too. Maintaining a healthy diet and weight can be helpful, too. And ask your doctor how you can reduce pain by applying heat and cold to the joints."
For more information on St. Joseph Heritage Medical Group, click here. For more information on Dr. Smith, click