Arthritis is the leading cause of disability. Nearly 7 million people in the U.S., including 20% of people with arthritis, are unable to perform major life activities such as working or housekeeping because of this disease. Arthritis sufferers endure more time in severe pain, experience more days with limited ability to perform daily activities, and have more difficulty performing personal-care routines than people without arthritis. As with other chronic pain conditions, arthritis has negative effects on mental health. Some forms of arthritis also make your body older.
The Definition of Rheumatoid Arthritis
Rheumatoid arthritis, known as Still's disease when it affects children, is a condition that causes inflammation of joints and associated pain, swelling, and stiffness. Rheumatoid arthritis causes the body's immune system to attack joint tissue, break down collagen, cartilage, and sometimes bone or other organs. This chronic disease varies between people and fluctuates over time, often marked by symptoms that improve only to re-emerge later. In some cases, rheumatoid arthritis is mild and lasts only a few months (this kind of rheumatoid arthritis is called type 1). While, in others, the disease becomes progressively complicated by disability and other health problems, lasting many years (this is called type 2 rheumatoid arthritis).
Rheumatoid arthritis often affects the wrist and finger joints closest to the hand, but can also affect joints in the feet and throughout the body. Anyone can be affected by rheumatoid arthritis, but women are more likely to develop symptoms, which usually begin between the ages of 20 and 30. The causes of rheumatoid arthritis are not yet understood, but many effective strategies have been developed to manage their symptoms.
Rheumatoid Arthritis Symptoms and Signs
The main symptom of rheumatoid arthritis is joint stiffness in the morning, often in the hands or feet. Stiffness that persists over an hour or swelling and pain that lasts for more than six weeks may indicate the development of rheumatoid arthritis. Joint discomfort is typically symmetrical, which means both hands will hurt or feel stiff, not just one. Early rheumatoid arthritis symptoms also may include fever, excessive tiredness, or pea-sized lumps called "nodules" that can be felt under the skin.
Other possible rheumatoid arthritis symptoms include anemia, appetite loss, and the accumulation of fluid in the ankles or behind the knee. In children, symptoms may include shaking chills; a pink rash may follow the characteristic painful and swollen joints.
Why Rheumatoid Arthritis Is Painful
The relation between joint pain and the destruction of cartilage is not fully understood. Cartilage itself does not cause pain because there are no nerve structures in cartilage to transmit pain signals. The pain of rheumatoid arthritis is caused by the irritation of other tissues in and around the affected joints. This irritation may be caused by chemical messenger substances, such as prostaglandin E2, that are associated with the disease process. Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the pain because they inhibit the production of prostaglandins.
Other Conditions That Can Cause Pain
Pain and stiffness similar to rheumatoid arthritis symptoms can be caused by many other conditions. Even if the injury or infection can be ruled out, anything from bunions to fibromyalgia or chronic fatigue syndrome can trigger pain.
Only a medical professional can identify the correct sources of joint pain because similar symptoms can result from other autoimmune diseases, cancer or other types of arthritis.
The Causes of Rheumatoid Arthritis
The causes of rheumatoid arthritis have not been fully understood, but important contributing factors have been identified. The self-destructive immune response of rheumatoid arthritis may be caused by a combination of genetic susceptibility and an environmental trigger. Changing hormones may also play an important part in the disease, possibly in response to an infection from the environment.
More than one gene has been linked to the risk of rheumatoid arthritis. Specific genes may increase the chance of developing the disease, and also can partially determine how serious the condition is. However, since not all people with a genetic predisposition to rheumatoid arthritis have the disease, other factors are important as well.
A specific environmental trigger has not yet been found, but some research suggests that infection by a virus or bacterium leads to rheumatoid arthritis in genetically susceptible people. This does not mean that rheumatoid arthritis is contagious. People with rheumatoid arthritis appear to have more antibodies in the synovial fluid of their joints, suggesting that there may be an infection.
Low levels of hormones from the adrenal gland are common in people with rheumatoid arthritis, but how hormones interact with environmental and genetic factors is unknown. Hormone changes may contribute to the progression of rheumatoid arthritis.