What is rheumatoid arthritis?
Rheumatoid arthritis is an autoimmune disease that can cause pain, swelling, inflammation, and destruction of the joints. Initially, the smaller joints such as the fingers and feet are most likely to be affected. Over time, however, the disease may progress and affect larger joints, including the knees and shoulders. Usually, unlike in osteoarthritis, symptoms occur bilaterally (on both sides of the body). People with rheumatoid arthritis often experience fever, fatigue, and a loss of appetite.
What complications can occur in rheumatoid arthritis?
- Osteoporosis: Both the disease itself and the medications used to treat it can cause bone fragility and increase the chances of fractures.
- Infections: It is especially important for individuals with autoimmune diseases to get vaccinations. Again, this complication can be brought about by both the disease itself and the immune-suppressing medications often necessary for treating it.
- Heart disease: A recent review of studies determined that more than half of all premature deaths among individuals with rheumatoid arthritis are related to cardiovascular problems. The same inflammation that causes joint damage also adversely affects cardiac health–narrowing the arteries, raising blood pressure, and lessening blood flow to the heart.
- Lung disease: Rheumatoid disease can directly affect the lungs, treatments can negatively impact lung tissue, and infections (bronchitis or pneumonia) can cause long-term damage to the respiratory system. It is not uncommon for those with rheumatoid arthritis to deal with breathlessness and a persistent cough.
- Lymphoma: This form of blood cancer is more common among individuals with rheumatoid arthritis.
- Anemia: Several types of anemia are common with rheumatoid arthritis, including both iron deficiency anemia and anemia of chronic disease.
- Vision problems: People with rheumatoid arthritis sometimes have to deal with dry eye and eye pain.
Who is at risk for developing rheumatoid arthritis?
People with a family history of the disease in a first-degree relative are more than three times as likely to get the disease themselves. While people can develop the disease at any age, it most commonly develops in those over the age of 60. The female to male ratio for developing rheumatoid arthritis is 10:1, and women are more likely to develop the disease during periods of hormonal flux, including pregnancy, lactation, and menopause. The first year after pregnancy is an especially common time for the condition to rear its head. According to the CDC, women who have never given birth may be at increased risk.
While some things that increase your chances of developing this condition are out of your hands, there are a few things that you can do to reduce your risk. Smoking is one of the worst things that you can do. People who smoke are believed to develop rheumatoid arthritis at least a decade before they otherwise would have, based on their genes alone. Smoking also speeds up the trajectory of the disease and can make symptoms substantially worse.
Many people who are already predisposed to rheumatoid arthritis first develop symptoms during, or shortly after, an intensely stressful period in their lives. Stress also worsens symptoms and makes it less likely that people will adhere to their treatment plan.
Because obesity increases the production of inflammation-causing hormones, being overweight is considered an independent risk factor. Certain foods, including sugar, refined carbohydrates, and red meat, are also known to increase inflammation.
Is there any good news?
Yes, there is some good news! According to a presentation at the 2019 Congress of Clinical Rheumatology West, joint progression and disability have both decreased with the advent of new medications used earlier and more aggressively. Circulatory, respiratory, and musculoskeletal outcomes have all improved. The best thing that you can do when facing this diagnosis is to find a team of healthcare providers that you trust–do it quickly; the earlier appropriate treatment is initiated, the better your outcomes will be for the rest of your life.
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This month’s free handout helps to break down the basics of rheumatoid arthritis. It covers the symptoms, complications, and treatment of this condition.