I Have Rheumatoid Arthritis: Now What?

By Dr. Sam Pegram

Rheumatoid Arthritis (RA) is unlike osteoarthritis, which the latter is a result of mechanical wear and tear on your joints. Instead, Rheumatoid Arthritis is a chronic auto-immune disease characterized by the infiltration of inflammatory cells into the joint capsules. Those cells release enzymes that reduce the overall cartilage and primarily affect the smaller joints in your body, such as your wrists and hands. 

Rheumatoid arthritis can spread to bigger joints in your body, like your elbows, ankles, and knees, but it typically doesn’t attack the largest joints in your body, like the ones in your back, for example. This is one of the main ways you can differentiate between other forms of arthritis; because osteoarthritis prefers to show up in larger joints. 

How do I know I have RA?

The main symptoms of RA are morning sickness that lasts thirty minutes or greater in duration. Because it is an auto-immune disease, you may also experience symptoms such as loss of appetite, fatigue, and fever. 

It is symmetrically disruptive, i.e., what happens on one side of your body, usually affects the same joints on the other. Therefore, if you have rheumatoid arthritis hands, toes, feet, etc., you may experience pain, swelling, and loss of motion in the exact same joints affecting your overall movements or quality of life. 

It is also systemic, which can leave you having inflammatory changes in other parts of your body, like your eyes, skin, bone marrow, kidneys, and cardiovascular and respiratory organs. 

It is important to note that RA symptoms show up and progress in everyone’s body differently. Though, RA progression typically follows the same path, starting with affecting your smaller joints and spreading to your bigger joints. 

Where did my RA derive from?

Doctors do not really know the reason people develop rheumatoid arthritis. There seems to be a genetic predisposition where you may have an abnormality in one of your chromosomes, which can increase your risk of development. However, it isn’t totally conclusive that you will contract this chronic disease because you have a family history. 

Other factors may include your sex and age, as more women between 20 and 40 develop the disease. There could be a hormonal link; however, no research conclusively proves this theory. Also, obesity, or being overweight, may increase your risk of developing the disease.  

There have been some thoughts around exposure to certain viruses or infections, which could make you more susceptible to developing rheumatoid arthritis, but unfortunately, this theory isn’t conclusive either. 

What is the cure/treatment for my RA? 

There is no cure for RA, but the treatment plan has exponentially gotten more advance in the past twenty-five years. Before this advancement, rheumatoid arthritis caused an increased mortality rate. Now, you are able to live a normal, productive life, and the disease can go into remission with no pain, swelling, and your complete range of motion back. 

It is important to note that remission doesn’t last long, as this is a chronic disease. However, since the turn of the 21st century, doctors have been using biologic agents made from proteins or blood products to reduce targeted inflammatory cells invading the joints. These are highly potent agents that are much safer than the chemical agents used before and are still being used to complement your Rheumatoid Arthritis treatment plan today. 

Doctors also use Methotrexate, which, out of all the chemical agents, is the most effective one. Even though this drug is a bit more toxic and has more side effects than the biologic agents, it can still be used to destroy the inflammatory cells in the joints. When taking Methotrexate, you may experience some side effects, such as digestive issues, i.e., vomiting or diarrhea. You also may experience headaches, rashes, or even shortness of breath. You should discuss the potential side effects with your doctor and inform them immediately if you are having a reaction from taking this drug. 

Doctors may also, as an adjunct treatment, inject you with cortisone steroids. They are quick pain relievers that can help decrease your flares but cannot prevent the progression of the disease. 

For those who work on their feet or with their hands a lot, your doctor may recommend that you protect the joints in those areas, especially while you work. You may be recommended to change your day-to-day behaviors, like how you work, i.e., sitting every hour for 15 minutes to relieve the pain or even light stretching. Or, create a workspace that supports you. 

How Can I support my RA at home? 

Diet and weight loss are going to be important for reducing pain and improving mobility in your Rheumatoid Arthritic joints. If you are suffering from aggressive involvement in your lower extremities, adding more weight to those joints can negatively impact your pain management. Non-significant stretching is also an effective way to support your joints and their range of motion and help to regulate your weight. 

There are no foods that restrict or prevent the progression of the disease.  However, turmeric, dietary fish oil, and other anti-inflammatory foods, supplements, and herbs can reduce the inflammation in your joints, supporting your pain and improving some mobility. 

You can also take some over-the-counter painkillers such as Acetaminophen or Ibuprofen, which also reduces inflammation. However, speak to your doctor to understand what are considered safe dosages to take and understand how those medicines can interact with your prescribed ones. 

Rheumatoid Arthritis is chronic and debilitating, which can affect your stress and mental health. Having a community of support can greatly reduce that stress and inflammation in your body, which can help you manage your disease more easily. Simply just seeking support from family, friends, loved ones, and your doctor is also an effective treatment. You can also seek support from third-party organizations that are conducting research and committed to finding advancements in treatment and a potential cure. Those organizations know what you are going through, and you can find other people suffering from the disease that can relate. Finding support is key to managing the disease for the long haul.