Rheumatoid arthritis causes inflammation of the lining of the joints, and can also affect other organs in the body. It is considered an autoimmune disease because there is an abnormal immune system response that causes infection- fighting white blood cells to release antibodies against the body's own healthy tissues.

Arthritis is a general term for inflammation of a joint. The two most common types are osteoarthritis, which most often occurs in older people, and rheumatoid arthritis, which can appear at any age.

Rheumatoid arthritis is three times more common in women than it is in men, and usually symptoms start between ages 40 and 60, although very young children can develop juvenile rheumatoid arthritis.

The symptoms of RA can include pain and swelling in joints, red and swollen hands, unusual fatigue, fever, weight loss and morning stiffness that lasts more than half an hour after awakening. Some people develop firm bumps under the skin of the arms, called rheumatoid nodules.

The joint pain of RA tends to start in several smaller joints, such as those in the wrists, hands, feet and ankles. As RA progresses, large joints - such as the elbows, shoulders, knees, hips and neck - can be affected by pain and swelling.

The symptoms of RA tend to flare up at times, then go into remission, even without treatment.

RA is probably a result of many factors, including genetics. Smoking cigarettes can increase the risk of RA.

It is diagnosed by a combination of a physical examination, blood tests (erythrocyte sedimentation rate, rheumatoid factor and anti-CCP antibodies), X-rays and the analysis of fluid from a joint in some cases.

The inflammation of RA can cause significant damage to the joints. In the worse-case scenario, people with advanced RA have such severe joint damage that they lose range of motion and are not able to stay active. The swelling of joints can be disfiguring as well.

Rheumatoid arthritis can also affect the eyes, skin, lungs and heart. About 60 percent of people with RA develop anemia.

Early and aggressive treatment for RA is important to minimize the chances of joint damage. Unfortunately, there is no cure for the disease - but it is possible for RA to go into remission for long periods of time.

Medications can help the pain and swelling of RA and reduce the risk of disability due to joint damage. The categories of RA medications include nonsteroidal anti-inflammatory drugs (such as ibuprofen and naproxen), steroids (such as prednisone and methylprednisolone), disease modifying antirheumatic drugs (hydroxychloroquine, auranofin, sulfasalazine, minocycline and methotrexate), immunosuppressants and biologics - genetically engineered proteins derived from human genes, which include TNF-alpha inhibitors.

If RA has already caused joint damage, surgery such as a total joint replacement may be helpful to restore function and reduce pain.

Gentle exercise- such as walking, swimming, gentle water exercises and tai chi - can strengthen the muscles around joints, and is recommended for most people with RA.

Early diagnosis of RA is important, so treatment can be started early, preventing or delaying joint damage.

Kathryn B. Brown worked as a registered nurse and a nurse practitioner before coming to work for the EO.

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