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Rheumatoid Arthritis Overview

Rheumatoid arthritis is an inflammatory disease that affects your joints. It can cause swelling, stiffness, pain and loss of function in the joints it affects. Unlike other types of arthritis, it does not usually affect just one joint, but the matching joint on the other side of your body as well. The most commonly affected joints are the wrists and fingers. There are several forms of the disease, ranging from a short period of pain lasting for only a year to severe pain that lasts many years or an entire lifetime.

Symptoms
Symptoms can vary from person to person, but there are several features of the disease that often occur:
•Tender, swollen and warm joints – often in the wrist or fingers
•Pain affecting the same joints on both sides of your body
•Inflammation in other joints such as the knees or hips
•Prolonged periods of pain and stiffness, after long periods of rest or after waking up
•Occasional fevers, fatigue, and an overall feeling of not being well

Factors Increasing the Risk of Rheumatoid Arthritis
•Rheumatoid arthritis can be hereditary, and can result from having specific genes that control your immune system. Several genes play a role in whether a person develops the disease, and how severely they are afflicted. Genetics, however, is not the only factor.
•It is believed that certain events trigger the onset of rheumatoid arthritis in people already susceptible to it because of their genes. The most likely causes are bacterial or viral infections.
•Women are more likely to develop the disease than men, and their hormone levels may affect the onset of the disease. For example, pregnancy often lessens the severity of the disease, while flare-ups often occur after giving birth.

The Basics of Rheumatoid Arthritis
Joints, where two bones connect, are normally surrounded by a protective and supportive capsule. The capsule surrounds the joint and the cartilage between the bones. Healthy joints have a lining of a tissue called synovium and produce a fluid that both nourishes and lubricates the bones and cartilage.

In people with rheumatoid arthritis, the immune system produces white blood cells that attack the synovium. This causes the inflammation consistent with arthritis, and makes the joint swollen and painful. Once the disease develops, the inflamed synovium actually attacks the joint and its bone and cartilage, working to destroy it. Eventually, the muscles around the joint become too weak to support it properly, causing often severe pain and joint damage.

Common Treatments
No matter what treatment doctors and patients choose, the goal is always to stop pain and inflammation, prevent further damage to joints and allow the person to function normally.

Dealing with the Disease:
•Splints can be used to support an affected joint, letting it rest. This will reduce swelling and pain. Other simple tools can make daily tasks easier for people with the disease. For example, patients may use special devices to help them get in and out of bed.
•A healthy blend of rest and exercise is also important. Doctors suggest getting more exercise while the disease is not severe, and getting more rest when attacks flare-up. Exercise improves flexibility, muscle strength, and joint mobility, while also contributing to the patient’s overall well-being. When resting, it is best to rest for short periods, rather than taking long naps.
•To reduce the stress involved in coping with the disease, patients can utilize relaxation techniques, regular exercise, and support groups. Eating a balanced diet also contributes to overall well-being.

Medication and Surgery
•Most people with rheumatoid arthritis take some form of medication. Types include those to relieve pain, to reduce inflammation and to slow the onset of the disease. Common drugs include Nonsteroidal Anti-inflammatory Drugs (NSAIDs) and aspirins.
•The most effective treatments often include a combination of more powerful medications.
•Surgery can be performed to reduce pain and improve joint function and daily life. Common surgeries include joint replacement, tendon reconstruction, and synovectomy, in which doctors remove the inflamed synovial tissue. This is done only as part of other reconstructive surgery.

For all patients, regular doctor visits, and routine blood and other laboratory tests are important and should be made on a regular basis.

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