Rheumatoid arthritis, also known as RA, is a type of systemic autoimmune disease. It occurs when the body’s immune system mistakenly attacks the joints, resulting in inflammation. The lining of the joints, known as the synovium (and also sometimes referred to as the synovial tissue or synovial membrane), then becomes affected. This lining is responsible for keeping the joints lubricated and allowing them to move. However, with rheumatoid arthritis, inflammation causes this lining to thicken which is what ultimately causes you to experience pain and swelling in the affected areas. To date, rheumatoid arthritis affects over 4.6 million Canadians, and that number is expected to rise to an estimated 7.5 million by the year 2036. On a global scale, it’s estimated that nearly 18 million people are living with RA.
Rheumatoid arthritis can affect people of all ages, including children, but it typically starts between the ages of 30 and 60. It’s also more prevalent in women, with a 3.5% risk of developing RA, while the risk for men is much lower (1.7%). Men also tend to be diagnosed with rheumatoid arthritis later in life compared to women.
The joints that are most commonly affected by rheumatoid arthritis include the hands, wrists, elbows, knees, ankles and feet. The effect that RA has on the joints is also typically symmetrical. For example, both hands would be affected as opposed to just one. Aside from joint pain and swelling, you may also experience joint stiffness (especially in the mornings.) The pain associated with rheumatoid arthritis can last for days, weeks or even months at a time, or they may come and go.
The joints aren’t the only thing affected by rheumatoid arthritis, either. It can also have an impact on other systems in the body (hence it being a “systemic” disease) including the respiratory and cardiovascular systems. For example, you may experience shortness of breath as a result of inflammation. That inflammation can also occur in the blood vessels and may affect the nerves and skin. You may also have a decreased level of red blood cells, known as anemia, and the eyes and mouth can also be affected – i.e. dry eye, eye pain, eye redness, sensitivity to light, blurred vision, dry mouth, and gum irritation or infection. It’s also not uncommon for people with RA to develop a decreased appetite, fatigue, and even low-grade fever.
As for what causes rheumatoid arthritis, it is not fully known other than the fact that the immune system definitely plays a role. However, there has been some scientific evidence to suggest that there may be hormonal, genetic and environmental factors – not only associated with RA, but with other disorders and diseases related to the immune system, too. Some of these factors may include obesity, exposure to cigarette smoke and/or air pollution, as well as both physical and emotional trauma.
When it comes to treating rheumatoid arthritis, the main strategies are to try and stop the inflammation and send the disease into a state of remission, relieve the painful symptoms, prevent joint and organ damage or other long-term complications, and improve the physical function and overall well-being of you, the patient. One approach that health experts recommend trying is the “treat to target” approach – which is also sometimes referred to as T2T. During the T2T approach, there are two primary targets: The first being remission. If remission does not occur, then the second target would be to decrease the disease activity by either aiming to control or suppress the inflammation through use of medications. Your disease activity will be measured on a monthly basis through different tests and examinations, and if the target is not reached then your medication will then be adjusted accordingly, which is done until the treat to target goal has been achieved. You can read more about the T2T approach here.
You can also take a proactive role in your treatment through different self-management tips, including making some dietary changes, getting regular physical activity, but also ensuring you get rest. While there’s no diet that has been specifically made for rheumatoid arthritis, certain foods have been known to help reduce inflammation, including salmon, blueberries, strawberries, spinach, kale, broccoli, pistachios, kidney beans and black beans. You should avoid processed foods, such as potato chips or snacks that are loaded with sugar (such as cookies), as these foods have been linked to inflammation. Staying fit through your diagnosis is also important, but at the same time it’s also important to rest when you need it, as rest is also crucial in reducing both inflammation and fatigue associated with flare-ups. When you do exercise, make sure it’s low-impact activity and that you’re not overexerting yourself. You can also try heat treatments (i.e. a heating pad or hot water bottle) for temporary relief of joint pain that is acute in nature.