Rheumatoid arthritis is a condition that can cause pain, swelling and stiffness in joints. It is known as an autoimmune condition. This means that the immune system, which is the body’s natural self-defence system, gets confused and starts to attack your body’s healthy tissues. In rheumatoid arthritis, the main way it does this is with inflammation in your joints.
Rheumatoid arthritis affects around 400,000 adults aged 16 and over in the UK. It can affect anyone of any age. It can get worse quickly, so early diagnosis and intensive treatment are important.
How does a normal joint work?
To understand how rheumatoid arthritis develops, it helps to know how a normal joint works. A joint is where two bones meet. Most of our joints are designed to allow the bones to move in certain directions and within certain limits.
For example, the knee is the largest joint in the body and one of the most complicated. It must be strong enough to take our weight and lock into position, so we can stand upright. It also has to act as a hinge, so we can walk, and needs to twist and turn when we run or play sports.
The end of each bone is covered with cartilage that has a very smooth, slippery surface. The cartilage allows the ends of the bones to move against each other.
The joint is held in place by the synovium which contains thick fluid to protect the bones and joint. The synovium has a tough outer layer that holds the joint in place and stops the bones moving too far. Strong tendons anchor the muscles to the bones.
What happens in a joint affected by rheumatoid arthritis?
If you have rheumatoid arthritis, your immune system can cause inflammation inside a joint or a number of joints. Inflammation is normally an important part of how your immune system works.
It allows the body to send extra fluid and blood to a part of the body under attack from an infection. For example, if you have a cut that gets infected, the skin around it can become swollen and a different colour. However, in rheumatoid arthritis, this inflammation in the joint is unnecessary and causes problems. When the inflammation goes down, the capsule around the synovium remains stretched and can’t hold the joint in its proper position. This can cause the joint to become unstable and move into unusual positions.
The main symptoms of rheumatoid arthritis are:
• joint pain
• joint swelling, warmth and redness
• stiffness, especially first thing in the morning or after sitting still for a long time.
Other symptoms can include:
• tiredness and lack of energy ‘fatigue’
• not feeling hungry
• weight loss
• a high temperature, or a fever
• dry eyes – as a result of inflammation
• chest pain – as a result of inflammation
The following can play a part in why someone has rheumatoid arthritis:
Rheumatoid arthritis affects adults of any age, although most people are diagnosed between the ages of 40 and 60. Around three-quarters of people with rheumatoid arthritis are of working age when they are first diagnosed.
Rheumatoid arthritis is two to three times more common among women than men.
Rheumatoid arthritis develops because of a combination of genetic and environmental factors. If you have a genetic predisposition to rheumatoid arthritis, it means you have an increased likelihood of developing the condition based on your genetic makeup. It is unclear what the genetic link is, but it is thought that having a relative with the condition increases your chance of developing the condition.
If you are overweight, you have a significantly greater chance of developing rheumatoid arthritis than if you are a healthy weight. The body mass index (BMI) is a measure that calculates if your weight is healthy, using your height and weight.
For most adults, an ideal BMI is in the 18.5 to 24.9 range.If your BMI is:
• below 18.5 – you’re in the underweight range
• between 18.5 and 24.9 – you’re in the healthy weight range
• between 25 and 29.9 – you’re in the overweight range
• between 30 and 39.9 – you’re in the obese range.
Rheumatoid arthritis develops through a combination of genetic and environmental factors. Cigarette smoking is classed as an environmental factor and significantly increases the risk of developing the condition. If you would like to stop smoking, visit the Smokefree website for advice.
There is some evidence that if you eat a lot of red meat and don’t consume much vitamin C, you may have an increased risk of developing rheumatoid arthritis.
How will rheumatoid arthritis affect me?
Because rheumatoid arthritis can affect different people in different ways, we can’t predict how the condition might develop for you.
If you smoke, it’s a very good idea to quit after a diagnosis of rheumatoid arthritis.
This is because:
• rheumatoid arthritis may be worse in smokers than non-smokers
• smoking can weaken how well your medication works.
Physical activity is also important, as it can improve your symptoms and benefit your overall health. The Versus Arthritis website has suitable exercises you can try. Blood tests and x-rays will help your doctor assess how fast your arthritis is developing and what the outlook for the future maybe. This will also help your doctor to decide which treatment to recommend. The outlook for people with rheumatoid arthritis is improving all the time, as new and more effective treatments become available. It is possible to lead a full and active life with the condition, but it’s important to take your medication as prescribed and make necessary lifestyle changes.
Do you suffer from Rheumatoid Arthritis and want some advice?
Click HERE to go to the new service that has been launched by the National Rheumatoid Arthritis Society (NRAS) at the BSR 2019 congress in Birmingham. New2RA Right Start supports people newly diagnosed with RA to understand their diagnosis and how it is likely to affect them.