Rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease that causes pain and inflammation of the joints. Other parts of the body can also be affected. Inflammation causes the joints to become painful and swollen and movement may be restricted. Stiffness in the joints is common, especially in the morning. The inflammation caused by rheumatoid arthritis can result in damage to the joints.

Rheumatoid arthritis usually starts in middle life, with onset generally occurring between the ages of 35 to 64, and affects 1 per cent of Australia’s population. An estimated 57 per cent of people with rheumatoid arthritis are women.

Symptoms of rheumatoid arthritis

The most common symptoms of rheumatoid arthritis include:

• Swelling, pain and heat in the joints
• Stiffness in the joints, especially in the morning
• Persistent fatigue
• Sleeping difficulties because of the pain
• Weak muscles
• The same joints on both sides of the body are usually affected.

Seek advice early

It is important to seek medical advice early in the course of the condition. Early treatment will help you manage pain more effectively and minimise long-term joint damage.

Anyone who experiences pain and swelling in one or more joints should discuss this with their doctor. If you are diagnosed with rheumatoid arthritis or suspected of having the condition, you may be referred to a medical specialist known as a rheumatologist.

An immune system attack

The cause or causes of rheumatoid arthritis are not yet fully understood. We do know that rheumatoid arthritis is an autoimmune disease. The normal role of the body’s immune system is to fight off infections, however when a person has an autoimmune disease, the immune system starts attacking the body’s healthy tissues.

In the case of rheumatoid arthritis, the immune system targets the lining of the joints, causing inflammation and joint damage. The characteristic swelling happens when the joint produces too much lubricating (synovial) fluid in response to the inflammation.

Some people may be more at risk of developing rheumatoid arthritis due to heredity factors. Exactly what triggers the body’s immune system to attack the joints is unknown.

There is no cure for rheumatoid arthritis. However, there are many strategies you can use to manage the condition and its symptoms.

Managing rheumatoid arthritis

To manage rheumatoid arthritis it is helpful to understand the nature of the disease. Self-management courses can help people with rheumatoid arthritis and other chronic (ongoing) conditions to build their skills and confidence to live with the condition. Arthritis Victoria can provide more information on these courses.

Other important strategies that can help you manage rheumatoid arthritis include:

• Medication – a rheumatologist may prescribe a number of different medications depending on your symptoms and the severity of your condition. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to reduce pain and inflammation. The disease-modifying anti-rheumatic drugs (DMARDs) are a special group of medications used to treat inflammatory arthritis. Biological DMARDs are the newest class of arthritis medication and work to stop the disease progressing and causing structural damage to joints.
• Aids and equipment – supports such as walking aids and specialised cooking utensils reduce joint strain and can help you to manage pain and fatigue. An occupational therapist can give you advice on aids.
• Relaxation techniques – muscle relaxation, distraction, guided imagery and other techniques can help you manage pain and difficult emotions such as anxiety.
• Exercise – some physical activity will help you maintain muscle strength and joint flexibility and assist you in managing pain. Appropriate activities include exercising in warm water, strength training and Tai chi. You may need to seek advice from a physiotherapist or exercise physiologist before you begin an exercise program.
• Physiotherapy – a physiotherapist can provide advice on managing pain and on physical activity.
• Rest – rest can help you to manage fatigue and is particularly important when your joints are swollen.
• Nutrition – while there is no specific ‘diet’ for people with rheumatoid arthritis, it is important to have a healthy, balanced diet to maintain general health and prevent other medical problems.
• Support – a peer support group can provide understanding, advice, support and information from others in a similar situation. Contact Arthritis Victoria for more information.
• Complementary therapies – such as massage or acupuncture may be helpful. Consult your doctor or rheumatologist before commencing any treatment.
• Joint surgery – may be necessary in some cases.

Any medication or treatment for arthritis must be discussed with, and monitored by, your doctor or rheumatologist. They will take into account the illness being treated, any other health issues and identifiable risk factors.

Where to get help

• Your doctor – for referral to a rheumatologist (a specialist in arthritis)
• Rheumatologist
• Arthritis Victoria Tel. (03) 8531 8000 or 1800 011 041
• Physiotherapist
• Australian Physiotherapy Association Tel. (03) 9092 0888 or Find a Physio
• Medicines Line (Australia) Tel. 1300 MEDICINE (1300 633 424) – for information on prescription, over-the-counter and complementary medicines.

Things to remember

• Rheumatoid arthritis commonly affects the hands, knees and feet. Generally both sides of the body are affected.
• The immune system attacks the joints, but the trigger for this isn’t known.
• There is no cure, but the disease can be managed.

You might also be interested in:

• Arthritis.
  
• Arthritis - juvenile.
  
• Arthritis and diet.
  
• Arthritis and exercise.
  
• Bursitis.
  
• Gout.
  
• Hip disorders.
  
• Immune system.
  
• Knee replacement surgery.
  
• Pain management - adults.
  
• Pain management - children.
  
• Polymyositis.
  
• Reactive arthritis.
  
• Sjogren's syndrome.
  

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Arthritis Victoria

Last reviewed: September 2012

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<a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Rheumatoid_arthritis?open">Rheumatoid arthritis - Better Health Channel</a><br/>
Rheumatoid arthritis is a disease in which inflammation (pain, heat and swelling) affects the joints and other organs of the body. The hands, feet and knees are commonly affected. Stiffness in the joints is common, especially in the morning. There is no cure for rheumatoid arthritis but there are ways to manage it.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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