What is Arthritis?
Arthritis is one of the most pervasive diseases in the United States and is the
leading cause of disability. According to the Centers for Disease Control and
Prevention one out of every three Americans (an estimated 70 million people) is
affected by one of the more than 100 types of arthritis.
For most people arthritis pain and inflammation cannot be avoided as the body
ages. In fact, most people over the age of 50 show some signs of arthritis.
Joints naturally degenerate over time. Fortunately, arthritis can be managed
through a combination of medication, exercise, rest, weight-management,
nutrition, and, in some cases, surgery. Your doctor can tell if you have
arthritis through blood tests and x-rays. He or she will then be able to help
you make a decision on the best treatment for your case.
Arthritis is a chronic disease that will be with you for a long time and
possibly for the rest of your life. Your treatments will probably change over
time and medication may be adjusted. Having a positive mental outlook and the
support of family and friends will help you live with arthritis and be able to
continue to perform your daily activities
Risk Factors for Rheumatoid Arthritis
A risk factor is something that increases your likelihood of getting a disease
or condition. It is possible to develop rheumatoid arthritis with or without
the risk factors listed below. However, the more risk factors you have, the
greater your likelihood of developing rheumatoid arthritis. If you have a
number of risk factors, ask your health care provider what you can do to reduce
You may have an increased risk of developing rheumatoid arthritis if you have
received blood transfusions.
Although rheumatoid arthritis can develop at any age, you’re most likely to
develop the condition between the ages of 25 and 45.
Women are 2.5 to 3 times more likely to develop rheumatoid arthritis than men.
You are more likely to develop rheumatoid arthritis if there are other people
in your family with this condition or with other autoimmune disorders.
You have a greater risk of developing rheumatoid arthritis if you are:
Native American (particularly belonging to the Yakima, Chippewa, or Inuit
People who are overweight may have an increased risk of developing rheumatoid
Coffee and Cigarettes
Some studies have suggested that there is a connection between drinking coffee
and developing rheumatoid arthritis. More work needs to done to confirm this
association. Long-term smoking may be a risk factor for the development of
Symptoms of Rheumatoid Arthritis
Joint symptoms usually involve three or more joints. The most commonly affected
joints are the wrists, fingers, knees, feet, and ankles.
Other symptoms of rheumatoid arthritis include:
Increased pain and stiffness in the morning and after inactivity
Morning stiffness and pain that lasts more than 30 minutes
Pain and stiffness symmetrically (that is, both feet or both hands are
affected, as opposed to only one)
Red, swollen, warm joints
Deformed, misshapen joints
Risk Factors for Rheumatoid Arthritis
Diagnosis of Rheumatoid Arthritis:
Intense fatigue, decreased energy
Fever and sweats
Bumps occurring under the skin (rheumatoid nodules)
Inflamed blood vessels
Bleeding stomach ulcers
Inflammation of the heart’s sac (pericarditis)
Inflammation of the heart muscle (myocarditis)
There are no specific tests to
completely confirm or eliminate the diagnosis of rheumatoid arthritis.
Your health care provider may begin to suspect rheumatoid arthritis after
taking a careful history of your symptoms and performing a thorough physical
According to The American Rheumatism Association, if you have four of the seven
symptoms listed below you are considered to have rheumatoid arthritis:
If there are any questions about the diagnosis, your health care provider may
recommend other tests to confirm the diagnosis or to evaluate whether your
internal organs are also involved. Such tests may include the following:
Morning stiffness that lasts over an hour
Arthritis in at least three joints
Arthritis of the joints of the hand
Arthritis on both sides of the body (for example, involving both hands or both
A positive blood test for rheumatoid factor (RF)
Presence of lumps under the skin, called rheumatoid nodules
X-rays that show signs of rheumatoid arthritis affecting the joints
– a number of blood tests can point to the presence of an autoimmune disorder.
– to best view the joints and any destruction caused by rheumatoid arthritis, a
specialized x-ray test called dual energy x-ray absorptiometry is used.
Erythrocyte sedimentation rate
Other imaging tests may be used to visualize the internal organs, in order to
see whether rheumatoid arthritis has affected them. Specific areas of the body
to be examined with imaging tests may be chosen based on your symptoms. Imaging
tests may include:
– removing some joint fluid for laboratory exam may reveal the presence of an
enzyme called MMP-3. MMP-3 is associated with rheumatoid arthritis.
Medications for Rheumatoid
The information provided here is meant to give you a general idea about each of
the medications listed below. Only the most general side effects are included,
so ask your health care provider if you need to take any special precautions.
Use each of these medications only as recommended by your health care provider,
and according to the instructions provided. If you have further questions about
usage or side effects, contact your health care provider.
There are a variety of medications available to treat the pain and inflammation
of rheumatoid arthritis. You may have to try different medicines before you
find the one that works best for you with the least number of side effects.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Cyclooxgenase-2 or COX-2 inhibitors
Naproxen (Naprosyn, Anaprox, Aleve)
Ibuprofen (Motrin, Advil, Nuprin)
Diclofenac sodium (Voltaren)
Diclofenac (Voltaren, Cataflam)
Disease-modifying antirheumatic drugs (DMARDs)
D-penicillamine (Cuprimine, Depen)
Hydroxychloroquine sulfate (Plaquenil)
Prednisone (Deltasone, Cortan)
Biologic response modifiers
Interleukin-1 receptor inhibitors
Common brand names include:
Acetaminophen can be helpful in relieving some of the pain associated with
rheumatoid arthritis. Do not take a larger dose than is recommended by your
health care provider. Do not drink alcoholic beverages while you are taking
Common brand name: Zostrix
Capsaicin cream is rubbed on the skin of an affected joint to relieve the pain
and inflammation of rheumatoid arthritis.
It’s made using the active ingredient of hot chili peppers. Some people prefer
to wear rubber gloves while applying the cream. If you don’t, be sure to wash
your hands very thoroughly with soap and water after using the cream. Be very
careful not to get the cream near your eyes, as it will burn and sting. If you
do get some in your eyes, flush them thoroughly with cool water.
Possible side effects include burning, stinging, or warm sensation when first
applied to the skin.
Whenever you are taking a prescription medication, take the following
Treatments for Rheumatoid Arthritis:
The following treatments can help to manage pain, inflammation, stiffness, and
Take them only as directed, not more, not less, not at a different time.
Do not stop taking them without consulting your health care provider.
Don’t share them with anyone else.
Know what effects and side effects to expect, and report them to your health
If you are taking more than one drug, even if it is over-the-counter, be sure
to check with a physician or pharmacist about drug interactions.
Plan ahead for refills so you don’t run out.
Application of Heat
Heat improves blood circulation to the treated area. Applying heat via warm
soaks, whirlpools, paraffin, or heating pads can be very soothing. Most health
care providers recommend that you apply the heat for about 10 minutes at a
time, 3-4 times a day.
Application of Cold
Cold can help decrease inflammation in an affected joint, thereby relieving
pain and improving stiffness and movement. Apply an ice pack for 20-30 minutes
at a time, several times each day.
Intra-articular Corticosteroid Injections
In this therapy, the affected joint is injected with a solution containing a
The steroids can help decrease inflammation and therefore pain in the joint.
Sometimes, your health care provider will remove excess joint fluid from the
joint just before injecting the steroid medicine.
Steroid injections often have to be repeated every several months. Most
practitioners believe that you shouldn’t get more than three or four such
injections in a year; more injections may cause damage to the cartilage.
Physical therapy can help you decrease pain and stiffness, increase muscle
strength, develop flexibility, and improve stamina. Physical therapists can
teach you exercises to do on your own, or you can attend regular physical
If you are having trouble getting around, a cane or walker may help. In
addition, a variety of devices are available to help you with tasks that
rheumatoid arthritis can make difficult or impossible, such as buttoning or
zipping your clothing, opening jars, opening doors, and other activities of
daily living. Talk to your health care provider about the kinds of assistance
you need; he or she may recommend a consultation with an occupational
Apheresis (Prosorba Column)
This is a new treatment that involves filtering your blood through a medical
device that removes antibodies. The rest of the blood is then returned to you.
The procedure takes about 2 hours, and is usually done weekly for 12 weeks.
Most patients don’t notice improvement of their symptoms until around the
12-week mark. Side effects may include:
Some people with rheumatoid arthritis become depressed and anxious. Consider
finding a support group where you can meet other people who have learned to
cope with the challenges of rheumatoid arthritis. Sharing your own experiences,
and learning from the struggles and triumphs of others can be very helpful
Fever and chills