Like osteoarthritis, rheumatoid arthritis causes pain and swelling in the joints. The difference lies in the cause: Rheumatoid arthritis is an autoimmune disorder in which the lining of the joints swells and produces antibodies called rheumatoid factors, which then attack the joint surface. Early rheumatoid arthritis tends to first affect the smaller joints-such as those in the fingers and toes-before progressing to larger ones like knees and shoulders.
In addition to causing joint problems, rheumatoid arthritis can also bring about fever, fatigue, and other symptoms affecting the whole body.
Common symptoms of rheumatoid arthritis are pain, swelling, stiffness (especially in the morning). Problems in more than one joint and systemic symptoms such as fever and fatigue are also indicators of rheumatoid arthritis.
Your physician will first ask you for a description and history of the problem, including when the pain started, what it feels like, whether it's constant or comes on with certain activities, etc.
A thorough physical exam will include checking the joint for swelling, warmth, lumps under the skin, deformities, and limitations in range of motion. An X-ray will show the extent of the disease, and a blood test will check for presence of the tissue-destroying rheumatoid factor.
While there is no "cure" for rheumatoid arthritis, certain surgical and nonsurgical treatments can help relieve pain and improve functioning.
- Medication: Medications used to treat rheumatoid arthritis fall into two categories:
- Nonsteroidal anti-inflammatory medications (NSAIDs) such as aspirin and ibuprofen can reduce pain and swelling.
- Disease-modifying antirheumatic drugs (DMARDs) such methotrexate and sulfasalazine can help slow the progression of the disease.
- Exercise and physical therapy: A physical therapist works with you to develop an exercise program that strengthens the affected joints without stressing them.
If nonsurgical options don't stop or slow joint damage, your physician may recommend one of the following surgical approaches:
- Arthroscopy:Using a thin, flexible instrument called an arthroscope, the surgeon can see inside the joint and remove inflamed tissue or debris.
- Synovectomy:The surgeon removes the inflamed joint lining (synovium) that is causing the problem.
- Joint replacement: The surgeon replaces the damaged joint with an artificial replacement (prosthesis). See Arthritis and Joint Replacement for more information.