If we’re like the average person, when told we have a medical condition we ask the question, “Why me? What did I do or not do to get this disorder?” With autoimmune diseases often the answer is, “No one knows for sure why …” And, rheumatoid arthritis (RA) is an autoimmune disease.
Actually, one of the most common autoimmune diseases (when you’re immune system mistakenly attacks your own body’s tissues), rheumatoid arthritis affects about 1.5 Americans. Roughly three times more women will have the disease than men, and it most often begins between ages 30 and 60.
“The cause of RA is not yet fully understood, although doctors do know that an abnormal response of the immune system plays a leading role in the inflammation and joint damage that occurs,” the Arthritis Foundation website says. “No one knows for sure why the immune system goes awry, but there is scientific evidence that genes, hormones and environmental factors are involved.”
The symptoms for RA closely resemble those of osteoarthritis (the form of arthritis all of us will probably get if we live long enough). Tender, warm, swollen, painful joints are the common denominator as well as joint stiffness that is usually worse in the mornings and after inactivity. If you suffer those symptoms plus fatigue, fever and weight loss, you probably have rheumatoid arthritis.
“Early rheumatoid arthritis tends to affect your smaller joints first, particularly the joints that attach your fingers to your hands and your toes to your feet. As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body,” Mayo Clinic explains.
About 40 percent of RA sufferers also have symptoms that aren’t related to joints that may come and go. They include those affecting the skin, eyes, lungs, heart, kidneys, salivary glands, nerve tissue, bone marrow and blood vessels.
The diagnosis is complicated by the fact that “no one knows for sure,” but, your primary care provider will ask about personal and family history, run blood tests, do x-rays, an ultrasound or magnetic resonance imaging scan, and examine you to see if any of the aforementioned symptoms are present.
Risk factors, besides your sex and age, include a family history of RA, smoking, environmental exposures such as asbestos or silica and obesity.
On the flip side, there is an interesting article in the August 21 posting on Medical Daily that tells of a Swedish study that credits oral contraceptives with lowering the risk for RA.
“Research from Karolinska Institute in Sweden indicates that taking hormonal birth control for several years may prompt certain hormonal changes in a woman’s body that can help lower her lifelong risk of developing rheumatoid arthritis. Women who were currently on birth control were about 15 percent less likely to develop RA, while women who had stopped using the pill were still about 13 percent less likely to develop the condition. Women who had used the pill for seven years or longer could lower their risk by as much as 19 percent,” the article said.
This would certainly confirm the correlation between hormones and RA. Yes? Well, “they don’t know for sure…” Obviously, more studies need to be done.
The primary goal of RA treatment is to stop inflammation, relieve symptoms, prevent joint and organ damage, improve physical function and overall well-being and reduce long-term complications.
“Doctors refer to inflammation in RA as disease activity. The ultimate goal is to stop it and achieve remission, meaning minimal or no signs or symptoms of active inflammation,” The Arthritis Foundation says.
“There are different drugs used in the treatment of rheumatoid arthritis. Some are used primarily to ease the symptoms of RA. Others are used to slow or stop the course of the disease and to inhibit structural damage,” AF says.
The patient with RA can take a proactive role in maintaining a good quality of life by eating a diet rich in antioxidants, balancing activities with sufficient rest and developing an exercise regimen consisting of low-impact aerobics emphasizing muscle strengthening and flexibility.
Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at 208-264-4029.