Rheumatoid arthritis (RA), the most common form of inflammatory arthritis, is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. RA is classified as an autoimmune disease, which develops because certain cells of the immune system malfunction and attack healthy joints.
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Explore This IssueNovember 2008
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More than one million Americans suffer from RA, and about 75% of those affected are women. The disease generally begins between the fourth and sixth decades of life; however, RA can develop at any age. Studies have shown that people who receive early treatment for RA feel better, are more likely to be able to lead an active life, and are less likely to experience the type of joint damage that leads to joint replacement. It is important for people with RA to remain physically active while occasionally scaling back activities when the disease flares.
Although the cause of RA remains unknown, exciting and rapidly advancing research reveals the factors that produce inflammation. Inflammatory chemicals released by the immune cells cause swelling and damage to cartilage and bone. According to patient–fact sheet writers Eric Ruderman, MD, and Siddharth Tambar, MD, “This research is giving us a better understanding of the immune and genetic factors that may be involved in the disease. As a result of this work, new medications have been developed that specifically block certain signals in the body from the immune system that are important in causing RA symptoms and joint damage.”
RA can be difficult to diagnose because it can begin gradually with subtle symptoms. There is no single test that confirms a diagnosis of RA. Rather, diagnosis is established by skillfully evaluating the appropriate symptoms, physical examination findings, laboratory tests, and X-rays.
Therapy for patients with RA has improved dramatically over the past 25 years. Current treatments offer most patients good to excellent relief of symptoms and the ability to continue to function at—or near—normal levels. Because there is no cure for RA, the goal of treatment is to minimize a patient’s symptoms and disability by introducing appropriate medical therapy early, before the joints are permanently damaged.
No single therapy is effective for all patients, and many patients will need to change treatment strategies during the course of their disease. Optimal treatment of RA often requires more than medication. Drs. Ruderman and Tambar agree that, “proper treatment requires comprehensive, coordinated care, patient education, and the expertise of a number of providers, including rheumatologists, primary-care physicians, and physical and occupational therapists.”