Rheumatoid arthritis is an autoimmune disorder that is characterized by inflammation, pain, and loss of function in the joints. It most often affects the wrist and hand, but sometimes it affects the elbows, shoulders, neck, knees, hips or ankles. The swelling, inflammation and damage to the joints occur when the body’s immune system attacks the tissue around the joints. Although not as common, rheumatoid arthritis may affect other parts of the body besides the joints. Rheumatoid arthritis may flare up and suddenly go into remission, or it can be a constant debilitating and painful condition.
Some rheumatoid arthritis patients will develop carpal tunnel syndrome or other mild forms of peripheral neuropathy. Symptoms tend to appear bilaterally, meaning that both sides of the body (i.e. both hands or both knees) are impacted in a similar way.
The cause of rheumatoid arthritis is unknown, but researchers believe that there are genetic, environmental and other factors that trigger the disease. Onset usually occurs in middle age, and is more likely to develop in women. Approximately 10 to 15 percent of patients suffering from rheumatoid arthritis will also develop Sjögren’s syndrome, an inflammatory disorder characterized by dryness in the eyes and mouth.
Early detection of rheumatoid arthritis positively impacts the ability to treat this disease and its symptoms. Early treatment may reduce the potentially crippling damage caused to bones. Unfortunately, rheumatoid arthritis is sometimes difficult to detect and diagnose because the symptoms vary from person to person and there is no one definitive test for the disease.
Symptoms & Signs
(Not all symptoms and signs may be present.)
- Fatigue, at times accompanied by fever
- Loss of appetite
- Tender, warm or swollen joints
- Difficulty moving affected joints
- Pain and stiffness
- Rheumatoid nodules (lumps under the skin)
Evaluation & Tests
(Not all evaluation and tests may be necessary.)
- Neurological exam 
- Electromyography 
- Nerve conduction velocity test 
- X-ray to determine joint damage
- Blood tests (for presence of rheumatoid factor antibody, anemia and to measure white blood cell count)
Treatment & Therapy
(Not all treatments and therapies may be indicated.)
Treatment focuses on relieving pain by reducing inflammation, slowing joint and bone damage and improving the ability to function with the disease.
- Rest and exercise programs
- NSAIDs (aspirin, ibuprofen and Aleve®) to reduce joint inflammation and pain
- Disease modifying anti-rheumatic drugs (DMARDs) to suppress the immune system and slow the onset of the disease (hydroxychloroquine (Plaquenil®), methotrexate (Rheumatrex®, Trexall®), leflunomide (Aravara®)
- Surgery may be considered to replace or repair severely damaged joints and tendons
- Take safety measures to compensate for loss of sensation
- Ask your doctor about special therapeutic shoes (which may be covered by Medicare and other insurance)