<p>Rheumatoid arthritis is when the body’s immune system attacks its healthy joints, causing inflammation in the lining of the joints. It can also affect other parts of the body, such as, the eyes, lungs and heart. The inflammation can be painful, and can lead to permanent damage if the disease is not treated and controlled. </p>
<p>Joint damage can occur in cases where the pain is not severe. This generally happens within the early stages of the disease. For many people with RA, damage is detected, from X-rays of the hands and feet, within two years of the onset of the disease. However, by the time X-rays discover the problem, the disease usually has progressed and is irreversible. Severe damage can lead to permanent joint deformity and disability. It can cause a high level of pain and swelling that one may be unable to walk.<br />
Rheumatoid Arthritis usually appears between the ages of 25 and 50. There is a range of signs and symptoms for RA. Some of the symptoms may include the following:</p>
<p>•	Sudden, severe attacks with flu-like symptoms.<br />
•	Periods of activity followed by joint inflammation (flare-ups).<br />
•	Weakness, tiredness, fever and/or sudden weight loss.</p>
<p>If any of the prior warning signs last more than two weeks, one should consult his/her physician. </p>
<p>One important way to distinguish RA from other forms of arthritis is by the pattern of joint involvement. For example, RA affects the wrist and many of the hand joints but usually not the joints that are closest to the fingernails. Other joints commonly affected by RA include: the elbows, shoulders, neck, jaw, feet, ankles, knees, and hips.</p>
<p>Along with painful, inflamed joints, RA can cause inflammation in body tissues and organs. In 20% of RA cases, lumps called rheumatoid nodules develop under the skin, often over bony areas. These occur most often around the elbow but can be found elsewhere on the body and even in internal organs. Occasionally, people with RA will develop inflammation of the membranes that surround the heart and lung or inflammation of the lung tissue itself. Inflammation of tear glands and salivary glands (called sicca syndrome) result in dry eyes and dry mouth. </p>
<p>There are five types of medicines used to treat RA:</p>
<p>•	Nonsteroidal anti-inflammatory drugs (NSAIDs) are a type of medicine that reduces pain and swelling. However, they do not prevent further joint damage. Two common NSAIDS are Aspirin® and Advil®. </p>
<p>•	COX-2 inhibitors (e.g. Celebrex®) are a specific kind of NSAID that may be prescribed if traditional NSAIDs are hard on your stomach, or if you have experienced stomach ulcers. People who have had a heart attack or stroke or experienced serious chest pain related to heart disease should not use NSAIDs or COXIBs. </p>
<p>•	Disease-modifying anti-rheumatic drugs (DMARDS). They work by slowing or stopping the immune system from attacking the joints. DMARDS take about one to three months before they begin to make a difference in the pain and swelling. </p>
<p>•	Persistent inflammation in several joints, due to inflammatory arthritis, for longer than six weeks requires stronger medicine; that’s when the so-called disease modifying anti-rheumatic drugs (DMARDs) are often used. Rheumatologists usually prescribe this class of medication in addition to NSAIDs. While the NSAID reduces day-to-day inflammation, the DMARD slows down the biological processes that are the driving force behind persistent inflammation. </p>
<p>•	Corticosteroids are drugs that closely resemble cortisone, a hormone natural produced by the body. In RA, these drugs are used to treat extreme inflammation that is accompanied by severe pain and stiffness. They are also used to treat systemic RA, which may affect the lining of the lungs and blood vessels. Corticosteroids sometimes are given as injection into one or more joints or other areas of inflammation. The most common form is Prednisone. </p>
<p>Some people with severe, advanced RA may benefit from surgery. There are a number of different kinds of surgery for RA ranging from minor procedures to complete joint reconstruction. Arthroscopic surgery, for example, involves using a scope through a small incision and cleaning or removing inflamed or damaged joint tissue. Some kinds of surgery repair bone deformity through realigning joints, fusing joints, or rebuilding parts of joints. Joint reconstruction involves removing all or parts of the damaged joint and replacing them with artificial materials. </p>
<p>No one knows for sure what causes RA. Scientists are trying to learn why the immune system attacks healthy body tissues, as well as, medicines to help prevent joint swelling.<br />
Until then, please contact your physician at the onset of the signs and symptoms of RA.</p>
