Rheumatoid arthritis is an autoimmune disease that occurs when the immune system attacks joint tissue and causes damage. Like other autoimmune diseases, it is believed to have a genetic component, meaning it occurs more frequently in patients with a family history of RA or other autoimmune conditions such as Sjögren’s syndrome or Crohn’s disease.
Flare-ups—times when the disease is active—are usually accompanied by joint pain, low-grade fever and lack of appetite. These symptoms are often subtle at first, and only gradually become obvious. The pain and stiffness typically manifests in a symmetrical pattern on the body, with corresponding joints affected on both sides.
There is no cure for rheumatoid arthritis, but there are a number of over-the-counter, prescription, and doctor-administered medications that can help alleviate symptoms and reduce the frequency and severity of flare-ups:
- NSAIDs, most of which are available over the counter, reduce inflammation and accompanying pain.
- Corticosteroids, including prednisone, can also reduce inflammation. However, side effects can include weight gain, osteoporosis and heightened emotions, and corticosteroids are often prescribed with the expectation that the patient will be tapered off the medication eventually.
- Disease-modifying antirheumatic drugs such as methotrexate, sulfasalazine and minocycline slow the progression of the disease and can help minimize long-term damage. These too can have severe side effects in some patients, such as liver damage, bone marrow loss and lung infections.
- Immunosuppressants reduce immune function, so the immune system stops attacking healthy tissue. Immune function overall is slightly lower, and you have to be careful about potential exposure to transmissible illness, though it’s not completely eliminated.
- TNF-alpha inhibitors reduce the amount of TNF-alpha, a protein naturally produced by the body that is linked to inflammation. This protein, however, is instrumental in preventing cancer, so the effects need to be monitored.
In addition to medical treatments, there are non-medical approaches that can be helpful. As with other forms of arthritis, heat and cold can help ease the pain in the affected joints, as can massage. Relaxation techniques such as meditation, deep breathing and guided imagery can be useful for pain management.
Your doctor can help you come up with a plan to help you take care of yourself. If you have rheumatoid arthritis, you don’t have to let it control your life.