What is rheumatoid arthritis and how is it treated?

Rheumatoid arthritis

What is rheumatoid arthritis?

Rheumatoid arthritis is a chronic (long term) inflammatory condition that causes pain and stiffness in the joints. The worst affected areas are usually your hands, wrists and feet but it can also affect other joints, your eyes, skin, lungs, heart and blood vessels.

What causes rheumatoid arthritis?

Rheumatoid arthritis is an autoimmune condition. Your immune system usually makes antibodies which fight infection caused by bacteria and viruses, but in the case of rheumatoid arthritis your immune system sends these antibodies to your joints, where they attack the tissue surrounding them (known as the synovium).

They release a chemical which can damage your bones, cartilage, tendons and ligaments causing the joint to lose its shape and alignment once the inflammation goes down. This can lead to erosion of the bones and cause deformity of the joint.

It’s not known why the immune system attacks perfectly healthy tissue.

What are some common rheumatoid arthritis symptoms?

The main symptoms of rheumatoid arthritis are joint pain, swelling and stiffness. These usually develop gradually over time but sometimes can progress quickly over a matter of days. The symptoms can become worse for periods of time, known as ‘flare-ups’.

Joint pain

You may notice that the pain in your joints is worse in the morning or if you’ve not moved for a while.

Joint stiffness

Joint stiffness means you may be unable to bend your fingers or clench your fist.

As well as pain, you might notice that your joints feel stiffer in the mornings. Unlike with osteoarthritis, where the stiffness can start to wear off as soon as you begin to move, the stiff ness associated with rheumatoid arthritis lasts a lot longer.

Swelling in your joints

As the lining of your joints becomes inflamed, they can swell and become hot or tender to the touch. Some people develop rheumatoid nodules – small bumps of tissue - around the affected joints.

Other symptoms of rheumatoid arthritis

You might also notice that you have more general symptoms, such as:

  • A temperature
  • Sweating
  • Poor appetite or weight loss
  • Tiredness or a lack of energy
  • Chest pain as a result of inflammation

If you experience any of these symptoms, you should make an appointment to see your GP.

How do I get a rheumatoid arthritis diagnosis?

Your GP will carry out a physical examination to check your joints for swelling and assess how well they move. If they believe you may have rheumatoid arthritis, they can refer you to our Rheumatology experts.

Is there a rheumatoid arthritis test?

Your Consultant may arrange a blood test to confirm rheumatoid arthritis. While a blood test can’t confirm or rule out a rheumatoid arthritis diagnosis, they can indicate the conditions. The main tests used are:

  • Full blood count – this can rule out other causes of your symptoms (for example, anaemia) and show how good your general health is
  • C-reactive protein (CRP) which can help measure the level of inflammation in your joints
  • Erythrocyte sedimentation rate (ESR) – another test which can measure inflammation levels
  • Rheumatoid factor (RF) and anti-CCP antibodies – according to Versus Arthritis, about 50% of people with rheumatoid arthritis have RF in their blood; although 5% of people without the condition also test positive

They may also refer you for an x-ray, ultrasound or an MRI scan. These scans can help ascertain which kind of arthritis you have and are useful in monitoring your condition over time.

What is the treatment for rheumatoid arthritis?

If you’ve been diagnosed with rheumatoid arthritis, your Consultant will carry out an assessment to see how well you can perform everyday tasks such as dressing, walking and holding items. This assessment can be repeated throughout your treatment to check how well you’re progressing.

There’s no cure for rheumatoid arthritis, but early treatment can reduce the risk of long-term joint damage.

Medication

If you’ve been diagnosed with rheumatoid arthritis, you’ll be offered DMARD (Disease-modifying anti-rheumatic drugs). These block the effects of the chemicals released when your immune system attacks your joints. These may be offered alongside biological treatments such as etanercept and infliximab.

You may also need to take painkillers, such as paracetamol or co-codomal, an NSAID such as ibuprofen, or a steroid to relieve pain. These medications can have side effects, but your Consultant will discuss the risks with you.

Therapies

Your Consultant may also recommend Physiotherapy or Occupational Therapy to help improve the health if your muscles and make your joints more flexible.

Surgery

In some cases, if medication and other supporting treatments haven’t worked, you may need surgery to correct joint problems. These can include carpal tunnel surgery (if your arthritis is in your hand or wrist) or an arthroscopy, where the damaged tissue is removed using keyhole surgery.

In some cases, people with rheumatoid arthritis may need a hip replacement, knee replacement surgery or a replacement shoulder.

How can I access private rheumatoid arthritis treatment?

For more information, or to arrange an appointment, complete our online enquiry form or contact our Private Patient team on 01580 363158.

Published on 04 January 2022