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Preventing joint damage from rheumatoid arthritis

Lasting joint damage is possible from rheumatoid arthritis and in addition swelling weakens ligaments, tendons and muscles around a joint that also contributes to joint damage.

Part of managing rheumatoid arthritis will be protecting the joints as much as possible to help prevent long-term damage.

Causes of rheumatoid arthritis joint damage

There are two main ways in which this process can cause joint damage:

  • The immune system attacks the lining of the joint causing inflammation. The inflammation inside the joint stimulates the joint lining (synovium) to grow and spread where it doesn't belong. If this process continues for long enough, it can harm healthy cartilage or bone.
  • Cartilage is the cushion between bones in a joint. Over time, putting stress on the joint or bearing weight on it can wear down the weak cartilage even more. This is called degenerative disease, and it is similar to what happens in 'wear and tear' arthritis ( osteoarthritis) - only it happens faster in people with rheumatoid arthritis.

The simple rule of thumb is, the "longer" and "stronger" the disease activity, the more joint damage is probably occurring.

  • A person with joint swelling and stiffness every day (longer disease activity) is more likely to have joint damage than a person with these symptoms once a month.
  • Someone with a lot of joint swelling (stronger disease activity) is more likely to have damage than a person with just mild swelling.

How can you tell if you are having disease activity? It may sometimes be difficult.

  • You can be feeling a lot of pain, yet suffering no damage to your joints.
  • Joint damage can also occur without you feeling any pain.
  • Joint swelling is a reliable sign, though. For the most part, joint swelling is proof of having ongoing disease activity.
  • The duration of morning stiffness each day is also a useful indicator. Ask yourself, after getting up: "How long does it take until I'm feeling as loose as I'll feel for the day?" The longer you feel stiff, the more likely it is that your rheumatoid arthritis is active.
  • Another sign to look for is a "boggy" joint. When the joint lining begins to grow abnormally, it may give the joint a mushy texture. This boggy condition will persist even when you are not having a flare. If you notice this happening, you should see your rheumatologist.

If you are diagnosed with rheumatoid arthritis, your doctor will do a complete examination of your joints and will get X-rays and blood tests soon afterwards. At later visits, you will be checked for any changes to your tests, and your doctor will address possible joint damage with you.

Now that you know how rheumatoid arthritis causes joint damage, and what to look for, you should also know how to prevent joint damage.

Because treatment for rheumatoid arthritis is improving, many experts believe that diagnosed patients will develop less joint damage than ever before. You can take control of the condition and improve your chances of staying mobile.

  • Get treated early. Much of the joint damage that eventually becomes severe begins soon after rheumatoid arthritis is diagnosed. The earlier you are treated, the less chance you have of joint damage.
  • Close monitoring. People who see their rheumatologist regularly have less joint damage than people who do not.
  • Exercise. You can exercise without causing joint damage. In fact, just the opposite is true - regular exercise makes joints stronger. Your doctor will help you with an exercise plan that is safe, effective and personalised for your fitness level and condition.
  • Rest when you need to. Finding the right balance between rest and exercise is important, so you don't overdo it.
  • Use a walking stick on the opposite side from a painful hip or knee. This reduces wear and tear of the affected joint.
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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on April 25, 2016

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