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Rheumatoid arthritis FAQs

What is rheumatoid arthritis (RA) and how is it different from ‘wear and tear’ arthritis?

RA is an autoimmune disease that causes the body to turn on itself, attacking tissue that normally helps to protect and preserve joint function. It most commonly begins in the 30s to 50s age group. The number of women affected exceeds the number of men by three to one.

During an RA ’attack‘ - known as a flare - the immune system sends out a barrage of white blood cells to the affected joint, which in turn causes inflammation in the area. It is this inflammation that is responsible for the symptoms of RA, including swelling, pain and deformity.

Doctors now believe that, within the first year, the inflammation caused by RA can inflict severe damage on cartilage (the protective tissue that is a key component of joints), thus making a strong case for early diagnosis and intensive treatment.

In some instances, RA can progress to causing symptoms all over the body. Eventually it can damage the bones, tendons and muscles surrounding the affected joints. It can also damage other parts of the body, including the eyes, the salivary glands, the heart and the lungs.

With treatment, however, many of the complications of RA can be avoided.

Osteoarthritis (OA), sometimes known as 'wear and tear’ arthritis’, is a natural degeneration of the cartilage between joints that occurs with aging. This degeneration can be aggravated by overuse or injury, but its impact is limited to the affected joints.

What are the specific symptoms of RA?

The most obvious symptoms of RA are pain, redness and swelling around specific joints, in a pattern that affects both sides of the body simultaneously. The most common joints to be affected are:

Other symptoms can include:

  • Fever
  • Fatigue
  • General achy, flu-like feelings
  • Joint pain and stiffness, commonly in the morning or when at rest, and lasting more than 30 minutes

Do symptoms occur suddenly, or gradually over time? And does RA get progressively worse?

In some instances RA symptoms, particularly pain, swelling and stiffness, develop rapidly, sometimes in a matter of weeks. Most often, however, symptoms develop gradually, with only a few symptoms appearing at first, making it easy to confuse RA with other types of arthritis or with other conditions that cause joint pain.

The full complement of RA symptoms can take years to develop, so they may easily elude diagnosis for some time.

For many people, RA ebbs and flows - causing ’flares‘ or ‘attacks’ followed by periods of remission. Sometimes a single attack will occur and no more will follow. More commonly, flares continue to occur over a period of years.

Without treatment, the condition usually does worsen, leading to joint deformity and sometimes causing inflammation of the lining of the heart ( pericarditis) and lungs (pleuritis). Inflammation of the tear and salivary glands can also occur, causing a problem known as Sjogren's syndrome.

People with RA are also at increased risk of blood-vessel inflammation that causes heart disease, and they may have a higher risk of heart attack and stroke.

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