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Rheumatoid Arthritis

Management of Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease that continues indefinitely, fluctuates in severity and may never completely go away.

Left untreated, the disease almost certainly will result in the progressive development of various degrees of joint destruction, joint deformity and a significant decline in a patient’s ability to function. In fact, rheumatoid arthritis is considered the leading cause of chronic disability in the United States.

Years into the disease, many people who suffer from the condition find themselves having difficulty carrying out the simplest tasks of daily living such as standing, walking, dressing, washing, using the toilet, preparing food and carrying out household chores. As many as half of all people with rheumatoid arthritis will be unable to work 10 to 20 years after the condition is diagnosed.

Although it is impossible to predict the course each case of rheumatoid arthritis will take, certain factors appear to play a role in how severe it will become. Research suggests that the presence of an antibody called rheumatoid factor, particularly at high levels, is associated with more severe joint damage and complications in other organs and tissues. However, only one in five people tests positive for it in the early stages of the disease.

Likewise, the presence of inflammation in more than 20 joints is also likely to result in severe joint damage. Serious inflammation that persists for more than one year, being over the age of 60 years at the time of diagnosis and having X-rays that show evidence of bone damage are also likely to indicate that severe joint damage will occur.

The Stages of Rheumatoid Arthritis
Most cases of rheumatoid arthritis are characterized by a pattern of painful flare ups (relapses) and less painful periods (remissions) where the disease does not seem to be a major problem. If a long-term remission is going to occur, it is most likely to occur in the first year of disease.

It is during the first few years that researchers believe the joint damage associated with rheumatoid arthritis progresses most rapidly. That explains why diagnosing it at the earliest possible stage and beginning effective treatment immediately is so important.

In most cases, the symptoms of rheumatoid arthritis come on gradually and include feelings of malaise and fatigue. Often those symptoms are accompanied by diffuse pain that usually involves the small joints in the fingers and toes. Numbness or tingling is also typical, as is the presence of Raynaud’s phenomenon in which the skin discolors, especially at the tips of the digits. Severe morning stiffness that limits function and generally lasts more than an hour is another notable symptom.

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