New Delhi, Aug. 8: Rheumatoid arthritis (RA), an autoimmune disease that causes chronic inflammation of the joints, can affect people of all ages. It is better to keep a close watch on related symptoms, like fatigue, loss of energy, lack of appetite, low-grade fever, muscle and joint aches, and stiffness and consult your doctor for proper treatment.  

The symptoms of rheumatoid arthritis mover from active (flare) phase, when body tissues are inflamed, to inactive (in remission) phase. In active phase, usually most notable in the morning, joints frequently become red, swollen, painful, and tender.

Although the cause of rheumatoid arthritis is not known yet, but it is universally accepted that RA occurs because the lining tissue of the joint (synovium) becomes inflamed, resulting in the production of excessive joint fluid (synovial fluid).

Initial symptoms of rheumatoid arthritis are very subtle in nature, and can start from anywhere like hand and wrists, leading to difficulty with simple tasks of daily living. Same thing can happen with the small joints of the feet as well. Interestingly, When only one joint is involved, the arthritis can mimic the joint inflammation caused by other forms of arthritis, such as gout or joint infection.

Frequent inflammation in long run can damage to body tissues, including cartilage and bone, resulting in joint deformity, destruction, and loss of function. Sometime RA can even affect vocal cords.

While inflammation of the tissue around the joints and inflammatory arthritis are characteristic features of rheumatoid arthritis, the disease can also cause inflammation and injury in other organs in the body.

Rheumatoid arthritis is three times more common in women than in men. It afflicts people of all races, age group. But it most often starts after 40 years of age and before 60 years of age.

Causes

The cause of rheumatoid arthritis is unknown, but  certain genes have been identified that increase the risk for rheumatoid arthritis.

Although it is not known what triggers the onset of rheumatoid arthritis, but immune cells, called lymphocytes, are activated and chemical messengers (cytokines) are expressed in the inflamed areas. Environmental factors also seem to play some role in causing rheumatoid arthritis.

Treatment

There is no known cure for rheumatoid arthritis. Whole focus is on how to reduce joint inflammation and pain, maximize joint function, and prevent joint destruction and deformity.

Optimal treatment for the disease involves a combination of medications, rest, joint-strengthening exercises, joint protection, and patient awareness.

Two classes of medications are used in treating rheumatoid arthritis: fast-acting "first-line drugs" and slow-acting "second-line drugs". The first-line drugs, such as aspirin and cortisone (corticosteroids), are used to reduce pain and inflammation. The slow-acting second-line drugs, such as gold, methotrexate promote disease remission and prevent progressive joint destruction.