What is Rheumatoid Arthritis?

What is rheumatoid arthritis?

Rheumatoid arthritis is a chronic inflammatory joint disease. Unlike an acute illness, chronic illness means that inflammation often persists for a long time. In common usage, rheumatoid arthritis is also known as “ rheumatism ”. Rheumatoid arthritis is one of the autoimmune diseases. The immune cells of the immune system attack the body’s own structures, such as the internal structure of the joints in rheumatoid arthritis. This causes inflammation. The internal structure of the joint then releases more fluid ( effusion ) into the joint space.

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Chronic inflammation severely limits the function of the affected joints and can completely destroy them in the long run. The disease affects the quality of life and the performance of those affected. They often feel tired, irritable, and slightly feverish.

Who is it seen in?

The disease can occur at any age, usually three times more common in women than in men. Most often, men get sick between the ages of 65-75, and women between the ages of 55-64. When children get sick, it is called juvenile rheumatism (juvenile idiopathic arthritis) .

What causes rheumatoid arthritis?

The causes of this type of arthritis have not yet been clarified. Genetic factors are likely to trigger the disease. Viruses or bacteria are also suspected. However, there is no convincing scientific evidence. In addition to hereditary factors, environmental influences also play a very important role.

Studies have shown that smoking increases the risk of disease. The disease is more severe in smokers. Treatment is more difficult for them. In addition to many risk factors such as obesity, it is thought that exposure to chemicals at work may also have an effect.

More is known about the inflammatory process in the joint. The immune system plays a big role in this process. This system actually has the task of protecting the body from diseases. In rheumatoid arthritis, cells of the immune system attack your own body tissue. This makes joints problematic. Doctors call such an attack on your own body an autoimmune reaction . Although the exact cause of the disease is still unknown, the course of the disease can now be improved with various measures.

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What are the symptoms of rheumatoid arthritis?

Rheumatoid arthritis usually begins with pain in the finger and toe joints. Joints swell and then hard to move after waking up in the morning. Rarely, there are several large joints that are inflamed, such as the shoulder joints.

More details about the symptoms are given below:

first symptoms

Initially, symptoms usually become noticeable in the small joints of the fingers and toes. Often the inflamed joints swell, which starts suddenly. It hurts at rest and is sensitive to pressure, often extremely hot, but rarely flushed.

Also typical is the immobility of inflamed joints upon awakening. It may take about 30 minutes for the joints to flex and move normally. Depending on the condition of the disease, this situation in the morning can last up to a few hours.

Subsequent symptoms

After weeks or months, other joints (elbows, shoulders, knees, hips) are also affected. Inflammatory processes spread to the tendon sheaths, bursae, hurt and swell. Sometimes the cervical spine is also affected, which can cause neck pain and stiffness .

Additionally, over the years, rheumatoid arthritis can also attack the lacrimal and salivary glands, skin, lungs, blood vessels, heart, eyes, and peripheral nervous system . About 20% of those affected develop rheumatoid nodules, particularly on the elbows and fingers.

General symptoms

There are a number of general symptoms that indicate that the inflammatory processes of rheumatoid arthritis affect the whole organism. This includes fatigue, weakness, poor performance, mild fever, night sweats and sometimes weight loss .

Regional symptoms

In the classic form of rheumatoid arthritis, the inflammation of the joints is distributed symmetrically on both sides of the body . For example, the fingers of the left and right hands or the left and right toes are affected simultaneously. But this is not the rule without exception. Especially at the beginning of the disease or in mild courses, only one side of the body may be affected.

Which doctor treats rheumatoid arthritis?

The first doctor you go to for an exam may order blood tests and X-rays to help confirm a diagnosis, or you may be sent to someone who specializes in the diagnosis and treatment of rheumatoid arthritis. This type of doctor is called a rheumatologist.

How is rheumatoid arthritis diagnosed?

Making a first diagnosis of rheumatoid arthritis takes some experience. It can never be done based on blood or x-ray findings alone. Typical symptoms and some rheumatological findings are required.

blood tests

Blood tests are done in the laboratory to detect rheumatoid factors and markers of inflammation in the blood. A newer method measures antibodies against specific proteins in the blood, namely antibodies to CCP. However, the absence of antibodies and signs of inflammation should not lead to the conclusion that it is not rheumatoid arthritis.

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Imaging tests

X-rays (x-rays) show the extent of damage to cartilage and bone. Two symptoms stand out clearly: on the one hand, the narrowing of the joint space and, on the other hand, theformation of bone holes ( erosions ) at the edge of the articular surface.

Additional information about the condition of the soft tissues of a joint can be obtained by ultrasound examinations. For example, joint effusion or inflammatory thickening of the internal structure is visible.

Additional imaging diagnostic procedures are used to clarify very specific questions. Magnetic resonance imaging can provide information about inflammation of the cervical spine.

How is rheumatoid arthritis treated?

The aim of treatment in rheumatoid arthritis is to suppress the symptoms completely or, if possible, to stop the disease. The rheumatologist will choose a treatment tailored to the patient’s current conditions.


It is important to treat the disease as early as possible to prevent irreversible destruction of the affected joints. The most effective way to do this is to use medication. The goal of drug therapy is remission of rheumatoid arthritis. This is complete regression or disappearance of symptoms associated with inflammation.

  • Essential medications : Medications called essential medications play a primary role in the treatment for rheumatoid arthritis. These are synthetic drugs that reduce immune reactions. They slow or completely stop inflammation. In this way, they prevent joint deformation.
  • Biological drugs : These are the new generation essential drugs. Unlike traditional essential drugs, they are complex protein substances produced by very complex processes from genetically modified animal or plant organisms.
  • Cortisone : The active ingredient cortisone prevents inflammatory cells from spreading to tissues and triggering inflammatory reactions. Thanks to this anti-inflammatory drug, the basic treatment can be completed.
  • NSAID : Non-steroidal anti-inflammatory drugs (NSAIDs) can be combined with essential drugs. These drugs reduce pain caused by inflammation and joint damage.

Remember, your doctor will decide which medicine to take and how.

Regional treatment

If there is severe inflammation of the local joints, applying a cortisone preparation directly to the affected tissue with a syringe may provide relief. Cortisone injections are well tolerated and work for weeks to months. Nuclear medicine substances, when injected into the joint, have a stronger effect, neutralizing the inflamed interior of the joint.

orthopedic treatment

Pain, swelling and joint damage in the feet caused by rheumatoid arthritis can be reduced with the help of specially adapted insoles. Patients should wear shoes that are not too tight and insoles that reduce pressure on the toes.

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Surgical treatment

If medication fails to stop the chronic inflammation of the joints, the inflamed interior of the joint can be surgically removed, this is called a synovectomy . Damaged joints can be replaced with prosthetic joints . Other surgical treatment options include position corrections.


Physical measures such as applying cold and heat relieve pain and help tense muscles. Rheumatoid arthritis patients can participate in and practice an exercise program to keep joints flexible. In general, physiotherapy improves strength, endurance, coordination, posture and walking ability.

Occupational therapy

Occupational therapy improves hand function and maintains independence in daily activities. Occupational therapy also includes joint protection and the use of aids. Sometimes, wrist splints also help.

Physical activity and sport

Physical and sporting activities should be well adapted to the existing inflammation and functional limitations of the joints. Only then will it have a positive effect on the disease. Controlled sport maintains joint mobility, increases strength and endurance, and thus avoids obstacles.

How should rheumatoid arthritis patients be fed?

A balanced diet with plenty of vegetables and fruits is best. Low-fat meat and especially fish are suitable for protein intake. Dairy products are a good choice because of their calcium content.

The need for calcium and vitamin D increases, especially when rheumatoid arthritis is treated with cortisone medication. Vitamin E and fish oils (omega-3 fatty acids) appear to have a positive effect on joint inflammation.

Can rheumatoid arthritis be prevented?

Autoimmune diseases such as rheumatoid arthritis indicate a serious malfunction in the body’s defense system. Modern medicine has no explanation for this. While it can be incredibly interfering with the immune system with essential medicine and biology, the stated goal of today’s medical treatment is not to combat the causes, but to alleviate, regress, symptoms.

Potential triggers for an immunological malfunction are currently discussed. These include – in addition to an inherited predisposition to an autoimmune disease – toxins, heavy metals, gluten, infections and stress.

For example, recent research considers nicotine a common rheumatoid arthritis trigger. Significantly, smokers have a more severe course of rheumatoid arthritis and are less responsive to treatment than non-smokers. Other studies are examining the important role that apparently inflammatory tissue hormones ( cytokines ) play in the development of rheumatoid arthritis.

Such research leads to new treatment options that offer hope for better prognoses, even when the true cause of rheumatoid arthritis is unknown. However, reliable recommendations for the prevention of rheumatoid arthritis are still unclear.

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