Rheumatoid arthritis
Rheumatoid arthritis is a long-term disease in which the immune system attacks the lining of the joints, causing pain, swelling and stiffness. It usually affects the small joints of the hands and feet on both sides, is two to three times more common in women, and often starts between 30 and 60. Without treatment it can damage the joints permanently, but early treatment with the right medicines can control it well.
Symptoms
- Pain, swelling and warmth in several joints, often the hands, wrists and feet on both sides
- Morning stiffness lasting more than an hour
- Tiredness, mild fever and weight loss
- Firm lumps under the skin near the elbows
- Over time, bent or deformed fingers if untreated
Causes
- The immune system wrongly attacks the joints (an autoimmune disease)
- Family history
- Smoking raises the risk and makes the disease worse
- More common in women
- The exact trigger is unknown; it is not caused by cold weather or cold water
Prevention
- It cannot be fully prevented
- Do not smoke
- See a doctor early if several joints stay swollen for more than a few weeks; early treatment prevents damage
- Stay active and keep a healthy weight
- Keep vaccinations up to date if you take medicines that lower immunity
Treatment
- Disease-modifying medicines such as methotrexate, started early by a doctor
- Regular blood tests while taking these medicines
- Short courses of steroid or anti-inflammatory medicines for flare-ups, only as prescribed
- Physiotherapy and joint exercises
- Folic acid alongside methotrexate if the doctor prescribes it
- Do not stop medicines on your own, and do not rely on herbal remedies or repeated steroid injections
Common questions
Is rheumatoid arthritis the same as the joint pain of old age?
No. The joint pain of old age is usually osteoarthritis, which is wear and tear. Rheumatoid arthritis is an immune disease that can start at a young age, causes swelling of many joints and needs special medicines early.
Is methotrexate dangerous?
At the low weekly dose used for arthritis, methotrexate is safe and very effective when blood tests are checked regularly. It is taken once a week, not every day, and must be stopped before pregnancy on a doctor's advice.