Updated 1 November 2022 | Approved By Dr. Umberto Russo
What is Rheumatoid Arthritis?
Rheumatoid arthritis is a chronic condition where the body's immune system begins to attack its own tissue, particularly the joints. This chronic condition results in inflammation, swelling and pain across multiple joints. In Australia, rheumatoid arthritis is the second most common type of arthritis, behind osteoarthritis. According to the Australian Institute of Health and Welfare, more than 400,000 Australians live with this condition [1]. Biological women and those over 55 have an increased risk of being diagnosed with rheumatoid arthritis. While those with rheumatoid arthritis experience physical symptoms but are also at risk of poorer overall health and psychological distress [2]. It's important to talk to your doctor to receive a proper diagnosis and treatment plan to address all your symptoms.  Rheumatoid Arthritis Symptoms
There are many symptoms of rheumatoid arthritis that can overlap with other conditions. You should not assume this condition if you experience any of the symptoms listed below [3]. Contact one of our GPs if you are experiencing any of these symptoms for appropriate testing and follow-up.- Stiffness in the morning which lasts longer than 30 minutes
- Multiple joints (more than three) that are swollen and painful, particularly the hands and feet
- Fatigue
- Fever
- Symmetrical symptoms on the other joint(s)
Rheumatoid Arthritis Causes
Rheumatoid arthritis is an autoimmune disease. Usually, our immune system helps defend the body from infections. However, in an autoimmune disease, the immune system will begin to attack the healthy tissue and cells in the body. For rheumatoid arthritis, this commonly affects the joints, leading to inflammation, swelling, warmness and pain. In severe conditions, the organs can also become impacted. Risk factors that may increase the likelihood of developing rheumatoid arthritis includes [4]:- Being female
- Exposure to tobacco smoke
- Hypertension (high blood pressure)
- Having a family history of rheumatoid arthritis
- Being overweight or obese
- Drinking alcohol
Rheumatoid Arthritis Diagnosis and Tests
There are multiple conditions with similar symptoms to rheumatoid arthritis. Your doctor may recommend specific tests to assist with a diagnosis. Appropriate examinations are required to start appropriate management and treatment plans.Blood Tests
Your GP may require you to undergo blood testing to look for certain markers, such as rheumatoid factors and specific antibodies. Once you have your test results, your GP will explain what they show and any potential diagnosis.X-rays
X-rays use radiation to create 2D images of the bones and joints. They will show any changes to these areas to determine the health of the region being investigated. X-rays alone cannot diagnose rheumatoid arthritis but may provide helpful information to your doctor(s).Referral to a Rheumatologist
Rheumatologists are medical specialists in the bones and joints. Depending on your results and any other findings, your GP may recommend that you see a rheumatologist for further testing and investigations for a diagnosis. Your GP will work closely with the rheumatologist to help provide ongoing medical attention and support.  Rheumatoid Arthritis Treatment
Treatment for rheumatoid arthritis may vary from person to person. After the appropriate testing, your doctor may provide several different treatment options. In some circumstances, your doctor will work with your rheumatologist to assist with treatment. The treatment will aim to help control your symptoms and prevent the progression of the condition.Weight Management
Being obese or overweight can increase stress on the joints and inflammation around the body. Your doctor may recommend strategies to help control your weight, including increasing physical activity and changing your diet. Dietitians, nutritionists and exercise physiologists may be recommended by your doctor to provide additional support.Physiotherapy
Your doctor may recommend that you see a physiotherapist specially trained to manage musculoskeletal and physical conditions. They will be able to provide a range of non-medicinal treatments to help with your pain, conditioning and other symptoms. These may include:- Corrective exercises
- Training for fitness and conditioning
- Hands-on treatment (e.g. massage, mobilisations, etc.)
- Dry needling
- Electrotherapy (e.g. TENS, interferential, etc.)
- Recommending braces and assistive devices (e.g. gait aids, etc.)
Smoking and Alcohol
Breathing in tobacco smoke and alcohol consumption can stir up symptoms of rheumatoid arthritis. Limiting or stopping these lifestyle habits is essential for managing this condition. Your doctor may refer you to other health professionals and services (e.g. counselling, etc.) to assist with your recovery.Medications
The goal of medication is to minimise the symptoms and halt the progress of rheumatoid arthritis [3]. Drugs like analgesics (e.g. paracetamol) and anti-inflammatories help ease joint pain. Drugs such as disease-modifying antirheumatic drugs (DMARDs) help prevent the condition from deteriorating.  Recovery
Currently, there is no cure for rheumatoid arthritis. Over time, people may experience the condition's progression with symptoms that come and go. It's essential to seek medical treatment early to help improve both short and long-term outcomes [5].  Complications
Complications of rheumatoid arthritis include: Joint pain and stiffness that worsens over time- Reduced mobility and conditioning
- Recurrent infections
- Reduced bone density and strength (i.e. osteopenia, osteoporosis, etc.)
- Lung conditions
- Pulmonary embolism
- Coronary artery disease
- Diabetes
- Depression
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   References
- https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/rheumatoid-arthritis/contents/what-is-rheumatoid-arthritis
- https://www.aihw.gov.au/getmedia/1e295637-e5fb-4059-a1d8-eb3936cfa7a9/phe188-rheumatoid-arthritis-factsheet.pdf.aspx?inline=true
- https://www.racgp.org.au/FSDEDEV/media/documents/Clinical%20Resources/Guidelines/Joint%20replacement/Algorithm-for-the-diagnosis-and-management-of-early-rheumatoid-arthritis.pdf
- Deane, K. D., Demoruelle, M. K., Kelmenson, L. B., Kuhn, K. A., Norris, J. M., & Holers, V. M. (2017). Genetic and environmental risk factors for rheumatoid arthritis. Best practice & research Clinical rheumatology, 31(1), 3-18.
- Chauhan, K., Jandu, J. S., Goyal, A., & Al-Dhahir, M. A. (2021). Continuing Education Activity. StatPearls [Internet]; Treasure Island (FL): StatPearls Publishing: Mountain View, CA, USA.