Rheumatoid Arthritis

JOINT PAIN AND SWELLING RELATED TO RHEUMATOID ARTHRITIS (RA)

CONDITION

Rheumatoid arthritis (RA) is an inflammation of the tissue surrounding your joints (called synovium), causing pain, swelling and stiffness. It occurs most often in the wrists, fingers, knees, feet and ankles. RA is probably the most common cause of joint swelling and pain in women.

RA occurs twice as often in women than men. It usually starts between ages 20 and 50, but can also develop in young children. RA may last months or years before going away or it may be with you all your life. It may progress slowly without causing many problems or can worsen quickly producing severe deformities and complications.

RA is different from osteoarthritis, a non-inflammatory degenerative arthritis that causes loss of cartilage and often comes with age. For one thing, RA usually occurs in a symmetrical pattern, meaning that if one knee or hand is involved, the other is as well.

RA can affect not only your joints but other parts of your body as well. You may get ulcers on the skin surrounding your joints. Your eyes and mouth may be dry. It may affect the lining of your lungs, your heart muscle, the sac that surrounds your heart and your blood vessels. RA may also cause fatigue, occasional fevers, anemia and a general sense of not feeling well. Some studies indicate RA may increase the risk of developing osteoporosis (a loss of calcium in your bones causing them to become brittle and break more easily), especially if you are taking a steroid medication.

Joint-specific symptoms may include:

  • pain, swelling and stiffness, especially in the morning upon arising
  • tenderness to the touch
  • weakness
  • reduced range of motion
  • small lumps (nodules), especially in the hands and feet
  • deformity.

Although other conditions can cause similar symptoms, RA can be diagnosed with blood tests and X-rays. Treatments include medication, lifestyle changes and surgery.

CAUSES

RA is an autoimmune disease, a disorder in which your body’s immune system attacks and damages its own tissue. Although no one knows why this happens, many factors may contribute, including:

  • genetics: Several members of the same family may be affected, suggesting a genetic link.
  • hormones: RA symptoms may improve when you take birth control pills or hormone therapy and during pregnancy when hormone levels rise. It may flare after delivery and while you are breastfeeding.
  • environmental influences: Some scientists think that something such as a virus or bacteria may trigger the disease process.

WHEN TO CALL YOUR DOCTOR

Call 911 if you have RA and:

  • chest pain
  • difficulty breathing.

Call your doctor right away (day or night) if you have RA and:

  • You develop severe pain and stiffness of your joints and cannot walk.
  • You develop severe pain and stiffness of your hands and cannot use them to eat or drink.
  • You are so tired you have difficulty standing or walking. You may be anemic.
  • You develop problems that may be related to your RA, such as stomach pains or black bowel movements. Black bowel movements can be sign of intestinal bleeding

Call your doctor within 24 hours if you have RA and:

  • You develop a fever 100F or higher and feel it is not the flu or a cold but related to your RA.
  • You develop an ulcer on your skin around a swollen joint.

Call your doctor during regular office hours if you have RA and:

  • You need stronger prescription pain medication
  • You need to see your doctor before your next regular appointment
  • You want a referral to an RA specialist because your problem is getting worse.

SELF-CARE AT HOME

  • Women who are not pregnant can take nonprescription medication (aspirin, acetamenophen, ibuprofen, naproxen) for minor pain or discomfort. If you are pregnant, however, take acetaminophen (Tylenol® ) if you need something for pain. Ibuprofen (Advil® , Motrin® ) or naproxen (Aleve® ) should only be taken at the direction of your doctor. They can reduce the amount of fluid within the amniotic sac, which could be harmful to the baby. Pregnant women should avoid taking aspirin because it can contribute to bleeding and also because it can cause stomach upset.
  • Take your prescription medications as directed. Do not wait for the pain to get worse.
  • Exercise regularly. Walking, aerobics, swimming, biking, and hand and arm exercises are all good.
  • Get proper rest during the day. If you work, rest during your breaks. Get enough sleep.
  • Try to maintain an appropriate weight by eating a balanced and healthy diet. Increased weight can aggravate your RA.
  • Practice good posture to avoid stressing affected joints, which can aggravate RA.
  • Avoid decaffeinated coffee. Some studies show it may increase the risk of developing RA.
  • Apply warm compresses to the affected joints or take hot baths. Heat around the joint releases muscle spasm and stiffness and increases the circulation to the joint.
  • For flare-ups, apply cold compresses for 15 minutes three or four times a day. Cold compresses numb the pain of the joint. Once the pain is better, warm compresses and baths can be used.
  • Join an RA support group if you need help coping with the disease.
  • Try yoga, acupuncture or hypnosis to help control pain and stiffness of your joints.
  • Seek help from a physical therapist.
  • Try wearing a splint on joints that are very painful. Splints decrease the movement of the joint and help relieve the pain.
  • Do not smoke. It can aggravate RA.

For More Information

References

American College of Obstetricians and Gynecologists

  • Precis V, 1994, Joint and Bone Disease, Rheumatoid Arthritis, Page 33; Immunologic Disorders, Rheumatoid Arthritis, Page 178.
  • Arthritis and Allied Conditions, A Textbook of Rheumatology; 15th Edition, Volumes 1 and 2, 2005; William J. Koopman, MD, Larry W. Moreland, MD

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Disclaimer:

Peer-Reviewed by the Faculty of the University of Colorado Denver Department of Obstetrics and Gynecology

This content is reviewed periodically and is subject to change as new healthcare information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional