RA is an autoimmune disease. Doctors also classify it as a systemic disease because it can have effects throughout the body. RA can affect almost any joint in the body, and it commonly develops in the fingers, hands, and feet.
It usually affects the same joint on both sides, for example, both knees. RA does not affect the sacroiliac joints, which join the spine to the pelvis. In the spine, it only affects two joints in the neck. The condition primarily targets the lining of the joints, called the synovium. In RA, the synovium becomes inflamed, swollen, and thick, due to cell proliferation. This it can lead to stiffness, pain, and a loss of mobility. Joint pain and stiffness in the morning can be an early sign of RA.
The joints contain cartilage, which prevents the bones in the joint from rubbing together. Over time, inflammation from RA can cause the cartilage to break down. If the bones rub together, it can permanently damage the joint. This is a significant cause of pain and stiffness in people with advanced RA.
RA can also cause the bones to lose density, leading to osteoporosis , which involves the bones becoming thinner and more brittle. Research from describes osteoporosis as a common complication of RA and suggests that it may happen because similar immune and inflammatory features play a role in both conditions.
A loss of bone increases the risk of breaks and fractures. People who use corticosteroids to manage RA have a higher risk of developing osteoporosis, and so experts recommend using the lowest possible dosage. These are small, firm bumps made of inflammatory tissue. Rheumatoid nodules develop under the skin, over bony areas. While they are often painless and generally not a cause for concern, they can cause discomfort if a person places pressure on them, such as when kneeling.
In some cases, infection and ulcers can occur. The most common places for nodules are the fingers and elbows, which people often rest on the arms of a chair. Ulceration in RA is usually a sign of vasculitis , which involves inflammation of the blood vessels.
List of Partners vendors. Rheumatoid arthritis RA is a progressive disease that mainly affects the joints. According to the American College of Rheumatology, RA is the most common type of autoimmune arthritis , affecting more than 1.
RA can affect many different body systems, including the musculoskeletal system, integumentary system, ocular system, immune system, circulatory system, and more. Read to find out more about these effects. Your musculoskeletal system provides the body with movement, stability, shape, and support. This body system is divided into two systems—the muscular system and the skeletal system.
Skeletal system : The main part of the skeletal system is bone. The bones come together at the joints, providing the body with a stable and mobile skeleton. The bones and joints are supported by other necessary structures—the articular cartilage, ligaments, and bursae.
Articular cartilage is the smooth, white tissue covering the ends of bones where they meet with the joints. The ligaments are the short, tough, and flexible fibers of connective tissues that connect bones and cartilage and hold together joints. The bursae are fluid-filled sacs that provide cushion to the moving parts of joints.
Muscular system : The muscular system includes all the muscles of the body. The skeletal muscles, for example, are the ones that support the joints to produce movements.
The muscular system also contains tendons that attach muscles to bones. One of the first indications of RA is inflammation in the small joints of the hands and feet. Often, RA is symmetrical—affecting both sides of the body at once. Symmetry is key to diagnosing RA.
The condition will become symmetrical as RA progresses. Additional joints symptoms of RA include pain, swelling, stiffness, and tenderness.
These are usually much worse in the morning and can last for 30 or more minutes. RA symptoms can affect any of your joints, especially as RA progresses.
This includes symptoms in the hands, feet, shoulders, elbows, hips, knees, and ankles. As the disease progresses, it will affect tendons, ligaments, and muscles. These symptoms will eventually lead to range-of-motion problems and difficulty with moving your joints. Long-term inflammation in affected joints will cause those joints to become damaged and deformed.
Having RA can put you at a higher risk for osteoporosis —a condition that bone loss and weakness. Ongoing inflammation in your wrists may lead to a condition called carpal tunnel syndrome , which can make it harder to use your wrists and hands.
This same inflammation can cause weakness and damage the bones of your neck and cervical spine causing severe, ongoing pain. Your healthcare provider can order X-rays or other imaging to look for joint or bone damage from RA.
When inflammation makes it harder to move your joints, the attached joints will get weak. People with RA can develop a condition called rheumatoid myositis that causes weakness, swelling, and pain.
Get our printable guide for your next doctor's appointment to help you ask the right questions. The integumentary system includes the skin, hair, and nails, and RA can affect all three. The most common skin problems associated with RA are rheumatoid nodules, skin rashes and ulcers, and skin reactions from the medications used to treat RA.
Rheumatoid nodules : These hard lumps of tissue tend to affect people who are rheumatoid factor RF positive. RFs are proteins produced by the immune system and are responsible for it mistakenly attacking healthy joints, glands, and other body cells. They develop under the skin in bony areas like the fingers, ankles, and elbows. Sometimes, nodules can form on the lungs.
RA treatments, including disease-modifying anti-rheumatic drugs DMARDs and corticosteroids, may help to shrink nodules, but some people might need surgery if nodules get too big, become infected, or are painful.
Nodules commonly occur in areas of pressure. For example, many people often put pressure on the back of the elbow olecranon by resting it on a table or chair.
This is a very common area of involvement. If the nodule is removed, it can commonly recur after a number of years. Skin rash and ulcers : For some people, nodules are a sign of rheumatoid vasculitis RV , a condition where the small and medium-sized blood vessels are inflamed. When RV affects the large blood vessels, a painful rash can occur, usually on the legs. Rashes from RV may appear as red and painful patches or red, itchy dots. The fingertips are the most commonly affected skin area in RA but any skin area can be affected.
If RV is severe, skin ulcers open sores or wounds can form and become infected. Medication side effects : The medications you take to treat RA can cause skin problems, including rashes, easy bruising, and skin sensitivity. Medication-related skin rash is usually a sign of an allergic reaction, so it is a good idea to let your healthcare provider know if your skin breaks out and feels itchy.
Unlike the risk factors above which may increase risk of developing RA, at least one characteristic may decrease risk of developing RA. RA is diagnosed by reviewing symptoms, conducting a physical examination, and doing X-rays and lab tests.
Diagnosis and effective treatments, particularly treatment to suppress or control inflammation, can help reduce the damaging effects of RA. A doctor or a team of doctors who specialize in care of RA patients should diagnose and treat RA.
This is especially important because the signs and symptoms of RA are not specific and can look like signs and symptoms of other inflammatory joint diseases. Doctors who specialize in arthritis are called rheumatologists, and they can make the correct diagnosis.
To find a provider near you, visit the database of rheumatologists external icon on the American College of Rheumatology ACR website. RA can be effectively treated and managed with medication s and self-management strategies. Treatment for RA usually includes the use of medications that slow disease and prevent joint deformity, called disease-modifying antirheumatic drugs DMARDs ; biological response modifiers biologicals are medications that are an effective second-line treatment.
Experts believe that inflammation in the mouth may stimulate the immune system, and in a people predisposed to RA the inflammation may trigger the body to start making antibodies associated with the disease. Researchers have been working to better understand the mechanism behind this, but the takeaway is that treating gum disease and preventing unnecessary gum infections is good for your RA, as well. Schedule frequent dental checkups to catch minor issues before they become major problems.
But beyond pain, RA can cause other distortions and deformities if it is not treated as early as possible with disease-modifying antirheumatic drugs DMARDs. Some of the most common symptoms affecting the hands include locking joints, ulnar drift weakening of tendons and ligaments that cause fingers to curve toward the pinkie , swan neck deformities distortions of the joints causing unusual bending and straightening , and even ruptured tendons.
All these effects can make basic life tasks such as writing, holding objects, and unscrewing lids difficult. The hands can also be affected by muscle cramping, which can be relieved by gentle movements and warm compresses. More concerning, the swelling of RA may put pressure on the median nerve which runs from the wrist to the fingers , causing numbness or carpal tunnel syndrome.
See your doctor if you experience any of these. In the feet, uncontrolled inflammation may lead to painful conditions like hammertoes abnormal bending of the toes , bunion a bony nodule on the outside edge of the big toe , pes planus loosening of the arch joint in the middle of the foot , and valgus hind foot loosening of the joint below the ankle, causing the foot to bend forward. In addition to seeing your rheumatologist and, if necessary, a podiatrist, you may also consult an occupational or physical therapist.
These experts help you learn ways of moving that are less painful and that strengthen muscles, says Rebecca Manno, MD , a rheumatologist and adjunct assistant professor of medicine at the Johns Hopkins University School of Medicine in Baltimore. A skin rash or ulcers on the arms and legs sometimes occur in people with rheumatoid arthritis, especially if the disease has gone untreated for a long time, Dr.
Greer says. Up to 30 percent of people with RA develop rheumatoid nodules — knots of inflammatory tissue just under the skin near a joint, according to research published in the journal Autoimmunity Reviews.
Most often appearing on the elbows, hands, and feet, they can be treated with a steroid injection if they become bothersome. Higher levels of inflammation in people with rheumatoid arthritis increase the risk of heart disease , especially heart attacks and strokes, Greer says. These heart conditions can also be more fatal.
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