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12/22/15 10:47 AM

Rheumatoid Arthritis (RA) is an autoimmune disease that is a chronic inflammatory condition usually affecting joints on both sides of the body in the hands and the feet, as well as the hips, knees, and elbows.

As an autoimmune disorder, RA occurs when your body’s immune system mistakenly attacks your own tissues.  In the case of RA, the lining of your joints are attacked leading to damage and erosion of cartilage and bone.  As the disease progresses, pain and deformity of the joints occurs.

1. Cause:

UNKNOWN:  Research has yet to determine the exact cause of the disease. 
It is known that it is not hereditary.  It has been shown that people with specific genes are more susceptible to the disease, but are not guaranteed to have RA.

Triggers:  There is usually a “trigger,” such as virus, infection, or environmental factor, that signals the immune system to respond.  When it responds, it does so inappropriately and produces substances that attack the joint lining.

2. Risk Factors:

  • Environmental Triggers:  Smoking, chronic periodontal disease, and exposure to silica mineral are all controllable factors that lead to an increased chance of developing RA.
  • Gender:  Women are more likely than males to develop RA.
  • Age:  Most cases are developed between 40 and 60, although RA can happen at any age.


  • Family History:  If a member of your immediate family has RA, you have an increased risk of developing the disease.


3. Symptoms & Diagnosis:

Tender, Warm, Swollen Joints:  these symptoms are persistent even with disuse, usually starting in the hands and feet and affecting multiple joints.
Morning stiffness that lasts for hours
Firm bumps under the skin of the arm:  called rheumatoid nodules, particularly around the elbow
Fatigue, fever, weight loss, and weakness
The American College of Rheumatology requires at least four of the following seven criteria to confirm the diagnosis:

  • Morning stiffness around the joint that lasts at least 1 hour
  • Arthritis of three or more joints for at least 6 weeks
  • Arthritis of hand joints for at least 6 weeks
  • Arthritis on both sides of the body for at least 6 weeks
  • Rheumatoid nodules under the skin
  • Rheumatoid factor present in blood testing
  • Evidence of rheumatoid arthritis on X-rays

4. Treatment:

Medication:  Multiple medications are used to manage RA with the goals of controlling pain and changing the course of the disease.  Seeking information from a qualified healthcare professional such as a rheumatologist is important to ensure you are getting the right medication for your symptoms.

Physical Therapy:  Physical Therapists will help create an individualized program to help you manage your RA.  At physical therapy you will learn valuable information including joint protection strategies, therapeutic exercise, and pain science to help decrease pain and swelling.  Physical therapists may provide manual therapy, aquatic therapy, functional training, and the use of assistive devices with the following goals in mind:

  • Decrease pain
  • Increase Joint integrity
  • Improve range of motion and mobility
  • Decrease joint swelling and stiffness
  • Improve quality of life

Surgery:  If conservative care fail to manage the disease, a doctor may elect to perform surgery to repair affected joints and restore function.  Total joint replacements, tendon repairs, and joint fusions are some of the surgeries that are associated with corrective care of RA.

Topics: arthritis, pain