RheumatoidArthritis.com - Living with RA
# Understanding RA
Rheumatoid arthritis (RA) can be a challenge, as anyone who has it knows. RA is a chronic, long-term disease that occurs because the body's immune system doesn't work the way it should. Most people associate the immune system with fighting infections. While it does this, in people with RA, the immune system also attacks the body. That's why RA is called an autoimmune disease.
What happens in RA?
When the immune system attacks the body like it does in RA, it leads to the symptoms that people with RA experience — from joint pain and stiffness to fatigue. Over time, the joints can become permanently damaged. Without proper treatment, this kind of damage can lead to disability. New, targeted therapies in RA provide hope for people with this condition.
Fortunately, doctors know a lot about RA and are constantly learning more about how to treat it.
The Immune System
The immune system is made up of a complex collection of organs and cells. Here are some things you should know about the cells and other substances used by the immune system that have a considerable effect on RA.
White blood cells: The body uses white blood cells to attack infections. They do this by producing a substance called antibodies. Antibodies are also responsible for causing inflammation. Two types of white blood cells involved in RA are:
•B cells: Some B cells make rheumatoid factor (RF), an antibody important for the normal functioning of the immune system. In many people with RA, B cells don't function properly, and produce too much RF.
•T cells: T cells are also very important for fighting infections. There are different kinds of T cells, each with a different function. In people with RA, T cells responsible for inflammation are seen in large numbers.
Cytokines: These are substances in the blood that communicate with white blood cells. Some of these cytokines organize the attack on harmful events like infections, which results in inflammation. When the immune system is working normally, the attack is ended once the infection has been fought off. However, people with RA have levels of certain cytokines that are too high. This means that the attack and the inflammation go on and on. It's this constant inflammation that causes the signs and symptoms of RA.
There are several cytokines involved in RA. Three of the most important are:
•TNF: This is an abbreviation for tumor necrosis factor. In people with RA, TNF is a cytokine that plays a large role in maintaining inflammation.
•IL-1: This is an abbreviation for interleukin 1. Interleukins are also cytokines. IL-1 plays a role in the immune system by communicating with white blood cells. People with RA have too much IL-1 in their systems, which is another factor in inflammation.
•IL-6: This is an abbreviation for interleukin 6. In people with RA, there is more IL-6 than any other cytokine in the lining of the joints. IL-6 is a major driver of inflammation in people with RA.
# Signs and symptoms of RA
Joint pain is one of the most common symptoms of rheumatoid arthritis (RA). It often goes along with warmth, redness, tenderness and swelling in the joints. These symptoms will usually occur symmetrically — on both sides of the body. Another common symptom is stiffness, especially in the morning. All of these symptoms will vary depending on the severity of the disease. These symptoms mean that the joints are being attacked, and if left untreated, this can lead to deformity. That's why it's important to get a diagnosis as early as possible.
Beyond the joints
People with RA may have other symptoms that go beyond the joints. When the immune system attacks the body, as it does in people with RA, symptoms can be felt throughout the entire body. These symptoms show that RA affects more than just the joints. Many people with RA may experience:
•Fatigue or tiredness
•Decreased quality of life
•Difficulty performing daily activities
•Occasional low-grade fever
People with RA might also have trouble performing activities they used to do like climbing stairs or carrying groceries. They may feel less able to participate socially, or feel that they have less energy and can feel sad or down.
If you think you may be experiencing RA symptoms, make an appointment to see your family doctor or a rheumatologist, a specialist who deals with joint diseases. During your appointment, be sure to tell him or her about all of your symptoms, even if some of them only happen once in a while, or seem unrelated.
# Diagnosing RA:
RA can be difficult to diagnose
Rheumatoid arthritis (RA) affects everyone differently. Some people will have joint pain, stiffness or fatigue every day, while others will have symptom flare-ups less often. All of these symptoms can vary from mild to severe. Since these symptoms are also common in other conditions, like osteoarthritis, fibromyalgia or lupus, diagnosing RA can be a real challenge.
Only a doctor can determine what your symptoms mean. The first step many people take is going to their family doctor to talk about them. He or she might make a diagnosis, but may often send the patient to a specialist called a rheumatologist. Rheumatologists specialize in joint problems and are the experts when it comes to RA. In fact, they are usually the doctors that make the diagnosis and treat the disease.
# Coping with pain and fatigue
Pain and fatigue are part of the everyday experience of living with rheumatoid arthritis (RA). Some days will be worse than others, and it's important to have ways of managing these symptoms. Below are some helpful suggestions about how to cope with the stiffness, pain and fatigue of RA. Make sure to speak to your doctor before beginning any new physical activities or health regimens.
Morning stiffness
•Set your alarm clock a little earlier than normal. Use this extra time to do some gentle range-of-motion exercises to prepare your joints for the day.
•Use an electric blanket to help warm up your body and joints before you get out of bed in the morning.
•Some doctors suggest going directly into a warm shower or bath. This will warm up your body and joints.
Pain
•Pay attention to actions that trigger pain. Be aware of them, and you can take steps to reduce the pain.
•Light exercise might also help prevent pain. Exercise strengthens the muscles around the joints, and can help build stamina. Talk to your doctor about creating an exercise program that is right for you. Learn more about exercise for people with RA here.
•To reduce pain after sitting, take frequent stretch breaks while sitting for an extended period of time.
•If you have pain or difficulty performing certain activities that you used to be able to do with ease, talk to your doctor. It may help to keep a journal of what's painful to help you remember.
Fatigue
Plan ahead
•Set your priorities for the day and think about how you're going to accomplish them.
•Realize that some days you just might not be able to do everything you want to do, and that's OK.
Get enough rest
•Get plenty of rest. Morning and/or afternoon naps may be helpful.
•If you can find the time, take a 15-20 minute break in the morning and afternoon. Breaks can help build up the stamina you need to complete your day.
•Pace yourself, even on good days. You will have days with less pain and fatigue, but if you do too much trying to make up for your bad day yesterday, you might make things worse for tomorrow.
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