Rheumatoid Arthritis

Rheumatoid arthritis is a chronic disease of unknown cause characterised by inflammation of the lining, or synovium, of the joints. Other symptoms include stiffness, swelling of the joints and tiredness, with morning stiffness being a common feature of the disease that usually improves with physical activity. Rheumatoid arthritis occurs in approximately 1% of the population, affecting women 2-3 times more often then men. The time when it usually starts is between the ages of 30 - 55 years. It can lead to long-term joint damage, resulting in long-standing (chronic) pain, loss of function and disability.

Rheumatoid arthritis usually occurs in three stages. The first stage is the swelling of the synovial lining, causing pain, warmth, stiffness, redness and swelling around the joint. Second is the rapid division and growth of cells, or pannus, which causes the synovium to thicken. In the third stage, the inflamed cells release enzymes that may destroy bone and cartilage, often causing the involved joint to lose its shape and alignment, resulting in more pain and loss of movement.

Because it is a chronic disease, rheumatoid arthritis continues indefinitely and may always be present. Frequent flares in disease activity can occur. Rheumatoid arthritis is a systemic disease, which means it can affect other organs in the body. Early diagnosis and treatment of rheumatoid arthritis is important to improve patient symptoms and maintain quality of life. Studies have shown that early aggressive treatment of rheumatoid arthritis can limit joint damage, which in turn limits loss of movement, increasing the ability to work.

Treatments in rheumatoid arthritis may include non-steroid anti-inflammatory drugs (NSAIDs), corticosteroids, disease modifying anti-rheumatic drugs (DMARDS ) and in hard to treat patients a group of medications known as biologic agents may be recommended by a specialist.