What is RA?
There are many myths about RA. Most people assume that RA is simple wear and tear on the joints, but that is osteoarthritis. RA is very different; it is in fact an autoimmune condition. The easiest way to understand an autoimmune condition is to imagine that you have an infection. Your body is designed to fight any such infection by attacking and destroying the source of the infection. This is the autoimmune system response. However, sometimes the autoimmune system can make a mistake and attack your body. This is what is happening when we talk about RA being an autoimmune condition or disease.
With RA, your immune system attacks the lining of your joints and this causes inflammation, stiffness and pain with the smaller joints (such as the knuckles) being affected first.
This means that RA is a ‘systematic’ disease and doesn’t just affect joints. It can also affect organs such as lungs, heart, and eyes.
What are the symptoms?
The important signs and symptoms are:
- pain, swelling and possibly redness around your joints. Hands and feet are often affected first, though RA can start in any joint
- stiffness in your joints when you get up in the morning or after sitting for a while, which lasts for more than 30 minutes and has no other obvious cause
- fatigue that’s more than just normal tiredness
Diagnosing RA can be difficult. This is because most people are not aware of RA and when they get the symptoms, they put it down to overactivity or knocks and bumps. In addition, painful joints can have many causes and it is often not possible for a GP to pinpoint the exact cause. Lastly, the symptoms can come and go.
There is no single test that can diagnose RA. A consultant rheumatologist will usually need to make or confirm the diagnosis. They will observe the swelling in the joints, may carry out a blood test, check for joint damage using x-rays or ultra-sound, check for family history of the condition and consider any other illnesses (such as psoriasis).
What are the causes of RA?
We do not yet know what causes RA.
However, we do know that genes play a part to a certain extent. The best summary of the available evidence is that genes indicate a risk or susceptibility to RA. If you have a family history of RA, then there is an increased risk that you will also develop RA.
We also suspect that environmental triggers (such as infection, trauma or extreme stress) have a role to play. However, the research is inconclusive.
What we do know is that smoking combined with a genetic predisposition makes RA more likely. Whilst there is nothing you can do about your genes; you can reduce the chances of getting RA by stopping smoking.
There is also a huge amount of research going on in this area, so we are optimistic that RA will become better understood and more effective treatments will be found in the near future.
What types of treatment are available?
There are many treatments available for RA and you should always consult your consultant rheumatologist, GP, independent prescriber or pharmacist.