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Rheumatoid arthritis

Most of us expect to become a little achy and creaky as we get older. It's because the cushion that protects our joints wears down over the years, a condition called osteoarthritis. But some people develop a form of arthritis at an earlier age, not because their joints are wearing away, but because their body is attacking and damaging their own joints. Let's talk about rheumatoid arthritis, or RA.

The immune system normally keeps the body safe against bacteria, viruses, and other harmful invaders. But sometimes this system goes a little haywire, and the body mistakenly attacks its own tissues. That's known as an autoimmune disease. In the case of rheumatoid arthritis, the immune system attacks and damages your own joints.

Like other forms of arthritis, rheumatoid arthritis makes the joints painful and stiff. If you have RA, you may notice that your joints feel stiffer in the morning, making it hard to get out of bed. Over time, you'll have trouble moving the affected joints, which can become deformed and bent out of shape.

So, how do doctors diagnose rheumatoid arthritis?

Well, there isn't one test that can tell for sure that you have RA. However, there are a couple of lab tests that can point your doctor to the diagnosis. You may also have an ultrasound, MRI, or x-rays so your doctor can see what's going on inside the affected joints.

If you do have RA, many drugs can treat it. However, each of these drugs can have some side effects, and some of them are serious. You'll have to decide with your doctor which drug to take by weighing the benefits against the risks. If you're like most people with RA, you'll start by taking medicines called disease modifying antirheumatic drugs, or DMARDs for short. These include methotrexate. Often antimalarial drugs are given along with DMARDs.

Anti-inflammatory medicines such as ibuprofen, naproxen, and celecoxib can help bring down the swelling in your joints. So can steroid drugs. If these medicines don't work, your doctor may suggest trying a biologic medicine, which targets the overactive immune response that's damaging your joints. Biologics are usually injected under the skin or into a vein.

Severely deformed joints may need to be treated with surgery to remove the joint lining or even totally replace the damaged joint. Whatever treatment you use, also remember to exercise your joints on your own, or by going to a physical therapist. The right exercise can help keep your muscles strong and improve your joint mobility.

When you have RA, don't try to overdo it. Think about your achy joints before doing any activity, so you don't overstress them. Also follow your doctor's treatment advice carefully. If you let this disease go, you could end up with permanent joint damage that can't be reversed. By treating RA early, you can get your joints, and the rest of you, moving more smoothly again.

Review Date: 2/19/2016
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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