Checkup: Rheumatoid Arthritis

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What's the difference between rheumatoid and osteoarthritis? 
When you think of arthritis, you probably picture joints that start aching as you get older and worsen thanks to excess weight or lack of physical activity (or too much high-impact activity). That's the case withosteoarthritis, the most common form. Rheumatoid arthritis (RA), on the other hand, is an autoimmune disease in which your body mistakenly attacks the tissues in your joints, eating up cartilage and bone. RA tends to affect small joints, namely the wrists and the knuckles of the hands and feet (osteoarthritis usually occurs in the knees, hips or back). No one knows what causes RA, but having a family member with the condition increases your risk, as does smoking.

What does it feel like? 
"Imagine morning stiffness that lasts all day," says Patience White, MD, chief public health officer for the Arthritis Foundation. RA causes inflammation, so the joints of your hands and feet are red, swollen and painful to move. Some sufferers initially have a lowgrade fever and no appetite. To make a definitive diagnosis, a rheumatologist examines you and may order blood tests to measure proteins and antibodies that are linked to RA.

How is RA treated? 
There's no cure, but RA is less likely to lead to disability than it was in the past—especially if it's treated early. Drugs such as methotrexate, Enbrel, Humira and Remicade are commonly prescribed to slow the progression of the disease and ease the pain. If initial treatments don't work, newer drugs like Orencia or Rituxan may help.

What else works? 
Staying at a healthy weight (extra pounds put more pressure on the joints) and exercising (to keep muscles and joints strong and limber) will ease pain and inflammation. Swimming and water aerobics are good choices since they don't put too much strain on your joints. Taking a self-help class (the Arthritis Foundation has a program) can also help you better manage the condition. Learn more at arthritis.org

Did you know? 
Swimming helps ease RA discomfort; studies are underway to see if yoga and tai chi can do the same. l RA affects more than twice as many women as men, and experts are seeing those numbers go up. l Symptoms usually start in your 40s and 50s, but children and younger adults can also develop it.

A Note from the Editors: 
Thank you all for your comments. We know that RA can cause severe pain, suffering and disability and certainly didn't want to undermine that fact. This online story ran as a one-page article in the magazine under our "Checkup" column. The column (and story) is designed to provide a basic primer and is aimed primarily at people who are not familiar with the condition. It's factually correct and the author interviewed a top rheumatologist. That being said, there are limitations to what we can cover in such a short amount of space. If we cover RA in the future, we hope to include real-life patient stories and provide more detailed information.