Rheumatoid Arthritis: What is it, anyway?
Getting a diagnosis of Rheumatoid Arthritis can be overwhelming and scary. A typical patient journey involves being asked to perform multiple tests and see multiple specialists, all while feeling lousy. You might be dealing with pain and fatigue that makes you feel like you’re just not yourself. The good news is that thriving with RA is absolutely possible.
At Motto, we are here to help you understand your condition and choose the right treatment options for you so you feel better and live your fullest life.
Different types of arthritis
Rheumatoid Arthritis, or RA, is an autoimmune disorder that mainly affects our joints. Many of us know someone who has been affected by this condition. It is seen in almost 1% of the US population. Although it is most commonly diagnosed in women during middle age, it can affect anyone at any age.
Rheumatoid Arthritis is often confused with Osteoarthritis, but they are very different. Osteoarthritis leads to joint pain and degeneration due to wearing down of cartilage, whereas the joint pain from RA is due to inflammation that results from autoimmunity. “Autoimmune” simply means the immune system, which is supposed to protect us from bacteria and viruses, has turned on itself and attacks our own body.
More than the joints
Focusing only on the “arthritis” of rheumatoid arthritis can be misleading because RA is more than joint pain. RA patients can develop a variety of symptoms throughout their body, including fever, weight loss, fatigue, brain fog, nodules, lung disease or even vasculitis (blood vessel inflammation).
Thankfully, because of significant advances to medications for RA, including those we call “biologics,” many of these complications are not as common as they once were. We also know a lot more about lifestyle changes, which can really help to reduce pain and inflammation.
Another thing to be aware of is a significant connection between RA and heart disease. This was not something doctors always understood, but thankfully, we now recognize it and can actively address it. By controlling the inflammation caused by RA, and addressing other risk factors, such as blood pressure, blood sugar, and cholesterol, we can significantly reduce the risk for heart attacks and strokes.
How do you know if you have Rheumatoid Arthritis?
For most people, their diagnostic journey starts with a visit to a Primary Care doctor. There, you will discuss your symptoms and your doctor will narrow down the possible causes. Being prepared to talk about your joint pain before your doctor’s visit will help you ensure you give the doctor complete information. Here are some questions to ask yourself:
How long have you had your symptoms?
Where are your symptoms and does anything make them feel better or worse?
Is there a part of the day where your symptoms are worse?
Based on this conversation, your doctor may decide to check some blood tests, including the rheumatoid factor. The rheumatoid factor, or RF, is an auto-antibody commonly seen in those with RA. Although it can be a very important piece of information, we do not make a diagnosis of RA solely on the RF result. The diagnosis of rheumatoid arthritis is based on multiple factors, and the RF is only one of them.
This is where your Motto rheumatologist comes in. We take into account a wide variety of factors when evaluating your arthritis and joint pain. Our appointments are structured to get to the root of the problem, and give you clarity on your condition. We take a complete lifestyle and family history, and engage with you in a thorough discussion of your symptoms. We also get all the blood work and x-rays we need to be clear about your diagnosis.
Do I need x-rays?
When looking for rheumatoid arthritis, x-rays of your hands, wrists and any other painful joints give us important information. X-rays are an important diagnostic tool because a joint with osteoarthritis looks different in x-rays from a joint with rheumatoid arthritis. Occasionally we may need to go a step further to get an MRI or joint ultrasound. These images can get a better look at the tendons and other structures inside the joint to see if and where the inflammation is located.
Why we get Rheumatoid Arthritis
As with most autoimmune conditions, the short answer is we don’t entirely know. We do know that if an individual with the right collection of genes is exposed to the right trigger, they can develop rheumatoid arthritis. But which are the “right” genes and what is the “right” trigger?
The answer is most likely different for different people. Triggers can be hormone changes, stress, or infections (specifically viral infections). We are currently not always able to identify the trigger in people or prevent the damage caused by exposure to that trigger.
There is one trigger we can definitely prevent. Smoking tobacco has time and time again been shown to contribute to the development of rheumatoid arthritis. This includes exposure to secondary smoke. Smoking not only increases our risk of RA, but if we do have RA, it can negatively affect one’s response to treatment. This is just one more in a long line of reasons to not use–or quit–tobacco!
Why do I need treatment with Rheumatoid Arthritis?
Before getting into the details of treatment, it’s important to understand why we need treatment beyond just pain or anti-inflammatory medications. Unfortunately for the vast majority of those with RA, when the condition is untreated or under-treated, it leads to a steady progression of inflammation, and subsequently irreversible joint damage. This damage leaves the joints permanently changed and difficult to use. In some cases, this can lead to disability. RA inflammation can also take a toll on the heart, brain and blood vessels, which leaves us susceptible to strokes and heart attacks.
Thankfully, we now have a variety of treatment options, making the frequency and severity of joint damage far less common than even 25 years ago. Rheumatologists now have targeted therapies to choose from to get your inflammation under control.
The options are diverse and there are multiple factors to consider when choosing the right medicines for you. When we sit down to make these choices together, we are thinking not only about how to reduce your pain & inflammation today, but also how to protect your health and vitality for tomorrow.
How you live your life matters
Successfully controlling RA is not all about medications! Lifestyle factors, including sleep, diet, movement, relationships and stress, all play a large role in pain and inflammation. That’s why Health Coaching and Nutrition are a core part of our care model. Together, your personal health coach and registered dietician will guide you through the 7 Pillars of Care, making sure you are eating an anti-inflammatory diet, getting enough restful sleep, have an effective and intentional stress management routine and that you are regularly moving your body. All of these factors are integral in helping your immune system regulate itself.
Becoming familiar with RA, its effect on your body and the best treatment options for you takes patience and guidance from a trusted, experienced health care team. With time it is even possible to learn what your RA can teach you about your body and yourself. At Motto, we understand what it takes to learn how to thrive with RA and are here to help you along your journey.