Rheumatoid Arthritis: Understanding a Difficult Joint Disease


When you hear about someone who has arthritis, you might think of an older person with pain or stiffness in his or her joints. But that’s not always the case.

There are many types of arthritis and millions of people in the U.S. have some form of it. One type of arthritis that affects more than 1.5 million people in the U.S. is rheumatoid arthritis.

Rheumatoid arthritis (RA) is an inflammatory autoimmune disease, which means the body’s immune system mistakenly attacks the tissues that line your joints instead of fighting infections.

RA causes pain, swelling, and stiffness in your joints. It usually affects your wrists, hands, and knees, preventing them from working properly. While RA is more common in women age 30 or older, RA can affect all people.

RA is different from the more common osteoarthritis, which is the arthritis that many older people develop over time. No one knows what causes RA. While there is no cure, it can be treated.

What to look for

Symptoms of RA range from mild to severe. Sometimes RA affects one joint at a time, but more typically it presents as pain, warmth, and swelling in the joints on both sides of the body at the same time or on alternating sides.

It can also affect body parts that are not joints, including your eyes, mouth, heart, and lungs. Symptoms can last for only a short time or they can come and go.

It’s important to recognize the signs of RA and see your health care provider as soon as possible to get a proper diagnosis. Your provider will use tests  to help diagnose you and then refer you to a rheumatologist, who focuses on autoimmune illnesses–many of which target the musculoskeletal tissues. You and your rheumatologist can determine the treatment that is best for you.

Symptoms of RA include some or all of the following:

  • Swollen, tender, or warm joints
  • Symmetric swollen joints (on both sides of the body), such as in both your right and left wrists
  • Swollen joints in the wrist and finger joints closest to the hand
  • Other swollen joints such as the neck, shoulders, elbows, hips, knees, ankles, and feet
  • Feeling tired and having low energy
  • Fevers
  • Pain and stiffness that lasts for more than 30 minutes in the morning or after a long rest
  • Symptoms that last for many years

SOURCE: National Institute of Arthritis and Musculoskeletal and Skin Diseases: Rheumatoid Arthritis Opens new window

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Reaching New Heights with Joint Disease


Patient doesn’t let rheumatoid arthritis slow her down

BJ Pessia is a jack of all trades and master of all.

A real estate agent, carpenter, painter, landscaper, ski instructor, soccer coach, and caregiver, she is always engaged in a hands-on project or busy caring for someone.

Physical work hasn’t always been easy for BJ. She was diagnosed with rheumatoid arthritis (RA) 24 years ago, when she was 30 years old.

“One day I noticed I had wrist pain. The pain moved to my other wrist and would fluctuate from each wrist with no consistency,” she says.

Health care providers told her it was carpal tunnel syndrome, but she didn’t do any repetitive work and was not convinced that was the problem.

After several blood tests and a visit to a rheumatologist, BJ was diagnosed with RA. By then the inflammation symptoms were also in her shoulders and her hips—but again, never consistent, and always moving from one side to the other with no pattern.

The original RA medications she was prescribed had serious side effects, including stomach issues and liver damage. Eventually she found a medication that worked for her.

Now, BJ rarely has big flare-ups.

“The new medication changed my life, and I can usually feel inflammation coming on when it does happen,” she says. “I can paint and do light construction to get houses ready to go on the market to sell.”

BJ says RA can be as much of a mind problem as it is a physical problem.

“I got tired of people telling me that my pain was caused by me doing too much—or people would try to figure out what I did wrong to make my wrists or shoulders hurt,” she says. “It’s nothing that I did. It’s my body reacting to an autoimmune disease and attacking a joint.”

In addition to finding the right medication to treat her RA, BJ also attributes her wellness to sticking to a healthy diet, keeping her weight down, and staying active.

She is currently training for the Pan Mass Challenge fundraiser, a 191-mile bicycle ride across Massachusetts that raises money for cancer research. She also plans to hike all the 4,000-foot mountain peaks in New Hampshire.

Her advice to those who have or suspect they have RA: “Go to a major rheumatology treatment center and talk to a rheumatologist who will really listen to you. Know your body and stay active.”

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