Dealing With Rheumatoid Arthritis Inflammation

Rheumatoid arthritis (RA) is an autoimmune disorder that causes excess inflammation in the body. With this condition, your immune system attacks its own cells, mistaking them as "foreign" to your body. RA primarily causes inflammation in the joints but can also damage your internal organs. This condition affects around 1% of the world's population and is more common in women than men.

This article discusses rheumatoid arthritis and the inflammation caused by this condition.

Rheumatoid Arthritis and Inflammation

Inflammation is the primary symptom of rheumatoid arthritis. Inflammation by itself is not bad. In fact, it helps your body fight off bacteria and viruses and heal injuries when they occur. However, with rheumatoid arthritis, inflammation is long-lasting and misdirected at your healthy cells.

The exact cause of RA isn't clear. However, there are risk factors that can increase a person's chance of developing this inflammatory condition. These include:

• Age: RA can occur at any age, but most commonly develops between ages 30 and 60.
• Family history: Having family members with RA can increase your risk of developing this condition. However, it is not "passed down" from your parents—people can develop RA even if there is no family history.
• Genetics: People with certain (human leukocyte antigen (HLA) genes are more likely to develop RA.
• Lifestyle factors: Smoking and obesity can both increase a person's risk of developing RA.

Blood work is used to assess inflammation in the early stages of RA, specifically the presence of rheumatoid factor and anti-CCP (cyclic citrullinated peptide) antibodies, higher levels of C-reactive protein (CRP), and increased erythrocyte sedimentation rate (ESR or sed rate).

Inflammation and Disease Progression

Early on, inflammation from RA causes vague symptoms that are similar to ones caused by other illnesses or injuries. These can include:

• Fatigue
• Fever
• Joint stiffness first thing in the morning
• General muscle and joint aches
• Loss of appetite
• Difficulty walking due to leg pain
• Joint swelling
  

As rheumatoid arthritis progresses, it typically attacks joints throughout the body. Rheumatoid arthritis affects multiple joints at the same time and causes joint damage on both sides of the body (symmetric joint involvement). This is different from osteoarthritis—a condition caused by "wear and tear" on your body that typically begins in one specific joint (asymmetric joint involvement).

Symptoms Caused by Inflammation

As RA progresses, inflammation causes significant damage to your joints. An inflamed joint is typically red, warm to the touch, and swollen. Chronic inflammation leads to the breakdown of cartilage (which provides padding between bones), ligaments (tissue connecting bone to bone), tendons (tissue connecting muscle to bone), and the bones themselves.

Over time, chronic inflammation can cause your joints to become unstable and no longer function properly. Joint deformities—particularly in the fingers—also commonly occur with RA.

While joint damage is the most visible sign of inflammation caused by RA, this condition also causes damage to organs, including the eyes, skin, heart, blood vessels, kidneys, liver, and lungs.

Levels of inflammation fluctuate when you have RA. As a result, you'll feel better on some days, and worse on others. Periods of worsening symptoms are called flare-ups (or flares).

How to Manage Inflammation From RA

While there's no cure for rheumatoid arthritis, there are steps you can take to keep your inflammation under control.

Medications

The following types of medications are commonly used to treat inflammation caused by RA:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs are available over the counter and can be useful in treating mild to moderate symptoms of RA. Examples include Advil (ibuprofen), Aleve (naproxen), and Bayer (aspirin).
• Steroid medications: These are stronger anti-inflammatory medications that can be used when NSAIDs are not effective. Prednisone is commonly prescribed for RA.
• Disease-modifying antirheumatic drugs (DMARDs): These drugs target your overactive immune system rather than just decreasing inflammation. However, because DMARDs suppress your immune system, they can increase your risk of developing other illnesses or infections. Examples of DMARDs include Trexall (methotrexate), Plaquenil (hydroxychloroquine), Arava (leflunomide), and Azulfidine (sulfasalazine).
• Biologics: These drugs help decrease inflammation by targeting the part of your immune system that destroys your joints. Biologics are given by injection or intravenous ( IV) infusion, while other RA drugs can be taken in pill form. They can also increase your risk of infection, similar to DMARDs.
  

Almost everyone with RA will need long-term therapy with a DMARD and/or biologic. NSAIDs and steroids are only meant to control inflammation in the short term (less than three months).

Joint Protection

During periods of increased inflammation with RA, joint protection principles help reduce pain and pressure on your affected joints. See a physical therapist or an occupational therapist for individualized recommendations.

Here are some general tips for protecting your joints:

• Rest: Whenever possible, rest the joints that are inflamed. Avoid aggravating activities—if you can't avoid them, take frequent rest breaks to decrease pressure on your joints. In some cases, wearing a splint on the affected joint can help reduce pain during a flare-up.
• Use larger joints: For instance, carry your purse or grocery bags in the bend of your elbow rather than holding the handles in your fingers.
• Make it bigger: Use thicker writing tools and look for cooking utensils with soft-foam built-up handles to reduce pressure on small joints in your fingers.
  

Lifestyle Factors

Lifestyle factors can increase pain with rheumatoid arthritis, and even trigger a flare-up. Making these changes can help:

• Pace yourself: Plan rest breaks into your day. Overusing your joints can lead to increased pain and stiffness.
• Reduce stress: High levels of stress can worsen RA symptoms. Incorporate stress management techniques into your daily schedule. These can include journaling, meditation, hobbies, or talking with a therapist.
• Stay active: While doing too much can make inflammation worse, staying active keeps you strong and mobile. Exercise at low to moderate intensity when you aren't experiencing a flare. Avoid activities that put a lot of stress on joints, such as jogging, and try activities that reduce pressure on your joints, such as swimming.

Summary

Rheumatoid arthritis is a chronic inflammatory condition that occurs when your immune system mistakenly attacks its own structures. RA often affects joints throughout your body. Inflammation from RA leads to pain, stiffness, swelling, redness, and warmth in the affected joints. While there's no cure for RA, symptoms can be treated with medications, joint protection principles, and lifestyle changes.

A Word From Verywell

Living with rheumatoid arthritis can be stressful. However, keeping your inflammation under control can make daily activities significantly easier. Follow your healthcare provider's instructions and seek additional support. Talk to a therapist or counselor about ways to manage stress and cope with your diagnosis. See a physical therapist or occupational therapist for practical advice for making daily tasks easier on your joints.