February 2 is observed as Rheumatoid Arthritis Day, giving Tidbits the opportunity to investigate this autoimmune disease and its effects on the human body.

The body’s immune system normally protects your body from disease. However, with rheumatoid arthritis, the immune system mistakenly attacks the healthy tissue lining the joints. Although the exact cause is unknown, research indicates that it’s caused by a combination of genetics, hormones, and environmental factors. The immune system can be triggered by an infection, smoking, stress, or even a change in the weather.

    RA creates inflammation that can cause joint erosion and permanent damage. The inflammation harms cartilage, which is the joints’ “shock absorber.”

Those born with a variation in the Human Leukocyte Antigen gene are more prone to develop RA. These genes assist the immune systems to distinguish the difference between proteins manufactured by the body and proteins from disease, viruses, and bacteria.     

    RA affects upwards of 1.3 million people in the U.S., affecting 2.5 times more females than males. Although it usually starts to develop between the ages of 30 and 60, it can attack children and young adults, and those older than 60. Smokers have a higher risk as do those who are obese. Family history also plays into increased chances.

Rheumatoid arthritis isn’t the same as osteoarthritis. With osteoarthritis, the cartilage between the joints breaks down, usually due to wear and tear, with the bones on either side of the cartilage aching. With RA, the immune sees the joints as enemies and attacks them. OA usually affects the joints you use most, such as your hands, spine, hips, and knees, while RA attacks smaller joints in the hands and feet. RA also occurs in the same joints on both sides of the body and can eventually result in bone erosion and joint deformity.

    RA goes after the body’s smaller joints first, specifically the joints that attach the fingers to the hands and the toes to the feet. It then spreads to the wrists, knees, ankles, elbows, hips, and shoulders. The damage usually occurs within the first two years, making it vital to see a doctor as soon as symptoms are noticed, when damage can be slowed.

    Tender, warm swollen joints are one of the first things that people notice, along with stiffness that is worse in the mornings and after periods of inactivity. Many say that fatigue is the worst symptom, accompanied by fever and loss of appetite.

    It’s not just the joints that can be affected. RA can also damage the skin, eyes, lungs, heart, blood vessels, kidneys, nerve tissue, and salivary glands. About 40% of those with RA experience symptoms that don’t involve the joints.

    Controlling joint inflammation is one of the keys to slowing joint damage and reducing pain. While Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and corticosteroids, such as prednisone and cortisone, help reduce chronic pain, inflammation, stiffness, and swelling, they do not slow down the disease. Drugs known as DMARDs slow the disease by modifying the immune system. They are anti-rheumatic drugs that block critical pathways inside immune cells, suppressing the immune system to control inflammation.