Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic (long-term) autoimmune disease that causes inflammation in and around the joints. Autoimmune disorders refer to when the body’s immune system attacks its own healthy cells and tissues.

The inflammation caused by RA damages joints over time, affecting how the joints look and function. In the hand, for example, RA may cause deformities in the finger joints, which makes using your hands difficult. Lumps known as rheumatoid nodules may form anywhere in the body.

RA often causes pain and movement problems, leading to disability. As a result, you may be less able to perform normal daily activities, which can lead to depression and anxiety.

RA can also damage other parts of the body, such as the lungs, heart, skin, nerves, muscles, blood vessels and kidneys, which can lead to life-threatening complications.

RA is most often diagnosed in people aged 30 to 50, but can occur at any age. In fact, juvenile rheumatoid arthritis (JRA) occurs in children 16 or younger. JRA causes inflammation and joint stiffness that last for more than 6 weeks and can affect bone development. But unlike adult RA, which lasts a lifetime, children often outgrow JRA.

The exact cause of RA isn’t known. Researchers think certain factors, including heredity, may play a role in this condition.

The good news on the RA front is that there are many new medicines available today for treating this condition and helping to slow or stop disease progression. These include oral medications, injectibles and intravenous (IV) infusions.

Diagnosing RA may be difficult in its early stages because symptoms may be mild, and signs of the disease may not be seen on X-rays or in blood tests. That’s why it’s important to work with a rheumatology specialist who has advanced training and experience in diagnosing and treating RA.

Why Choose Cooper to Diagnose and Treat Rheumatoid Arthritis

Cooper University Health Care’s Division of Rheumatology has a team of expert, board-certified and fellowship-trained rheumatologists with extensive experience in diagnosing and treating RA. Our capabilities include:

  • Thorough diagnostic testing: Diagnosing RA begins with a comprehensive medical history, physical exam and laboratory tests. These tests may include:
    • Diagnostic imaging, including X-rays, musculoskeletal ultrasound or MRI, to look for bone damage and inflammation
    • Joint aspiration, in which a small fluid sample is taken from a swollen joint to look for signs of infection
    • Nodule biopsy, in which tiny tissue samples are taken from rheumatoid nodules to check for cancer or other abnormal cells 
    • Blood tests are performed to detect certain antibodies such as rheumatoid factor, cyclic citrullinated antibody and other signs of RA
  • A multidisciplinary team approach to care: Because RA can affect so many different organs and body systems, you may need a variety of specialists working together on your care team. As an academic medical center, Cooper has physician experts in more than 75 specialties, giving you convenient access to all the expertise you need, all in one place.
  • Personalized treatment based on your symptoms, age, general health, and how severe your condition is. The goals of RA treatment are to limit pain and inflammation, and preserve function, and may include:
    • Medication options include anti-inflammatory, pain-relieving, immunosuppressive and disease-modifying antirheumatic drugs (DMARDs), as well as an exciting new class of drugs known as biologics that inhibit inflammation and slow or stop disease progression
    • Splints may be used to help protect the joints and strengthen weak joints
    • Physical therapy may be used to help increase the strength and movement of the affected areas
    • Surgery may be an option to help correct deformities caused by RA, and can include:
      • Surgical cleaning to remove inflamed and diseased tissues
      • Joint replacement to reduce pain and help increase joint function in the hand
      • Joint fusion in which a joint is removed and the two ends of bones are fused together

Rheumatoid Arthritis Causes and Risk Factors

RA occurs when the immune system mistakenly attacks the lining of the membrane that surrounds your joints (the synovium). Over time, the synovium thickens, which can destroy the joint’s cartilage and bone. Then the tendons and ligaments holding the joint together weaken and stretch, and the joint loses its shape and alignment   

Doctors and scientists don't yet know what starts this autoimmune process, but a genetic component appears likely. This means that while your genes don't actually cause RA, they can make you more susceptible to certain environmental factors that may trigger the disease.

These risk factors include:

  • Gender: Women are more likely to develop RA than men
  • Age: RA commonly is most commonly diagnosed between the ages of 30 and 50, but it can occur at any age
  • Family history: If a relative has RA, you may have an increased risk of the disease
  • Smoking: Cigarette smoking increases the risk of developing RA, especially if you have a genetic predisposition for developing the disease. RA also appears to be more severe in smokers.
  • Environmental exposures: Research is limited, but exposure to substances such as asbestos or silica may increase the risk of developing RA
  • Obesity: People who are overweight or obese appear to be at slightly higher risk of developing RA, particularly women diagnosed with the disease before age 55

Rheumatoid Arthritis Symptoms

The joints most often affected by RA are in the hands, wrists, feet, ankles, knees, shoulders and elbows. The disease is symmetrical, which means that if one hand or foot is affected, the other one usually is, too.

Symptoms may begin suddenly or develop slowly over time, and can vary from person to person. Symptoms may include:

  • Joint pain
  • Joint stiffness, especially in the morning
  • Swelling over the joints
  • Decreased movement, flexibility
  • Pain that gets worse with joint movement
  • Bumps over the small joints
  • Trouble performing the activities of daily living, such as tying shoes, opening jars or buttoning shirts
  • Difficulty grasping or pinching things
  • Fatigue
  • Occasional fever

Managing Rheumatoid Arthritis

There is no cure for RA, which is why it’s important to help keep your joints functioning well by managing pain and inflammation. Follow your doctor’s recommended treatment plan, which is likely to include medicine and physical therapy.

In addition to taking your medications as directed, it’s important to maintain a healthy lifestyle, which includes:

  • Activity and rest: To reduce stress on your joints and lessen your symptoms, alternate between activity and rest
  • Use assistive devices: Canes, crutches and walkers can help to reduce stress on certain joints and improve your balance
  • Use adaptive equipment: Reachers and grabbers enable you to extend your reach, and reduce straining and the risk of injury. Dressing aids help you get dressed more easily.
  • Use medicines wisely: Medicines for treating RA have some risks; work closely with your doctor to create a plan to reduce this risk
  • Seek support: RA can be a challenging and life-altering condition; find a support group that can help you cope (we can help)

Make an Appointment With a Rheumatoid Arthritis Expert at Cooper

To learn more about the services available for treating rheumatoid arthritis in the Division of Rheumatology or to request an appointment, please call 800.8.COOPER (800.826.6737).