Understanding Rheumatoid Arthritis

One morning more than 26 years ago, Kathy Lubbers woke up and found that she could not bear to lift the sheet from her body because the pain was so great. Although she had been experiencing pain in both hands, nothing had prepared her for this.

With the help of her husband, she got to her doctor and then a rheumatologist. The diagnosis was lupus—an autoimmune disease with symptoms such as inflammation, swelling, and damage to joints, skin, kidneys, blood, the heart, and lungs.

It would be another 18 months of pain before a different doctor gave her the right diagnosis—rheumatoid arthritis (RA). Lubbers then began trying different medicines, including several common RA medications.

For a period of a dozen years, Lubbers dealt with significant pain. Her husband lifted her in and out of her car and the bathtub. She had her desk in the bedroom, and she could take a couple of steps to do her work as a consultant in marketing communications and strategic planning—and then step slowly back to the bed.

Finally, about 10 years ago, she transitioned to a medication for moderate to severe RA, as well as psoriasis and psoriatic arthritis—generic name, enteracept. It worked, and Lubbers has been thrilled with it ever since.


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The reversal has been so great that Lubbers has finished six marathons. She and friends run together as a group called America 2 Anywhere 4 Arthritis. They have raised significant funds for the Arthritis Foundation. Lubbers served nine years on the National Arthritis Foundation Board.

For others with RA, Lubbers says, "Remember, you are not alone. Stay positive and connected to others."

What Is Rheumatoid Arthritis?

Rheumatoid arthritis is a disease that affects the joints. It causes pain, swelling, and stiffness. If one knee or hand has rheumatoid arthritis, usually the other does, too. This disease often occurs in more than one joint and can affect any joint in the body. People with this disease may feel sick and tired, and they sometimes get fevers.

RA is an autoimmune disease, which means the arthritis results from your immune system attacking your body's own tissues.

The course of rheumatoid arthritis can range from mild to severe. In most cases it is chronic, meaning it lasts a long time—often a lifetime. For many people, periods of relatively mild disease activity are punctuated by flares, or times of heightened disease activity. In others, symptoms are constant.

Scientists estimate that about 1.3 million people in the United States have rheumatoid arthritis.

Who Gets Rheumatoid Arthritis?

The disease occurs in all racial and ethnic groups, but affects two to three times as many women as men.

Rheumatoid arthritis is more commonly found in older individuals, although the disease typically begins in middle age. Children and young adults can also be affected.

How Is Rheumatoid Arthritis Diagnosed?

People can go to a family doctor or rheumatologist to be diagnosed. A rheumatologist is a doctor who helps people with problems in the joints, bones, and muscles. Rheumatoid arthritis can be hard to diagnose because:

  • There is no single test for the disease.
  • The symptoms can be the same as other kinds of joint disease.
  • The full symptoms can take time to develop.

To diagnose rheumatoid arthritis, doctors use medical history, physical exam, X-rays, and lab tests.

Rheumatoid arthritis is different from osteoarthritis, the common arthritis that often comes with older age. RA can affect body parts besides joints, such as your eyes, mouth, and lungs.

What Causes Rheumatoid Arthritis?

Doctors don't know the exact cause of rheumatoid arthritis. They know that with this arthritis, a person's immune system attacks his or her own body tissues. Researchers are learning many things about why and how this happens. Things that may cause rheumatoid arthritis are:

  • Genes (passed from parent to child)
  • Environment
  • Hormones

Questions to Ask Your Healthcare Provider

  1. What tests indicate I might have RA?
  2. Are there medicines that can help treat RA?
  3. Is joint-replacement surgery an option with RA?
  4. What lifestyle changes can I make to help reduce the symptoms of rheumatoid arthritis?
  5. May I exercise with RA?
  6. Are there complementary and alternative medicines that might help my RA?

What You Can Do: The Importance of Self-Care

Although healthcare professionals can prescribe or recommend treatments to help patients manage their rheumatoid arthritis, the real key to living well with the disease lies with the patients themselves. Research shows that people who take part in their own care report less pain and make fewer doctor visits. They also enjoy a better quality of life.

Self-management programs teach about rheumatoid arthritis and its treatments, exercise and relaxation approaches, communication between patients and health care providers, and problem solving. Research on these programs has shown that they help people:

  • understand the disease
  • reduce their pain while remaining active
  • cope physically, emotionally, and mentally
  • feel greater control over the disease and build a sense of confidence in the ability to function and lead full, active, and independent lives.

This article appeared in part in NIH Medline Plus


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