Pain Management and Rheumatoid Arthritis

Introduction

Arthritis is a general term that describes inflammation in joints. That inflammation is characterized by redness, warmth, swelling, and pain.

Rheumatoid arthritis is a type of chronic arthritis that occurs in joints on both sides of the body (such as hands, wrists, or knees). This symmetry helps distinguish rheumatoid arthritis from other types of arthritis.

In addition to affecting the joints, rheumatoid arthritis may occasionally affect the skin, eyes, lungs, heart, blood, nerves, or kidneys.

What Are the Symptoms of Rheumatoid Arthritis?

Symptoms of rheumatoid arthritis include:

Rheumatoid arthritis affects everyone differently. In most people, joint symptoms develop gradually over several years. But in some, rheumatoid arthritis may progress rapidly and yet other people may have rheumatoid arthritis for a limited period of time and then enter a period of remission.

Who Gets Rheumatoid Arthritis?

Rheumatoid arthritis affects about 1% of the U.S. population. It is three times more common in women than in men. It usually occurs in people 20 to 50 years old, however, young children and the elderly also can develop rheumatoid arthritis.

What Causes Rheumatoid Arthritis?

The exact cause of rheumatoid arthritis is unknown, but it is thought to be due to a combination of genetic, environmental and hormonal factors. With rheumatoid arthritis, something seems to trigger the immune system to attack the joints and sometimes other organs. Some theories suggest that a virus or bacteria may alter the immune system, causing it to attack the joints.

Research hasn't been able to determine exactly what role genetics plays in rheumatoid arthritis. However, some people do seem to have a genetic or inherited factor that increases their chance of developing rheumatoid arthritis.

How Does Rheumatoid Arthritis Affect the Body?

Once the immune system -- the disease fighting center of the body -- is triggered, immune cells migrate from the blood into the joints and produce substances that cause inflammation. The increased number of cells and inflammatory substances within the joint irritate the area and cause cartilage (cushioning material at the end of bones) to wear down and the joint lining (synovium) to swell and produce fluid.

As the cartilage wears down, the space between the bones narrows. If the condition worsens, the bones could rub against each other, causing significant pain.

As the swelling and inflammation worsens, the joint lining may invade or erode into the bone, resulting in irreversible damage to the bone. All of these factors cause the joint to become very painful, swollen, and warm to the touch.