Introduction to Rheumatoid Arthritis

Medically Reviewed On: October 04, 2006

Arthritis is not a single disease, but an umbrella term that is used to describe more than 100 chronic conditions that affect the musculoskeletal system. All of them cause pain, stiffness and swelling of the joints. Often, these symptoms can make the simplest of everyday tasks, from opening a jar to walking up stairs, difficult to accomplish.

The most debilitating form of arthritis is rheumatoid arthritis (RA). According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, it affects about one percent of the United States population, or about 2.1 million Americans. The condition occurs in all races and ethnic groups.

Rheumatoid arthritis often begins in middle age, usually somewhere between the ages of 30 and 50. However, it can also affect people who are over 50. A similar condition, known as juvenile rheumatoid arthritis, can strike children and teenagers.


No one knows exactly what causes rheumatoid arthritis, but a variety of factors, including genetics and hormones are suspected. The hormone link may explain why women have proven to be at a much higher risk for the disease. Research indicates that between one and three percent of all women may develop rheumatoid arthritis in their lifetime, and women comprise approximately 70 percent of all people with the disease. The hormone connection also appears likely because of studies which demonstrate that the disease seems to go into remission during pregnancy, and the symptoms tend to increase in intensity after the baby is born. Research has also found that the disease often develops in the year after giving birth.

The Role of the Immune System

Unlike other forms of arthritis, which can result from wear and tear on the joints, rheumatoid arthritis is an autoimmune disease. That means it is an illness which occurs when the immune system malfunctions and produces antibodies or specialized cells which attack and damage the body's own tissues.

In a healthy individual, the immune system protects the body by fighting off foreign substances, called antigens, such as viruses and bacteria. When an autoimmune disease is present, the immune system seems to go into overdrive and starts reacting to the body's healthy cells as well. The result is often damaging inflammation in different organs, joints and body tissue.

In rheumatoid arthritis, inflammation primarily occurs in the membrane that lines the joint, called the synovium. This process is called synovitis and is responsible for the chronic pain, stiffness, swelling and limited motion and function that many people with rheumatoid arthritis experience. The inflammation can destroy the cartilage, bone and ligaments and can eventually cause the joints to become deformed. Most often it is the smaller joints that are affected, such as the ones in the hands, feet, wrists, elbows, knees and ankles.

However, the damaging effects don't stop there. Rheumatoid arthritis is considered a systemic disease, meaning it can affect other parts of the body as well. It can harm virtually every organ or system in the body including the heart, lungs, kidneys, blood vessels and skin.

Long-Lasting Effects

Although the disease is chronic, meaning it can last for years, its symptoms actually wax and wane. There are times when the disease will be active, which is referred to as a flare. There are also times when people with rheumatoid arthritis will experience no symptoms, and those episodes can last for years.

Despite its cyclical nature, rheumatoid arthritis is a progressive illness. If the inflammation is not stopped or slowed down with treatment early, it can cause extensive joint damage and long term disability. Many people with rheumatoid arthritis have difficulty carrying out normal activities associated with daily living, including simple things like standing, dressing themselves, going to the bathroom and carrying out household chores.

The debilitating symptoms can also interfere with people's ability to perform their jobs. As many as half of those with rheumatoid arthritis are no longer able to work ten to 20 years after their condition is diagnosed. Nationwide, rheumatoid arthritis and related arthritic conditions are considered a major cause of disability in the United States, costing the U.S. economy more than 124 billion dollars per year in medical care and indirect expenses such as lost wages and production.

Help is Available

Rheumatoid arthritis has been a primary focus of research for many decades, and the treatments now available have dramatically improved outcomes for patients. Many of these therapies have made it possible to stop or at least slow down the progression of the joint damage, especially if started early.

Arthritis self-management programs also play an important role in helping people learn how to cope with the pain, as well as the other effects of the disease. Research shows that these programs can lead to a reduction in pain and can help people remain active and learn to cope better physically, emotionally and mentally. Giving people the tools they need to manage their condition and take care of themselves has proven useful in helping patients learn to lead independent and productive lives