Rheumatoid arthritis (RA) is an autoimmune disorder which causes chronic inflammation of the joints.  It is estimated to affect about 1% of the population, affecting all races, but females tend to be more commonly affected by this condition.  It can be a disabling and painful condition, which can lead to substantial loss of functioning and mobility if not adequately treated.   The inflammation caused by RA can also affect other tissues in the body, including the skin, eyes, lungs and other organs.

Our immune system serves to protect us from foreign invaders, such as bacteria and viruses.  It recognizes these foreign invaders and produces specially tailored antibodies to combat them.  In autoimmune diseases, however, the body's immune system mistakes normal, healthy body tissues, for foreign invaders.  It produces antibodies directed at specific groups of tissue in the body, thereby destroying them.

Who Are Affected?

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The number of women affected by rheumatoid arthritis far outnumber men, with up to about 75% of RA sufferers being female.  RA can occur at any age, but frequently begins between 20 and 45 years old.  While the exact cause is unknown, it has been observed that infection, genes, and hormone changes may be linked to the disease.

What Are The Symptoms?

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Joints become swollen, tender, warm and stiff.  The stiffness in RA is very pronounced, typically worse on waking up in the morning, and lasts for over an hour.  This is useful in helping differentiate it from other non-inflammatory arthritis, in which the signs of inflammation and early morning stiffness are less prominent with stiffness typically lasting less than 1 hour.  With time, RA nearly always affects multiple joints, most commonly affecting the small joints of the hands, feet and cervical spine, but larger joints like the shoulder and knee can also be involved.

Chronic inflammation of the synovium (synovitis) and erosion of the joint surfaces result in loss of movement, joint deformity and consequently, loss of function. The condition often begins slowly, usually with only minor joint pain, stiffness, and fatigue.  Oftentimes, the condition is present for a significant length of time before it is diagnosed, because the early symptoms may be very subtle.

Other symptoms include:

• Dry eyes and mouth (Sjogren syndrome)

• Pleurisy (chest pain on breathing in)

• Eye burning, itching, and discharge

• Nodules under the skin (known as rheumatoid nodules)

• Numbness, tingling, or burning in the hands and feet (due to peripheral neuropathy, mononeuritis multiplex and carpal tunnel syndrome)

• Giddiness due to anaemia

• Fatigue, low grade fever, malaise, morning stiffness, loss of appetite and loss of weight are common systemic manifestations seen in patients with active rheumatoid arthritis.

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