The Challenges of Rheumatoid Arthritis

(This article was submitted by Dr. Leia Meir, Rheumatology from White Plains Hospital)
Many people are aware of what arthritis is, but they may not know that there are over 100 different forms of the disease and related conditions. Rheumatoid arthritis is the most common type of autoimmune arthritis, affecting an estimated 1.3 million Americans. While there is no cure for RA (or other arthritic conditions), there are effective ways of treating and managing the disease.

The need for doing so is plain. RA affects joint linings, causing painful swelling in such locations as the joints, back and muscles. If not treated effectively, the inflammation associated with RA can lead to bone erosion and result in joint deformity. There is also quality of life to consider for all arthritic patients: The Centers for Disease Control and Prevention estimates that more than one-third of adults who have arthritis report that it limits their leisure activities and work, while 25% of them say it causes severe pain. Fatigue, an inability to focus on tasks, depression, and other mental difficulties have all been associated with the disease.
Risk factors include whether you have a first-degree (parent, sibling) or second-degree (grandparent) relative who suffers from RA. If so, keep in mind that just because such a relative has it does not automatically mean you will develop it. Other risk factors include exposure to cigarette smoke, bacteria, viruses, gum disease, and lung disease.|

Determining whether you have RA can be tricky. Especially as we age, many of us experience stiffness when we first get out of bed. But if that stiffness lasts for 30 minutes or more, over six weeks or more, then you may have a chronic case of RA. There are also other physical manifestations to watch for, including rheumatoid nodules, firm, usually non-painful, subcutaneous (under the skin) bumps that tend to appear on fingers and knuckles, elbows, knees, and forearms. In fact, up to 40% of people with RA will eventually develop these nodules.

Ideally, diagnosing RA will be completed early before the more severe symptoms appear. There is no one test to provide a definitive answer, however, as RA presents in a similar fashion to osteoarthritis (the most common type of arthritis, affecting over 32 million Americans), Lupus, Sjogren’s Syndrome, and others. Nevertheless, an Anti-CCP antibody test (ACCP or CCP) looks for cyclic citrullinated peptide (CCP) antibodies, which can be found in the blood of 60% to 80% of people with rheumatoid arthritis. This test is usually conducted along with rheumatoid factor (RF) blood test. Depending on those results, a doctor may recommend X-rays, MRIs and ultrasounds to determine the severity of the disease and track the rate of its progression.

As is often the case, early detection is key when discussing treatments. Over the last couple of decades, biologics – also known as DMARDS, or disease-modifying antirheumatic drugs – have come to the forefront in treating RA, given they can quickly and effectively alleviate pain and essentially put the disease into remission. These medications can be taken in pill form, or via infusion or injection. While not everyone is excited about receiving a shot, an injection may be the preferable way to go for certain individuals.

The big takeaway here is that if something is hurting, you need to discuss it with a healthcare professional, starting with your primary care provider. They can run some of the aforementioned tests and, if necessary, refer you to a rheumatologist. Living with RA in a comfortable manner is certainly achievable – but only with professional help.

Dr. Lea Meir is a rheumatologist at White Plains Hospital Physician Associates, with offices in Larchmont and New Rochelle. To make appointment, call 914-849-7400 (Larchmont) or 914-235-8224 (New Rochelle).

Health Matters
The original version of this article was published in Health Matters, a White Plains Hospital publication.