Rheumatoid arthritis is an autoimmune disease that causes pain, swelling, stiffness, and loss of function in the joints. It has several special features that make it different from other kinds of arthritis. For example, it generally occurs in a symmetrical pattern, meaning that if one knee or hand is involved is affected, the other will be as well. Rheumatoid arthritis affects people differently; some have the condition only temporarily and it goes away without causing noticeable damage, while others have a severe form that lasts a lifetime and can lead to serious joint damage and disability. Rheumatoid arthritis often affects the wrist joints and the finger joints closest to the hand. It can also affect other parts of the body besides the joints. In addition, people with rheumatoid arthritis may have fatigue, occasional fevers, and a general sense of not feeling well.
The autoimmune disease rheumatoid arthritis affects joints in causing pain, inflammation, and decreased mobility. About 1% of the population suffers from rheumatoid arthritis, with women being two or three times as likely to develop it. While there is neither a known cause nor a cure for this degenerative condition, early diagnosis and treatment can extend joint flexibility and reduce discomfort.
The reason rheumatoid arthritis classifies as a systemic, autoimmune disorder is that it occurs throughout the body when our antibodies begin to attack healthy tissue. This type of arthritis can affect muscles and organs, in addition to joints, as it progresses. Usually, onset of rheumatoid arthritis occurs between 40-60 years old, and first manifests in wrists and hands. The medical community believes there is a genetic as well as environmental factor in its development. Cigarette smoking increases your risk of rheumatoid arthritis.
Rheumatoid arthritis goes through worsening stages, but can also have cycles of flaring up and going into remission. At first, joints stiffen and redden when their delicate lining, the synovium, swells. Symptoms will vary from pain and discomfort in symmetrical parts of the body, to a low fever, loss of appetite, or fatigue. Next, the body reacts by trying to cushion the joint, thickening the synovium. Finally, antibodies assault the entire joint by breaking down bone, ligaments, tendons, synovium, and cartilage. This results in deformed or askew joints that bend with difficulty. The whole joint area will be inflamed, discolored, heavy, and painful.
Doctors can diagnose rheumatoid arthritis by taking a history of your joint paint and ruling out other types of arthritis. Treatment by a specialist, a rheumatologist, will be personalized to both reduce symptoms and postpone worsening joint health. Your tailored treatment might include mild exercise, anti-inflammatory medicine or cortisone shots to reduce swelling, analgesics to ease pain, or medication like prednisone to prevent further damage to joints. In some cases, your doctor might extract liquid from the joints with arthrocentesis. This relieves some pressure and gives the doctor something to chemically analyze. Overall, treatment of rheumatoid arthritis continues to improve with better medication and a broad understanding of this disease that affects the whole body.
Scientists estimate that about 2.1 million people, or between 0.5 percent and 1 percent of the U.S. adult population, have rheumatoid arthritis. Interestingly, some recent studies have suggested that the overall number of new cases may actually be going down. Scientists are investigating why this may be happening.
Rheumatoid arthritis occurs in all races and ethnic groups. Although the disease often begins in middle age and occurs with increased frequency in older people, children and young adults also develop it. Like some other forms of arthritis, rheumatoid arthritis occurs much more frequently in women than in men. About two to three times as many women as men have the disease.
Rheumatoid arthritis has several special symptoms that make it different from other kinds of arthritis. For example, symptoms of this condition generally occur in a symmetrical pattern, meaning that if one knee or hand is involved, the other one also is. Symptoms of rheumatoid arthritis often affect the wrist joints and the finger joints closest to the hand. They can also affect other parts of the body besides the joints.
Although rheumatoid arthritis symptoms often affect the wrist joints and the finger joints closest to the hand, they can also affect other parts of the body besides the joints. Some symptoms that affect the joints include a decrease in motion; tender, warm, and swollen joints; and pain that is worse with movement. A few examples of signs and symptoms that may develop outside of the joint include osteoporosis, dry eyes, and dry mouth.
In about two out of every three people, early symptoms are pretty vague. These symptoms can include things such as:
Fatigue
Occasional fevers
A general sense of not feeling well
A decreased appetite.
These early symptoms of rheumatoid arthritis may continue for weeks or months before joint symptoms begin, making a diagnosis quite difficult.
About one in every three people will have early symptoms that affect one or two joints. About 10 percent of people diagnosed with rheumatoid arthritis will have a very rapid progression, with early symptoms that involve multiple joints along with fever, enlarged lymph nodes, and an enlarged spleen.
For a person with rheumatoid arthritis, symptoms that affect the joints usually differ from other forms of arthritis. Within the affected joints, common symptoms of rheumatoid arthritis include:
Tender, warm, and swollen joints
Pain that is worse with movement
A decrease in motion
A symmetrical pattern affecting both the right and left sides of the body
Pain and stiffness lasting for more than 30 minutes in the morning or after a long rest.
Rheumatoid arthritis symptoms often affect the wrist and finger joints closest to the hand. However, joint inflammation can sometimes affect other joints, including the neck, shoulders, elbows, hips, knees, ankles, and feet.
The majority of people with symptoms of rheumatoid arthritis will also have more generalized symptoms that include weakness, tiring easily, decreased appetite, weight loss, and a low-grade fever.
As rheumatoid arthritis progresses, a person may develop other symptoms outside of the joint. Some of these other rheumatoid arthritis symptoms may include:
Rheumatoid nodules, which are small lumps. These can occur under your skin at pressure points. They can occur anywhere, but some common areas for rheumatoid nodules include the elbow, wrist, Achilles tendon, and the back of the head.
Loss of strength in the muscles that surround the affected joints.
Dry eyes and mouth.
Anemia, which is a decrease in the production of red blood cells.
Osteoporosis or osteopenia, which is thinning of bones.
Very rarely, inflammation of the blood vessels, the lining of the lungs, or the sac enclosing the heart.
Rheumatoid arthritis affects people differently. For some people with rheumatoid arthritis, symptoms last only a few months or a year or two and go away without causing any noticeable damage. Other people have mild or moderate forms of the disease, with periods of worsening symptoms (called flares) and periods in which they feel better (called remissions). Others may have a severe form of rheumatoid arthritis that is active most of the time, lasts for many years or a lifetime, and leads to serious joint damage and disability.
The exact cause or causes of rheumatoid arthritis are unknown. In recent research, however, scientists have considered a number of factors that may influence who develops rheumatoid arthritis. These include genetic, environmental, and hormonal factors. Although the causes are unknown, it is believed that the disease develops as a result of a combination of many factors.
Rheumatoid arthritis is an autoimmune disease. This means that for some reason the immune system mistakes a person's own cells as invaders and attacks them, causing damage. Similar to other autoimmune diseases, scientists still do not know the cause or causes of rheumatoid arthritis and why the immune system turns against itself. However, research over the last few years has begun to piece together the factors involved.
Based on recent research, it is believed that the main rheumatoid arthritis causes may be linked to a combination of:
Genetic factors
Autoimmune condition
Environmental factors
Hormones.
Genetic (Inherited) Factors
About 10 percent of people with rheumatoid arthritis have a first-degree relative with the disease. This suggests that genetics plays a role in the cause of the disease. Rheumatoid arthritis research scientists have also discovered that certain genes known to play a role in the immune system are associated with a tendency to develop rheumatoid arthritis. Some people with rheumatoid arthritis do not have these particular genes; and still others have these genes but never develop the disease.
These somewhat contradictory data suggest that a person's genetic makeup plays an important role in determining if he or she will develop rheumatoid arthritis, but that it is not the only factor. What is clear, however, is that more than one gene is involved in determining whether a person develops rheumatoid arthritis and how severe the disease will become.
Autoimmune condition
Rheumatoid arthritis is an autoimmune condition. This type of condition causes the body's immune system to attack itself. Normally, your immune system makes antibodies that attack bacteria and viruses, helping protect your body against infection. If you have rheumatoid arthritis, your immune system sends antibodies to the lining of your joints, where instead of attacking harmful bacteria, they attack the tissue surrounding the joint.
One or more genes may make it more likely that the body's immune system will attack the tissues of the joints. This immune response may also be triggered by bacteria, a virus, or some other foreign substance.
The abnormal immune response causes ongoing inflammation of the tissues lining the joint, a breakdown of cartilage, and loosening of the ligaments and tendons supporting the joint. Ongoing inflammation also causes the membrane that lines the joint (synovium) to grow into a thick, abnormal tissue called pannus. These processes result in destruction of the cartilage, the underlying bone surrounding the joint, ligaments, and tendons and can eventually lead to deformed joints.
The synovium is a membrane (thin layer of cells) that covers each of your joints. When antibodies attack the synovium, they leave it sore and inflamed. This inflammation causes chemicals to be released, causing the synovium to thicken. These chemicals can also damage bones, cartilage (the stretchy connective tissue between bones), tendons (tissue that connects bone to muscle) and ligaments (tissue that connects bone and cartilage). The chemicals gradually cause the joint to lose its shape and alignment and, eventually, can destroy the joint completely.
Environmental Factors
As with other autoimmune diseases, many scientists think that something must occur to trigger the disease process in people whose genetic makeup makes them susceptible to rheumatoid arthritis. A viral or bacterial infection appears likely, but the exact agent is not yet known. Given that rheumatoid arthritis occurs all over the world, it is thought that this organism must be everywhere. Scientists have studied bacteria such as mycoplasmas, as well as viruses such as cytomegalovirus, parvovirus, Epstein-Barr virus, and the rubella virus. However, to date there have been no convincing data to show that these viruses can cause rheumatoid arthritis.
Also, keep in mind that this does not mean that rheumatoid arthritis is contagious; a person cannot catch the disease from someone else.
Hormones
Some scientists also think that a variety of hormonal factors may be a possible rheumatoid arthritis cause. This is based on the fact that women are more likely to develop rheumatoid arthritis than men, pregnancy may improve the disease, and the disease may flare after a pregnancy. Hormones, or possibly deficiencies or changes in certain hormones, may promote the development of rheumatoid arthritis in a genetically susceptible person who has been exposed to a triggering agent from the environment.
Rheumatoid arthritis can be difficult to diagnose in its early stages for several reasons. First, there is no single test for the disease. In addition, symptoms differ from person to person and can be more severe in some people than in others. Also, symptoms can be similar to those of other types of arthritis and joint conditions, and it may take some time for other conditions to be ruled out.
Finally, the full range of rheumatoid arthritis symptoms develops over time, and only a few signs may be present in the early stages.
Tools used for making a diagnosis are a physical examination, laboratory tests, and x-rays.
A variety of approaches are used to treat rheumatoid arthritis, including medications, surgery, and lifestyle changes. With this disease, treatment is a team effort, involving several types of healthcare professionals. However, the individual patient also plays an important role in his or her own treatment. Patients who are well-informed and participate actively in their own care have less pain and make fewer visits to the doctor than do other people with the disease.
Healthcare providers use a variety of approaches when treating rheumatoid arthritis. These approaches are used in different combinations and at different times during the course of the disease, and are chosen according to the person's individual situation. No matter what types of treatment the healthcare provider and patient choose, however, the goals are the same:
Relieving pain
Decreasing inflammation
Slowing down or stopping joint damage
Improving a person's sense of well-being and ability to function.
Current treatment options for rheumatoid arthritis include:
Lifestyle changes
Medications
Surgery
Routine monitoring and ongoing care.
Keep in mind that good communication between the patient and healthcare providers is necessary for effective rheumatoid arthritis treatment. Talking to the healthcare providers can help ensure that exercise and pain management programs are provided as needed and that drugs are prescribed appropriately. Ultimately, however, successful treatment begins with you. Studies have shown that patients who are well-informed and participate actively in their own care have less pain and make fewer visits to the doctor than do other patients with rheumatoid arthritis.
As part of treating rheumatoid arthritis, certain activities can help improve a person's ability to function independently and maintain a positive outlook. These activities can include:
Rest and exercise
Joint care
Stress reduction
Helpful diet
Climate.
Rest and Exercise
People with rheumatoid arthritis need a good balance between rest and exercise, with more rest when the disease is active and more exercise when it is not. Rest helps to reduce active joint inflammation and pain and to fight fatigue. While the length of time needed for rest will vary from person to person, shorter rest breaks every now and then are generally more helpful than long times spent in bed.
Exercise is important for maintaining healthy and strong muscles, preserving joint mobility, and maintaining flexibility. Exercise can also help people sleep well, reduce pain, maintain a positive attitude, and lose weight. Exercise programs should be planned and executed based on the person's physical abilities, limitations, and changing needs.
Joint Care
Some people find using a splint for a short time around a painful joint reduces pain and swelling by supporting the joint and letting it rest. Splints are used mostly on wrists and hands, but may also be used on ankles and feet. A doctor or a physical or occupational therapist can help a person choose a splint and make sure it fits properly. Other ways to reduce stress on joints include self-help devices (for example, zipper pullers, long-handled shoe horns, etc.); devices to help with getting on and off chairs, toilet seats, and beds; and changes in the ways that a person carries out daily activities.
Stress Reduction
People with rheumatoid arthritis face emotional challenges as well as physical ones. The emotions they feel because of the disease (including fear, anger, and frustration) combined with any pain and physical limitations can increase their stress level. Although there is no evidence that stress plays a role in causing rheumatoid arthritis, it can make living with the disease difficult at times. Stress may also affect the amount of pain a person feels. There are a number of successful techniques for coping with stress. Regular rest periods can help, as can relaxation, distraction, or visualization exercises. Exercise programs, participation in support groups, and good communication with the healthcare team are other ways to reduce stress.
Healthful Diet
With the exception of several specific types of oils, there is no scientific evidence that any specific food or nutrient helps or harms people with rheumatoid arthritis. However, an overall nutritious diet with enough -- but not excessive quantities of -- calories, protein, and calcium is important.
Some people may need to be careful about drinking alcoholic beverages because of the medications they take for rheumatoid arthritis. Those taking methotrexate may need to avoid alcohol altogether, since one of the most serious long-term side effects of methotrexate is liver damage.
Climate
Some people notice that their arthritis gets worse when there is a sudden change in the weather. However, there is no evidence that a specific climate can prevent or reduce the effects of rheumatoid arthritis. Moving to a new place with a different climate usually does not make a long-term difference in a person's rheumatoid arthritis.
For most people who have rheumatoid arthritis, treatment also involves taking medications. Some rheumatoid arthritis medicines are used only for pain relief, while others are used to reduce inflammation. There is also another class of medications, often called disease-modifying antirheumatic drugs (DMARDs), that is used to try to slow down the course of the disease.
Some important factors for deciding which medication is most appropriate as part of a treatment plan for rheumatoid arthritis include the:
Person's general condition
Current and predicted severity of the illness
Length of time he or she will take the drug
Drug's effectiveness and potential side effects.
Biologic response modifiers are new drugs that are used in rheumatoid arthritis treatment. They can help reduce inflammation and structural damage to the joints by blocking the action of cytokines, proteins in the body's immune system that trigger inflammation during normal immune responses. Three of these drugs -- etanercept (Enbrel), infliximab (Remicade), and adalimumab (Humira) -- reduce inflammation by blocking the reaction of TNF-alpha molecules. Another drug, called anakinra (Kineret), works by blocking a protein called interleukin 1 (IL-1) that is seen in excess in people with rheumatoid arthritis. Abatacept (Orencia) is a new biologic response modifier that seems to prevent T cells from becoming active. T cells are a type of white blood cell (leukocytes) that play an important role in rheumatoid arthritis.
For many years, healthcare providers initially prescribed aspirin or other pain-relieving drugs for rheumatoid arthritis, as well as rest and physical therapy. Other more powerful drugs were prescribed only if the disease worsened.
Today, however, many healthcare providers have changed their approach, especially for people with severe, rapidly progressing rheumatoid arthritis. Studies show that early treatment for rheumatoid arthritis with more powerful drugs and the use of drug combinations instead of one medication alone may be more effective at reducing or preventing joint damage. Once the disease improves or is in remission, the healthcare provider may gradually reduce the dosage or prescribe a milder medication.
Doctors typically prescribe medications with the fewest side effects first. You may need stronger drugs or a combination of drugs as your disease progresses.
NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin, others) and naproxen (Aleve). Stronger NSAIDs are available by prescription. Side effects may include ringing in your ears, stomach irritation, heart problems and liver and kidney damage.
Steroids. Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage. Side effects may include thinning of bones, cataracts, weight gain and diabetes. Doctors often prescribe a corticosteroid to relieve acute symptoms, with the goal of gradually tapering off the medication.
Disease-modifying antirheumatic drugs (DMARDs). These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. Common DMARDs include methotrexate (Trexall), leflunomide (Arava), hydroxychloroquine (Plaquenil), sulfasalazine (Azulfidine) and minocycline (Dynacin, Minocin, others). Side effects vary but may include liver damage, bone marrow suppression and severe lung infections.
Immunosuppressants. These medications act to tame your immune system, which is out of control in rheumatoid arthritis. Examples include azathioprine (Imuran, Azasan), cyclosporine (Neoral, Sandimmune, Gengraf) and cyclophosphamide (Cytoxan). These medications can increase your susceptibility to infection.
TNF-alpha inhibitors. Tumor necrosis factor-alpha (TNF-alpha) is an inflammatory substance produced by your body. TNF-alpha inhibitors can help reduce pain, morning stiffness, and tender or swollen joints. Examples include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), golimumab (Simponi) and certolizumab (Cimzia). Potential side effects include increased risk of serious infections, congestive heart failure and certain cancers.
Other drugs. Several other rheumatoid arthritis drugs target a variety of processes involved with inflammation in your body. These drugs include anakinra (Kineret), abatacept (Orencia), rituximab (Rituxan) and tocilizumab (Actemra). Side effects vary but may include itching, severe abdominal pain, headache, runny nose or sore throat.
Several types of surgery are available for people with severe joint damage. The primary purpose of these procedures is to reduce pain, improve the affected joint's function, and improve the person's ability to perform daily activities.
Surgery is not for everyone, however, and the decision should be made only after careful consideration by the patient and healthcare provider. Together, they should discuss the person's overall health, the condition of the joint or tendon that will be operated on, and the reason for, as well as the risks and benefits of, the surgical procedure. Cost may be another factor.
Some surgical procedures that are commonly performed to treat rheumatoid arthritis include:
Joint replacement
Tendon reconstruction
Synovectomy.
Joint Replacement
This is the most frequently performed surgery for treating rheumatoid arthritis, and it is done primarily to relieve pain and improve or preserve joint function. Artificial joints are not always permanent and may eventually have to be replaced. This may be an important consideration for young people.
Tendon Reconstruction
Rheumatoid arthritis can damage and even rupture tendons, the tissues that attach muscle to bone. Tendon reconstruction is a type of surgery used most frequently on the hands, and it reconstructs the damaged tendon by attaching an intact tendon to it. This procedure can help to restore hand function, especially if the tendon is completely ruptured.
Synovectomy
In this surgery, the healthcare provider actually removes the inflamed synovial tissue. Synovectomy by itself is seldom performed now because not all of the tissue can be removed, and it eventually grows back. Synovectomy is done as part of reconstructive surgery, especially tendon reconstruction.
Regular medical care is important to monitor the course of the disease, determine the effectiveness and any negative effects of medications, and change therapies as needed. Monitoring typically includes regular visits to the doctor. It also may include blood, urine, and other laboratory tests and x-rays.
People with rheumatoid arthritis may want to discuss preventing osteoporosis with their healthcare provider as part of their long-term, ongoing care. Osteoporosis is a condition in which bones become weakened and fragile. Having rheumatoid arthritis increases the risk of developing osteoporosis for both men and women, particularly if a person takes corticosteroids. Such people may want to talk with their healthcare provider about the potential benefits of calcium and vitamin D supplements, hormone therapy, or other treatments for osteoporosis.
Special diets, vitamin supplements, and other alternative approaches have been suggested for rheumatoid arthritis treatment. Although many of these approaches may not be harmful in and of themselves, controlled scientific studies either have not been conducted on them or have found no definite benefit to these therapies. Some alternative or complementary approaches may help the person cope or reduce some of the stress associated with living with a chronic illness.
As with any therapy, people should discuss the benefits and drawbacks with their healthcare provider before beginning an alternative or new type of therapy. If he or she feels the approach has value and will not be harmful, it can be incorporated into the treatment plan. However, it is important not to neglect regular healthcare.
You can take steps to care for your body if you have rheumatoid arthritis. These self-care measures, when used along with your rheumatoid arthritis medications, can help you manage your signs and symptoms:
Exercise regularly. Gentle exercise can help strengthen the muscles around your joints, and it can help fight fatigue you might feel. Check with your doctor before you start exercising. If you're just getting started, begin by taking a walk. Try swimming or gentle water aerobics. Avoid exercising tender, injured or severely inflamed joints.
Apply heat or cold. Heat can help ease your pain and relax tense, painful muscles. Cold may dull the sensation of pain. Cold also has a numbing effect and decreases muscle spasms.
Relax. Find ways to cope with pain by reducing stress in your life. Techniques such as hypnosis, guided imagery, deep breathing and muscle relaxation can all be used to control pain.
Other promising alternative remedies for arthritis include:
Acupuncture. This therapy uses fine needles inserted at specific points on the skin to reduce many types of pain, including that caused by some types of arthritis.
Glucosamine. Although study results have been mixed, it now appears that glucosamine works no better than placebo. However, glucosamine and the placebo both relieved arthritis pain better than taking nothing, particularly in people who have moderate to severe pain.
Transcutaneous electrical nerve stimulation (TENS). Using a small device that produces mild electrical pulses, TENS therapy stimulates nerves near the aching joint and may interfere with the transmission of pain signals to the brain.
Stretching. Slow, stretching movements may help improve joint flexibility and range of motion in people with some types of arthritis.
Diagnosing and treating rheumatoid arthritis requires a team effort involving the patient and several types of healthcare professionals. A person can go to his or her family doctor, an internist, or a rheumatologist to seek medical attention. A rheumatologist is a doctor who specializes in arthritis and other diseases of the joints, bones, and muscles. As treatment progresses, other professionals often help. These may include:
Nurses
Physical or occupational therapists
Orthopedic surgeons
Psychologists
Social workers.
Studies have shown that people who are well-informed and participate actively in their own care have less pain and make fewer visits to the doctor than do other people with rheumatoid arthritis. Patient education and arthritis self-management programs, as well as support groups, help people to become better-informed and to participate in their own care.
Self-management programs teach about rheumatoid arthritis and its treatments, exercise and relaxation approaches, communication between patients and healthcare providers, and problem solving. Rheumatoid arthritis 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 their ability to function and lead full, active, and independent lives.
If you suffer from rheumatoid arthritis, you may have heard that a specific diet or certain foods can ease your pain, stiffness, and fatigue. Someday, food may be the medicine of choice for those with arthritis and related inflammatory diseases. For now, though, here's information that may help you separate the facts from the myths about diet and rheumatoid arthritis.
Eating certain foods or avoiding certain foods may help your rheumatoid arthritis symptoms. However, according to the Arthritis Foundation, there is no specific "arthritis diet." On the other hand, if you find certain foods worsen your rheumatoid arthritis symptoms and others help your symptoms to improve, it makes sense to make some adjustments in your diet.
A recent study showed that 30% to 40% of people with rheumatoid arthritis may benefit from excluding "suspect" foods that are identified with an elimination diet. An elimination diet guides you in removing suspected "trigger" foods from your daily diet. Then, after a period of time, you slowly add the suspect foods back into your diet and watch for increased pain and stiffness. For some people, eliminating those foods that seem to trigger pain and stiffness may help decrease rheumatoid arthritis symptoms.
Yes. Studies show that saturated fats may increase inflammation in the body. Foods high in saturated fats, such as animal products like bacon, steak, butter, and cream, may increase inflammatory chemicals in the body called prostaglandins. Prostaglandins are chemicals that cause inflammation, pain, swelling, and joint destruction in rheumatoid arthritis.
In addition, some findings confirm that meat contains high amounts of arachidonic acid. Arachidonic acid is a fatty acid that's converted to inflammatory prostaglandins in the body. Some people with rheumatoid arthritis find that a vegetarian diet helps relieve symptoms of pain and stiffness. Other people with rheumatoid arthritis, however, get no benefit from eating a diet that eliminates meat.
Omega-6 fatty acids are in vegetable oils that contain linoleic acid. This group of vegetable oils includes corn oil, soybean oil, sunflower oil, wheat germ oil, and sesame oil. Studies show that a typical western diet has more omega-6 fatty acids compared to omega-3 fatty acids. Omega-3 fatty acid is a polyunsaturated fat found in cold-water fish.
Consuming excessive amounts of omega-6 fatty acids may promote illnesses such as cancer and cardiovascular disease. It may also promote inflammatory and/or autoimmune disease such as rheumatoid arthritis. Ingesting fewer omega-6 fatty acids and more omega-3 fatty acids, on the other hand, may suppress inflammation and decrease the risk of illness.
Many studies show that lowering the ratio of omega-6 fatty acids to omega-3 fatty acids contained in the diet can reduce the risk of illness.
Omega-3 fatty acids, the polyunsaturated fats found in cold-water fish, nuts, and other foods, may have an anti-inflammatory effect in the body. The marine omega-3 fatty acids contain EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). These are substances that may decrease inflammation. Some studies show a positive anti-inflammatory effect of omega-3 fatty acids with rheumatoid arthritis. The same is true for heart disease. This is important because people with rheumatoid arthritis also have a higher risk of heart disease.
Human studies with marine omega-3 fatty acids show a direct relationship between increased DHA consumption and diminished C-reactive protein levels. That means reduced inflammation.
For omega-3 fatty acids, select cold-water fish such as salmon, tuna, and trout. Some plant foods are also sources of omega-3 fatty acids. They include walnuts, tofu, and soybean products, flaxseed and flaxseed oil, and canola oil.
According to the American College of Rheumatology, some patients with rheumatoid arthritis report an improvement in pain and joint tenderness when taking marine omega-3 fatty acid supplements. You may not notice any benefit at first from taking a fish oil supplement. It may take weeks or even months to see a decrease in symptoms. But studies do show that some people who have a high intake of omega-3 fatty acids benefit from decreased symptoms and less use of anti-inflammatory drugs.
The American College of Rheumatology reminds consumers that fish oil supplements may have high levels of vitamin A or mercury.
Many studies suggest that a diet high in fruits, vegetables, and vitamin C may be linked to a lower risk of rheumatoid arthritis. In fact, we know that rheumatoid arthritis is less severe in some Mediterranean countries such as Greece and Italy. In those countries, the main diet consists of large amounts of fruits, vegetables, olive oil, and fatty fish high in omega-3s. The Mediterranean-type diet may even protect against severe rheumatoid arthritis symptoms.
Fruits, vegetables, grains, and legumes are high in phytonutrients. These are chemicals in plants that have disease-fighting properties and immune-boosting antioxidants such as vitamin C, vitamin E, selenium, and the carotenoids. A plant-based diet is also high in bioflavonoids. These are plant compounds that reportedly have anti-viral, anti-inflammatory, and anti-tumor activities.
Nutrition researchers who test the antioxidant activity of foods believe that certain foods may reduce the risk of some degenerative diseases associated with aging. These diseases include arthritis, heart disease, diabetes, and cancer. More recent findings show that the higher intake of omega-3 fatty acids with the Mediterranean diet may be linked to the improvement in rheumatoid arthritis symptoms.
Folic acid, or folate, is a B vitamin found in food. It can also be obtained by supplementation. It is important to you if you take methotrexate, a commonly prescribed medication for rheumatoid arthritis. Your body uses folic acid to manufacture red blood cells. Supplementing with folic acid may allow people with rheumatoid arthritis to avoid some side effects of methotrexate.
Selenium helps to fight free radicals that cause damage to healthy tissue. Some studies indicate that people with rheumatoid arthritis have reduced selenium levels in their blood. These findings are preliminary and no recommendations have been made for selenium supplementation. One 3.5-ounce serving of tuna gives you a full day's requirement of selenium.
Supplementing your diet with bone-boosting calcium and vitamin D is important, especially if you take corticosteroids (like prednisone) that can cause bone loss. The risk of bone loss is higher in people with rheumatoid arthritis. So check with your doctor to see how much calcium and vitamin D you need to get daily through foods, supplements, and sunlight.
A study published in the Annals of Rheumatic Diseases concluded that drinking alcohol in moderation may be linked to a significantly reduced chance of getting rheumatoid arthritis. While the researchers did not know how alcohol protects against rheumatoid arthritis, they believed the data should encourage further study on how arthritis may be prevented through diet and lifestyle measures. Talk to your doctor about drinking alcohol if you take any rheumatoid arthritis medication. Avoid drinking excessive alcohol or drinking alcohol in combination with the drug methotrexate because liver damage could be a serious side effect.
Although some research has shown that drinking the equivalent of one glass of an alcoholic beverage a day could lower your risk of developing rheumatoid arthritis, once you have rheumatoid arthritis, drinking alcohol may be quite dangerous.
Alcohol also has the potential to irritate the lining of the stomach. Rheumatoid arthritis patients who consume alcohol at the same time they take an NSAID may increase their risk for ulcers and GI bleeding. Prednisone, a steroid used to treat rheumatoid symptoms, also has the potential to cause GI bleeding. Additionally, rheumatoid arthritis patients who drink alcohol and take large doses of acetaminophen have an increased risk for liver toxicity.
Another problem with drinking alcohol while taking medication for rheumatoid arthritis is that alcohol can make it difficult for your physician to assess your tolerance of the particular drug if you have increased liver enzymes. Your doctor may not be able to determine if it is the rheumatoid arthritis drug or the alcohol that is causing your increased liver enzymes. Even if you do not drink alcohol, to prevent potential damage to the liver, your doctor may have you stop your rheumatoid arthritis medication if your liver enzyme numbers increase.
Yes. Studies show that dropping extra pounds is important for your joints and overall health. Excess pounds put extra strain on knees, hips, and other weight-bearing joints, not to mention your heart. Being overweight or obese actually worsens the joints -- making them stiffer and more painful -- and can exacerbate rheumatoid arthritis flares.