Rheumatoid Arthritis Q & A

This week is National Rheumatoid Arthritis Week, which raises awareness of a condition that's little known, yet can have a significant impact on work, education and relationships.

Here Dr Sara Carty, Consultant Rheumatologist at Shalbourne, explains what it is, and how with treatment the outlook for those diagnosed in now very good.

Q. What is the difference between osteoarthritis and rheumatoid arthritis?

There are many types of arthritis, of which rheumatoid and osteoarthritis are the most common and well known. Osteoarthristis is a condition of wear and tear of the cartilage and surrounding bone which occurs mainly after middle age.

Rheumatoid arthritis is an auto-immune condition. The immune system, which usually fights infection in the body, becomes overactive and attacks the cells lining the joint. This can cause inflammation, pain and swelling, and without treatment it can damage joints. However, we do have very effective treatments for rheumatoid arthritis these days.

Q. How common is it, and who can develop it?

Rheumatoid arthritis is the second most common form of arthritis in the UK, affecting about 1 in 100 of the population. It most commonly starts between the ages of 40 and 50 but can affect adults of any age. It affects two to three times more women than men. Although children can get inflammatory arthritis, it is not called rheumatoid.

Q. What are the symptoms?

The most common symptoms are of pain, swelling and stiffness lasting more than an hour in the mornings. It usually affects the knuckles, wrists, elbows and feet.

Q. How might I know if I've got it?

If you have the symptoms mentioned above and they have persisted for a week or two, do visit your doctor. They can examine you and refer you to a rheumatologist if they are concerned. (Most people who have joint pain will not have rheumatoid, but it's important not to miss it!)

Q. What are the causes of rheumatoid arthritis?

There is a genetic predisposition to getting rheumatoid, but genetic factors alone do not cause it. Smokers are 40 per cent more likely to develop rheumatoid arthritis. Other suspected triggers include gum disease and possibly other infections.

Q. Can I lower my risk of getting it?

Stopping smoking is the most important thing people can do. Eating a healthy diet containing oily fish and fresh fruit and vegetables is also important. Looking after your teeth and visiting a dentist regularly may help too.

Q. Can it be cured?

A. We cannot cure rheumatoid arthritis but the treatment aim these days is remission.

Q. So how can it be managed?

We usually use disease-modifying drugs to treat rheumatoid arthritis. The most well-known is methotrexate. These aim to rebalance the immune system to dampen down inflammation without affecting the body's ability to fight infection. We often use steroids in the early stages as well.

Rheumatology consultants work as part of a full team of specialists including nurses, physiotherapists and occupational therapists who all play an important role in the treatment. The outlook these days for people diagnosed with rheumatoid arthritis is very good.