Rheumatoid Arthritis (RA)

Getting the proper diagnosis and treatment for fibromyalgia can sometimes be very difficult. This is because there are no diagnostic tests available to diagnose fibromyalgia. Additionally, fibromyalgia syndrome is associated with a number of associated conditions that often mimic the illness. Many pain patients seeking diagnosis are actually suffering from a condition called Rheumatoid Arthritis. Rheumatoid arthritis is a chronic disease that can produce symptoms that are similar to fibromyalgia but which are actually caused by a different illness.

What is Rheumatoid Arthritis? Rheumatoid arthritis is a chronic illness that causes severe joint and muscle pain. One of the most serious types of arthritis, rheumatoid arthritis attacks the lining of your joints (called the synovial lining), causing it to become swollen and inflamed. Rheumatoid arthritis gradually causes your joints to become deformed, decreasing joint mobility and range of motion. Many sufferers of rheumatoid arthritis eventually become unable to perform simple, everyday tasks because of this joint disease.

Who Gets Rheumatoid Arthritis?
Rheumatoid arthritis affects about 1% of the general population; this means that more than two million people in the United States are affected by the disease. The majority of these sufferers are women; in fact, women are three times more likely then men to develop rheumatoid arthritis. Rheumatoid arthritis usually onsets between the ages of 30 and 50, however, children under the age of 16 can also be affected by juvenile rheumatoid arthritis.

Causes of Rheumatoid Arthritis?
Unfortunately, the cause of rheumatoid arthritis remains elusive. Great amounts of research have been performed and a number of possible causes for the disease have been pinpointed. It is possible that rheumatoid arthritis is actually the result of many different factors, or it may be an amalgam of different diseases. Possible causes include:


  • Immune System Dysfunction: Rheumatoid arthritis may be the result of an immune system dysfunction. Your immune system is responsible for keeping your body healthy; it attacks any invading cells or bacteria to keep you from getting sick. People with rheumatoid arthritis, however, seem to have a dysfunctional immune system. It attacks healthy cells throughout the tissue and joints, causing inflammation
  • Genetics: There appears to be a specific gene that is involved in causing rheumatoid arthritis. Known as HLA-DR4, this gene is found in more than two-thirds of rheumatoid arthritis sufferers. This suggests a genetic component to the disease.
  • Infection: Though still unproven, some researchers suggest that certain bacterial infections may trigger rheumatoid arthritis in people who are already at risk for the disease.
  • Environmental Factors: There is some research to suggest that rheumatoid arthritis may be caused by certain environmental factors. People who smoke tobacco for long periods of time appear to be more likely to develop rheumatoid arthritis.


Symptoms of Rheumatoid Arthritis
Rheumatoid arthritis usually begins in the small joints, like the hands, fingers, and wrist. Joint inflammation tends to be symmetrical: if your left wrist is affected, it is likely that your right wrist will also become inflamed. Rheumatoid arthritis symptoms tend to come and go over time. Many people will experience symptom relief for many years, only to be hit suddenly by a symptom flare up. Common symptoms of rheumatoid arthritis include:


  • joint pain and stiffness
  • weakened joints
  • redness in the joints
  • low fever
  • fatigue
  • gradual joint deformity
  • skin ulcers
  • loss of mucus and tear production (Sjogren�s Syndrome)


Complications Associated with Rheumatoid Arthritis
If left untreated, there are numerous complications associated with rheumatoid arthritis. Without proper care, joints will continue to break down and become damaged. Eventually, this could lead to loss of joint movement and disability. Rheumatoid arthritis also causes inflammation of the vital organs, including:


  • inflammation of the lungs (pleuritis)
  • inflammation of the heart (pericarditis)


Rheumatoid Arthritis and Fibromyalgia
Rheumatoid arthritis is often confused with fibromyalgia because it produces so many of the same symptoms. Similar symptoms include:


  • muscle pain
  • morning stiffness
  • loss of mobility and range of motion


Despite these similar symptoms, the two illnesses are actually quite different. Fibromyalgia is not associated with inflammation, unlike rheumatoid arthritis. It is important that you are not misdiagnosed, because each is treated using different medications. It is possible to suffer from both rheumatoid arthritis and fibromyalgia, but this is rare. If this occurs, it is important to find a knowledgeable health care provider who can treat both illnesses.

Rheumatoid Arthritis Treatment
Unfortunately, there is no cure for rheumatoid arthritis. However, there are rheumatoid arthritis treatments available to help relieve your pain and prevent joint damage from progressing. Treatment is multifaceted, and includes regular exercise, physical therapy, and dietary changes. Medicinal treatment is also available. Common rheumatoid arthritis medications include:


  • NSAIDs, including Cox-2 inhibitors
  • Analgesics, like acetaminophen
  • Disease Modifying Antirheumatic Drugs (DMARDS), which help to slow joint damage.
  • Biologic Response Modifiers, which help to inhibit inappropriate immune system response.



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This article is fairly helpful but I am concerned about the treatments you recommend. You state "Treatment is multifaceted, and includes regular exercise, physical therapy, and dietary changes". You do state that medication is also available. I fear that is poor advice. 50% of people who do not medically treat their RA in the first 2 years can end up being disabled within 10 years. Diet, exercise, PT are valuable add on treatments but far from the main treatment. The idea is that you must try to stall the progress of the disease which the medications do help to do. Please consider fixing this because as a person living with RA, I would hate to see others get misinformation regarding how to treat their disease. Treatment can help slow joint damage (not prevent it). It is important that you rephrase your treatment section to reflect accurate information.
Hi, as an patient with RA and Sjogrens, I know all to well the pain and disability of the disease and I know several folks who have RA and Fibro, First I would like to point out that with a disabling disease such as RA medical treatment is a must, and early, aggressive treatment is strongly recommended. Damage often occurs early on in the disease process, within the first 2 years and although nothing can stop the process of the disease the medications can slow it down, and once the damage happens there is nothing that can undo the damage. Thank you for your time and attention to this, as a volunteer for the IAAM, the International Autoimmune Arthritis Movement, we do everything we can to help sort out misinformation, if we can help avoid the confusion then perhaps a diagnosis can come sooner for those in pain.
I appreciate this article highlighting the similarities and differences between Fibromyalgia and Rheumatoid Arthritis, but I'd like to mention a problem with the emphasis placed on medicinal treatments and physical therapies for RA "Treatment is multifaceted, and includes regular exercise, physical therapy, and dietary changes. Medicinal treatment is also available." Medicinal treatments such as anti-inflammatory drugs to relieve pain from inflammation, and disease-modifying drugs that act to suppress the immune system are the first-line treatments for most people with RA. Exercise may be helpful for general well-being, but with an active RA flare may not be recommended at all due to the impact on the inflamed joints. While physical therapies may provide some relief for some patients, it will not change the course of the disease whereas DMARDs and Biologics can slowdown joint damage for many patients. There is no compelling evidence that dietary changes, apart from ensuring a healthy diet, have any impact on RA symptoms or causes (which is not to deny some people say they experience remission at the same time as undertaking dietary changes and many individuals may find their general health is improved overall with a healthier diet). So medicinal treatments, rather than being 'also available' are in fact the cornerstone in any treatment plan for RA that has the intention of slowing the course of the disease.
This is actually a very helpful article for those who have fibromyalgia and/or rheumatoid arthritis, or those, like myself, who have both. I do, however, have some concerns about certain statements in the article I believe are misleading, which I feel should be revised. The first is where you mention "gradual joint deformity". It is very important to note that if early and aggressive treatment is not started within the first weeks to months after presenting with the disease (RA), deformity and destruction of the joints can be very quick and can lead to early loss of joint mobility and possible permanent disability. Treatment within the first 2 years is CRUCIAL; those who do not receive treatment within that time have a 50% higher risk of leaving the workforce and being on disability within 10 years. According to the American College of Rheumatology the first weeks/months after the onset of symptoms are called the “window of opportunity,” and it’s crucial that patients get appropriate treatment in that time period to avoid long-term complications. Early and aggressive treatment during that period can prevent damage to joints and other organs and increase the likelihood of achieving disease remission. The other statement I take issue with is where you state, "...there are rheumatoid arthritis treatments available to help relieve your pain and prevent joint damage from progressing." Treatment for RA can help slow joint damage, but not always prevent it. Please update your article so that the public will be provided with the accurate depiction of this serious and debilitating illness. Thank you.