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| What is it? |
| A chronic illness characterized by joint disease that affects muscles, membrane linings of the joints and cartilage. Sometimes the eyes and blood vessels are affected. It is 3 times more common in women than men. It begins between ages 20 and 60, with a peak incidence between ages 35 and 45. |
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| Causes |
| Unknown, but probably an autoimmune disease. |
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| Signs and Symptoms |
| * Slow or sudden onset of: |
| * Redness, pain, warmth and tenderness in any or all active joints in the hands, wrists, elbows, shoulders, feet and ankles. |
| * Morning stiffness. |
| * Low-grade fever. |
| * Nodules under the skin(sometimes). |
| * Fatigue. |
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| Risk Factors |
| * Family history of rheumatoid arthritis or other autoimmune disorders. |
| * Genetic factors, such as autoimmune system defects. |
| * Female age 20-50. |
| * Native American ethnicity (prevalence is higher in this group). |
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| Prevention |
| No specific preventive measures. |
| Diagnosis and Treatment |
| General Measures |
| * Laboratory blood studies. |
| * Splints at night may be helpful to support and protect a joint with active disease. |
| * Gloves at night to retain heat. |
| * Relieve pain with heat, including hot soaks, heat lamps, heating pads or whirlpool treatment. |
| * If you don't have a firm mattress, place 3/4 inch plywood between your bed springs and mattress to support your back. |
| * Consider moving to a dry climate. Damp weather aggravates symptoms. |
| Medications |
| * Nonsteroidal anti-inflammatory drugs, including aspirin and other salicylates; gold compounds; immunosuppressive drugs. |
| * Cotisone drugs usually relieve pain dramatically for short periods, but they are less effective for long-term use. They don't prevent progressive joint destruction, and they sometimes have hazardous side effects. Cortisone injections into joints can temporarily relieve pain. |
| * Caution: nonsteroidal anti-inflammatory drugs may cause stomach ulcers and gastritis. |
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| Activity |
| * Stay in bed, except to use the bathroom, until fever and other signs of an active flare-up disappear. |
| * Remain active, but include daily rest periods. Sleep for 10-12 hours each night. Don't become overtired. |
| * Stand, walk and sit erectly. |
| * When able, exercise actively to preserve strength and joint mobility. Build up slowly to the amount suggested. Exercsing in a heated pool is good for stiff joints. |
| * Exercise disabled joints passively to help prevent contractures. |
| * Physiotherapy may be prescribed. |
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| Diet |
| Eat a normal, well-balanced diet. Avoid arthritis diet fads, which are common. Lose weight if you are obese. Obesity stresses the joint. |
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| Possible Complications |
| * Impaired vision. |
| * Permanent deformity and crippling. |
| * Drugs used in treatment can induce complications, such as gastric problems, and those associated with long-term steroid use. |
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| Prognosis |
| * The disease may be mild or severe. It is presently incurable, but pain relief, prevention of disability and an active, normal life span are usually possible with early diagnosis. |
| * Conservative treatment relieves symptoms in 1 year in 75% of patients. About 5% to 10% of patients are eventually disabled, despite treatment. |
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