Q: What is causing the pain and stiffness I feel in my joints when I wake up every morning?
A: Arthritis means inflammation in a joint, which is characterized by redness, warmth, swelling, and pain within the joint. Rheumatoid arthritis is a type of chronic arthritis that typically occurs in joints on both sides of the body, such as hands, wrists, or knees. This symmetry helps distinguish rheumatoid arthritis from other types of arthritis. Rheumatoid arthritis may occasionally affect the skin, eyes, lungs, heart, blood, or nerves.
Symptoms include joint pain and swelling; stiffness, especially in the morning or after sitting for long periods; and fatigue. Rheumatoid arthritis can develop gradually over several years or progress rapidly. Others may have rheumatoid arthritis for a limited period of time and then enter a period of remission.
The exact cause is unknown but genetic, environmental, and hormonal factors could play a role. With rheumatoid arthritis, something seems to trigger the immune system to attack the joints and sometimes other organs.
The treatment of RA is directed toward the control of inflammation and the prevention of joint damage. Early treatment is important because of the new biologic disease modifying antirheumatic drugs called (DMARDs). These can slow or stop progression of this disease.
Other treatments include medications, rest and exercise, and surgery to correct damage to the joint. The type of treatment depends on the person's age, overall health, medical history, and severity of the arthritis. Medications can help decrease joint pain, swelling and inflammation. Other drugs can be used such as anti-inflammatory painkillers, topical pain relievers, corticosteroids, such as prednisone, and narcotic pain relievers
Rest and exercise are also important. During flare-ups, or a worsening of joint inflammation, it is best to rest the joints that are inflamed. The temporary use of a cane or joint splints can help. Exercise is necessary to maintain flexibility of the joints and to strengthen the muscles that surround the joints. Range-of-motion exercises should be done regularly to maintain joint mobility.
A doctor may consider surgery to restore function to a damaged joint if the rheumatoid arthritis becomes severe or pain is not controlled with drugs.
By Donn Fuhrmann, MD, ThedaCare Physicians-New London.
