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Rheumatoid Arthritis

Rheumatoid Arthritis Inflammation

Rheumatoid arthritis symptoms, notably joint pain and swelling, are caused by inflammation.

Rheumatoid arthritis (RA) affects about 1.3 million Americans. Rheumatoid Arthritis Symptoms are caused by inflammation, which is the body's normal response to a foreign invader like a virus or bacteria.

How Inflammation Causes Rheumatoid Arthritis Symptoms

Typical rheumatoid arthritis symptoms include redness, swelling, warmth, and pain. In the early phases, inflammation causes joint pain and stiffness.
Over time, inflammation can chew into joints, damaging the joint and the bone and resulting in deformity.

Here is what happens during inflammatory response:

Chemicals are released. White blood cells release chemicals that increase the amount of blood flowing to the joint affected by RA, resulting in joint symptoms of warmth and redness.
There is a reaction to chemicals. Some of these chemicals cause blood vessels to leak fluid into the tissue around and inside the joint causing swelling and irratings nerves.
Joint pain begins. The increased fluid inside the joint and nerve stimulation from the chemicals cause joint pain.
Pain increases. The number of cells in the lining of the joint — called the synovium — increases, causing the lining to thicken.
Joint destruction begins. Substances released by inflamed cells eat away bone and cartilage, causing more pain, deformity, and loss of movement.

Possible Causes of Rheumatoid Arthritis Inflammation

Joint pain most commonly affects the hands, knees, feet, and ankles. In later stages of rheumatoid arthritis, symptoms may also include fatigue, fever, swollen glands, and weakness. Researchers now think that rheumatoid arthritis may actually be several different diseases acting together.

Although the exact cause of rheumatoid arthritis is not known, there are several theories about what may lead to the development of RA:

Genes are found more commonly in people with RA and may be associated with the condition, but not everyone who has these genes develops rheumatoid arthritis.

Gender. Women are up to three times more likely to develop RA than men. Rheumatoid arthritis symptoms often get better during pregnancy, only to come back more severely after childbirth, so female hormones may also play a role in RA.

Women are up to three times more likely to develop RA than men. Rheumatoid arthritis symptoms often get better during pregnancy, only to come back more severely after childbirth, so female hormones may also play a role in RA.

Rheumatoid factor (RF). Rheumatoid factor is a type of protein — called an antibody — that the body uses to regulate its immune response. People with rheumatoid arthritis usually have too much RF, and this may be one reason they have abnormal joint inflammation. Generally, the more rheumatoid factor you have, the worse your RA symptoms are. However, 20 percent of people with rheumatoid arthritis do not have elevated levels of RF, and some people with elevated levels do not develop the disease.

Rheumatoid factor is a type of protein — called an antibody — that the body uses to regulate its immune response. People with rheumatoid arthritis usually have too much RF, and this may be one reason they have abnormal joint inflammation. Generally, the more rheumatoid factor you have, the worse your RA symptoms are. However, 20 percent of people with rheumatoid arthritis do not have elevated levels of RF, and some people with elevated levels do not develop the disease.

Infection. Rheumatoid arthritis is not an infection, meaning it can't be spread to others. But for some people who already are susceptible to developing the condition, RA may be triggered by an infection. However, this theory has not been proven.

Tips for Exercising With Rheumatoid Arthritis

Stretching, strengthening, and aerobic exercises are all important for managing this condition. Here are a few tips:

Getting plenty of exercise is an important part of coping with rheumatoid arthritis, according to the Arthritis Foundation. It can help alleviate joint pain and stiffness, make you more flexible, improve your sleep, and boost your endurance. An exercise program should include stretching, aerobic exercises, and strengthening routines, says Marian Minor, PT, PhD, a clinical professor in the division of immunology and rheumatology at the University of Missouri-Columbia School of Health Professions, who focuses on exercise in people with rheumatoid arthritis.

Start Stretching

People with rheumatoid arthritis can take different approaches to stretching, For example, if you're going to garden, you might want to stretch your hips, knees, and ankles. Or you might stretch after your exercises to prevent stiffness, or "if you have particular joints that get stiff or have limited motion, you might want to add something to your regular exercise routine that will help flexibility and range of motion. A gentle yoga class can also alleviate some of the pain.

Try Tai Chi

Tai Chi is an ancient Chinese practice that features sets of slow, flowing movements. The practice emphasizes physical motion, mental focus, and regular breathing. Many practitioners do it to relieve stiffness and improve their strength and balance.

Do Low-Impact Aerobic Exercise

The best forms of exercise for people with rheumatoid arthritis are those that put minimal impact on affected joints, according to the American College of Rheumatology. These include low-impact aerobic dance, water exercises, walking, or stationary bicycles. Keep in mind that activities with sudden stops and changes of direction, like soccer or basketball, might be inappropriate. However, if you don't have problems with your knees, ankles, and hips, even light jogging might be okay for you.

Get Ready for Resistance Exercises

For strengthening your muscles, you can choose from a variety of resistance tools, including elastic bands, free weights, and machines. Free weights may be better than machines since they "don't force the joint into a specific predetermined movement pattern," she says. However, if you have wrist involvement as part of your rheumatoid arthritis, holding a dumbbell might cause pain.

Take Up Swimming

Swimming is particularly good for people with rheumatoid arthritis since the water supports your body, thus limiting the amount of stress on your joints, according to the Arthritis Foundation. In addition to swimming, another good water exercise is walking in a pool; the effort to move yourself through the water while walking makes your muscles stronger. You can walk in water that's up to your waist or chest or put on a flotation belt and walk in deeper water.

Add Weight-Bearing Exercises

People with rheumatoid arthritis face a higher risk of the bone-thinning condition osteoporosis due to the arthritis itself, medications used to treat it, or reduced physical activity. According to the National Institutes of Health, weight-bearing exercises are helpful for preserving your bones. Walking is a good type of weight-bearing exercise.

Get the Right Intensity

If you're unfamiliar with exercise or you want to drastically shake up your workout, it's a good idea to meet with a trainer with experience helping people with rheumatoid arthritis, Minor suggests. It's particularly important for people with rheumatoid arthritis to avoid exercising too hard, and a professional can help you aim for the right duration and level of intensity.

Seek Variety

Practice a variety of exercises to help ensure that you'll always have a type of physical activity to enjoy. If you usually walk, but you're having a flare in your knees or ankles, perhaps swimming for a while will allow you to stay active without pain.

Medically reviewed by Cynthis Haines, MD