Rheumatoid arthritis is a long-term (chronic) inflammatory disease that causes pain, swelling, and stiffness of the joints. It can affect the entire body, including the eyes and lungs. The effects of rheumatoid arthritis vary widely among those with the condition.

CAUSES
The cause of rheumatoid arthritis is not known. It tends to run in families and is more common in women. Certain cells of the body's natural defense system (immune system) do not work properly and begin to attack healthy joints. It primarily involves the connective tissue that lines the joints (synovial membrane). This can cause damage to the joint.

SYMPTOMS
•    Pain, stiffness, swelling, and decreased motion of many joints, especially in the hands and feet.
•    Stiffness that is worse in the morning. It may last 1–2 hours or longer.
•    Numbness and tingling in the hands.
•    Fatigue.
•    Loss of appetite.
•    Weight loss.
•    Low-grade fever.
•    Dry eyes and mouth.
•    Firm lumps (rheumatoid nodules) that grow beneath the skin in areas such as the elbows and hands.

DIAGNOSIS
Diagnosis is based on the symptoms described, an exam, and blood tests. Sometimes, X-rays are helpful.

TREATMENT
The goals of treatment are to relieve pain, reduce inflammation, and to slow down or stop joint damage and disability. Methods vary and may include:
•    Maintaining a balance of rest, exercise, and proper nutrition.
•    Medicines:
•    Pain relievers (analgesics).
•    Corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation.
•    Disease-modifying antirheumatic drugs (DMARDs) to try to slow the course of the disease.
•    Biologic response modifiers to reduce inflammation and damage.
•    Physical therapy and occupational therapy.
•    Surgery for patients with severe joint damage. Joint replacement or fusing of joints may be needed.
•    Routine monitoring and ongoing care, such as office visits, blood and urine tests, and X-rays.

HOME CARE INSTRUCTIONS
•    Remain physically active and reduce activity when the disease gets worse.
•    Eat a well-balanced diet.
•    Put heat on affected joints when you wake up and before activities. Keep the heat on the affected joint for as long as directed by your caregiver.
•    Put ice on affected joints following activities or exercising.
•    Put ice in a plastic bag.
•    Place a towel between your skin and the bag.
•    Leave the ice on for 15-20 minutes, 03-04 times a day.
•    Take all medicines and supplements as directed by your caregiver.
•    Use splints as directed by your caregiver. Splints help maintain joint position and function.
•    Do notsleep with pillows under your knees. This may lead to spasms.
•    Participate in a self-management program to keep current with the latest treatment and coping skills.

SEEK IMMEDIATE MEDICAL CARE IF:
•    You have fainting episodes.
•    You have periods of extreme weakness.
•    You rapidly develop a hot, painful joint that is more severe than usual joint aches.
•    You have chills.
•    You have a fever.

MAKE SURE YOU:
•    Understand these instructions.
•    Will watch your condition.
•    Will get help right away if you are not doing well or get worse.

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