Rheumatoid arthritis (RA) is a systematic autoimmune disease. The immune system of the body normally protects against foreign objects such as bacteria and viruses. However, in rheumatoid arthritis, the immune system gets confused and attacks the body’s own joints instead (What is Rheumatoid Arthritis, 2015). In the joint, or synovial area, RA forms inflammation which thickens, resulting in pain at the joint. If the disease is allowed to continue it will cause damage to the cartilage as well as the bone itself (What is Rheumatoid Arthritis, 2015). Joints can become unstable and painful, as well as deformed. This disease, unlike Osteoarthritis, can affect the entire body. The patient with Rheumatoid arthritis may complain of fatigue, muscle aches, or have a low-grade fever. In advanced stages, the patient may also have lumps under the skin called rheumatoid nodules which can be tender to the touch (Grossman & Porth, 2014). Rheumatoid arthritis cannot be reversed. However, it can be controlled with medication and some forms of activity (Grossman & Porth, 2014).
It is estimated that over 1.5 million people in the United States have rheumatoid arthritis (What is Rheumatoid Arthritis, 2015). The majority of those are women. Rheumatoid arthritis is usually seen between ages of 30 and 60 (What is Rheumatoid Arthritis, 2015). However in men, it is seen to start later in life. There also seems to be a genetic component, although there is no known cause of RA (Grossmam & Porth, 2014).
Rheumatoid arthritis has a gradual onset. In the early stages, the patient may notice redness or swelling at the joint or experience tenderness and pain (Grossman & Porth, 2014). However, this continues to worsen over time and includes morning stiffness, fatigue, loss of appetite, and even a low-grade fever (What is Rheumatoid Arthritis, 2015). Rheumatoid arthritis tends to affect more than one joint including small and large joints of the knee or wrist and typically affects joints on the same side of the body. Symptoms can come and go. The patient may experience a flare that can last for days or months as well. The longer the inflammation continues, additional problems will be seen throughout the body. Some of these may include sensitivity to light, impaired vision, eye pain, dry mouth, gum irritation, lumps under the skin or bony areas, shortness of breath due to inflammation in the lungs, damage nerve cells, skin and other organs can be impacted due to inflammation in the blood vessels, and anemia (What is Rheumatoid Arthritis, 2015). Studies also suggest a higher incidence of cardiovascular problems in individuals with Rheumatoid arthritis (Palmer & Miedany, 2013).
The goal of interventions is to prevent or reduce pain, stiffness, swelling, and maximize activity. Interventions include rest, therapeutic exercises, and medication. Because this is a chronic disease there is a need for continuous adherence to treatment that must be integrated into the person's daily activities (Grossman & Porth, 2014). Hot and cold treatments may help to relieve some of the pain. The use of supportive shoes and other assistive devices may be used along with education positioning and body mechanics (Grossman & Porth, 2014).