The ancient Greeks believed the human body is filled with various substances
they called “humors.” Sometimes they said the humors got out of
balance and caused illnesses, such as the aches and pains of swollen joints.
The humors, they believed, could get back in balance, and the pain would
subside. However, the problems also could return. One disease the Greeks
observed is what was later called rheumatoid (ROO-ma-toid) arthritis.
“Rheuma” derives from a Greek word that means “flux” or “discharge.”
The Greeks believed the humors were fluxing, or flowing, through the
body to cause the bouts of pain.
When the body turns on itself In a way, rheumatoid arthritis is
a disease in which substances in the body are out of balance. The body
fights infections with chemicals known as antibodies. However in rheumatoid
arthritis, the antibodies turn against healthy areas of the body and
cause the thin covering around joints to become inflamed.
The pain usually starts in the hands or feet, but rheumatoid arthritis
can affect many different joints as well as other parts of the body, such
as the heart and lungs. The disease’s cause is unknown. Some researchers
believe that the immune system’s attack on healthy tissues may be
caused by the body’s overreaction to viral infection. Rheumatoid arthritis
is sometimes associated with Raynaud’s disease*
More than 2 million Americans have rheumatoid arthritis, and most
of them are women. Although it is primarily a disease that begins at middle
age, its onset may be much earlier.
Known as the most disabling of the various diseases that cause arthritis,
rheumatoid arthritis can lead to deformed joints, extreme pain, and
loss of the ability to do common tasks such as walking.
Stiffness in the morning The symptoms of the disease can develop
in a few days, or over months or years. For most people, a joint in the
hands, feet, arms, or legs feels stiff, as it does in osteoarthritis and other
forms of arthritis. Rheumatoid arthritis, however, has a few distinctive
features. People tend to feel worse in the morning after awakening. They
also can get a fever, and their joints can seem warm to the touch.
At first, the antibodies attack only the thin covering around joints.
This covering contains cells that produce fluid to keep joints lubricated
and working properly. As the covering is injured, it becomes thicker. Soon,
damaging cells appear and eat away cartilage, bone, and other tissue.
Swelling and pain result, and the joints become deformed. People with
rheumatoid arthritis also can develop small bumps around joints, especially
in their hands and elbows. Often, the disease flares up and then subsides
on its own. Some people, however, receive no relief without treatment.
Diagnosis Doctors diagnose rheumatoid arthritis with special blood
tests. They also look for other causes of the joint problems and use x-rays
to look at the spaces between bones to see if they are narrowing.
Treatment Over-the-counter medications such as aspirin can ease the
pain. Stronger prescription pain relievers and anti-inflammatory drugs are
also available. Weight loss is urged for people who are too heavy. Some people
need surgery to replace badly damaged joints in the arms, legs, or hips.
Many people, however, learn to live with the disease through a combination
of rest and exercise. When the symptoms are at their worst, patients
with rheumatoid arthritis try to avoid putting stress on their joints to help
reduce damage. When the symptoms are less severe, however, doctors
want the patients to exercise as a way of maintaining flexibility in the
joints and strength in the muscles around them.
Patients with rheumatoid arthritis often learn relaxation techniques
because the disease is known to flare up in times of emotional stress.
