Rheumatoid arthritis (RA) is most often described as a type of arthritis that causes progressive degeneration of the synovial joints. Unfortunately, RA is more complex than joint pain and damage, with some people suffering from other joint problems and systemic complications.
The same processes that can cause joint erosions also cause damage to the soft tissues surrounding the joint. Some people may find their soft tissues flare up much like their joints, which can manifest itself as bursitis, tendinitis, and tenosynovitis. Since swelling in and around the joints is a major concern with RA, this frequent swelling can weaken the soft tissues that support the joints. When tendons and ligaments become weakened, joint laxity occurs. Excess motion of the joint caused by laxity may explain significant joint pain that is more than would be expected based on an x-ray. Depending on the degree of laxity, joints may partially (subluxation) or fully dislocate during simple activities. Sometimes, physical therapy can strengthen the surrounding muscles and minimize the instance of dislocation.
Many aspects of the vascular system can be adversely affected by RA. Sometimes the blood vessels become inflamed (rheumatoid vasculitis) and may decrease blood flow to different areas of the body. Even major blood vessels, such as arteries, may be affected by the immune system. Another vascular concern in RA is the increased incidence of coronary artery disease. The incidence of heart attack and having a heart attack at a younger age is higher among people with RA than the normal population. People with RA may have more controllable risk factors for vascular disease, such as being sedentary, due to pain and limitations associated with RA. Uncontrollable risk factors include the chronic, systemic inflammation associated with RA.
Although organ involvement occurs to a lesser degree than with other autoimmune diseases, this does not mean people with RA are immune to these effects. Lung involvement is possibly more common than the involvement of other organs. One way RA can affect the lungs is the development of rheumatoid nodules. Typically, nodules only form around the joints, but these benign growths can occur elsewhere. Fortunately, most instances of nodules in the lungs do not cause serious problems, but they may be indicative of a more serious disease course. Another lung problem, interstitial lung disease, causes scarring in the lungs and is more common among people with autoimmune diseases, including RA.
Although RA primarily affects the joints, systemic problems can occur. Finding a treatment regimen that reduces inflammation and disease progression will give you the best chance at minimizing the systemic effects of RA. Contact a rheumatologist to learn more.