RA is an inflammatory autoimmune disease, which means that the body’s immune system — whose job it is to protect your body from harm by viruses, bacteria, or injuries — mistakenly attacks the body’s own healthy tissues. In the case of RA, this faulty immune response causes inflammation that leads to RA symptoms such as joint pain, swelling, stiffness, and fatigue.
RA is a complex illness that can be unpredictable and confusing. Many misconceptions about the chronic condition exist — we’re clearing up three of the main ones below.
#1: RA Only Affects the Joints
Most people associate arthritis with the joints, and while joint symptoms are a hallmark feature of the disease, RA’s bodily impact is widespread and far-reaching.
Rheumatoid arthritis causes systemic inflammation, which means the inflammation occurs throughout the body. RA symptoms outside of the bones and joints are described as “extra-articular” symptoms. Around 40 percent of people with RA experience extra-articular involvement at some point during their illness.
The inflammatory effect of RA can affect vital organs such as the heart, lungs, and brain as well as the eyes, nails, and skin. For example, a person with RA may develop rheumatoid arthritis rash, atopic dermatitis (eczema), and skin ulcers. Eye involvement may include dry eyes, uveitis, and scleritis.
RA can also increase the risk of other conditions. Cardiovascular disease is more than twice as common in people with RA due to inflammation and thickening of the heart muscles.
Brain fog and fatigue are other common RA complications.
#2: RA Pain Is From the Bones Grinding Together
A common misunderstanding about RA is that the telltale joint pain is the result of the bones rubbing together. However, the pain actually comes from inflammation of the joints, tendons, ligaments, cartilage, and the lining of the joints (called the synovium). Without proper treatment or management, RA-related inflammation can do a lot of damage to the synovium. The inflamed and damaged synovium can, in turn, damage the cartilage, ligaments, and other tissues that support and provide the functionality to your joints — compounding the pain.
For instance, the chemicals released by inflammation can dissolve bones and lead to small holes in the bones around your joints. Cartilage damage can lead to bone-on-bone contact and friction which compounds the inflammatory pain. Ligament damage and tears can result in frequent joint dislocation and eventual painful joint deformity.
#3: Rheumatoid Arthritis and Osteoarthritis Are the Same Things
RA and osteoarthritis (OA) are both types of arthritis and both include joint pain in their list of symptoms, but they’re quite different conditions with different behaviors and treatments. While RA is an autoimmune disease causing painful inflammation in the joints and throughout the body, osteoarthritis is what many people think of when they hear “arthritis” — it is the result of wear and tear of the cartilage between joints over time or due to overuse or injury, and it may be more common in older adults. OA is caused by the wearing down of the cartilage that provides a cushion in the joint itself and is not considered a systemic disease like rheumatoid arthritis is. The onset of RA is completely unrelated to age or wear and tear of the joints. RA is caused by a faulty autoimmune response.
Because of their differences, it is possible to have osteoarthritis and rheumatoid arthritis at the same time.
- These 15 Myths About Rheumatoid Arthritis Can Be Downright Dangerous to Believe
- Extra-articular Manifestations in Rheumatoid Arthritis
- 15 Things Doctors Don’t Always Tell You About Rheumatoid Arthritis (But You Really Should Know)
- Rheumatoid Arthritis Rashes: Causes and Treatment
- Raising the Voice of Patients: A patient’s guide to living with rheumatoid arthritis