With Rheumatoid Arthritis (RA), your immune system doesn’t work the right way and attacks the tissue that lines the inside of your joints (called the synovium). This causes joint swelling, pain, and perhaps most importantly – impacts our ability to use our joints, leading to loss of range of motion and our ability to use them for normal essential activities. The disease most often affects the hands, wrists, knees, and ankles. There are over 1.3 million Americans living with RA. Also, 130 thousand people in the US are diagnosed with this disorder each year, and as is the case with many autoimmune diseases, most of them are women (1).
Beyond the joint
Rheumatoid Arthritis may cause problems in other parts of the body as well, such as the:
- eyes
- heart
- lungs
- skin
- digestive system, and
- blood vessels
Hidden symptoms and hidden conditions affect people living with RA every day. It’s time to speak about them. We want to support people, like you, living with a health issue that brings pain and discomfort to your body.
Lung Problems are one of the most common hidden conditions of Rheumatoid Arthritis. These can include:
- pulmonary nodules (small growths in the lungs),
- pleural effusion (a build-up of fluid between the lung and chest wall), and
- interstitial lung disease (ILD) (scaring of lung tissue)
The American Arthritis Foundation estimates that 1 in 10 people with Rheumatoid Arthritis will develop scarring of lung tissue (2). If enough scarring happens, people can find it difficult to move or exercise without having difficulty breathing.
Chronic Fatigue, or feeling more tired than usual, can be a frustrating symptom to deal with because you may appear well despite your fatigue. Your family and friends may think you are ‘just tired.’ – rather than understanding that fatigue is a (biological) result/by-product of the RA disease process. Also, chronic or long-term fatigue can add to pain and stiffness when your movement is reduced. This is often worse just after you wake up.
Food Sensitivity or intolerance can be a chronic issue but may also arise to foods that had previously been well tolerated. We don't fully understand how our diets may impact RA, much recent work is being done to uncover how our gut microbiome (all of the bacteria and other microorganisms that colonize our intestinal tract) are affected by what we eat and how this impacts RA and other autoimmune diseases. However, people with this disease are more likely to develop digestive problems due to the medicines they take and how activated their immune system is. These problems can be:
- ulcers (sores on your stomach),
- bleeding,
- constipation,
- diarrhea, and
- osophagitis (inflammation (swelling) and irritation of the tube that brings food from your throat to your stomach).
Mental Health can also be affected by Rheunatoid Arthritis. You may experience mental and emotional exhaustion. The stress of living with a long-term illness, keeping track of the medicines you must take, and the costs and time spent making visits to the doctor can impact your mental health. Some people may feel anxious or depressed. You are not alone in this.
Cognitive Issues casuing many people with RA to have difficulty learning new things, remembering, concentrating, making decisions and problem solving. This is often referred to as brain fog and can impact a lot of people with RA (4). This is caused by inflammation changing the patterns of brain connections in the area of the brain known as the inferior parietal lobe. Brain fog can be a very frustrating symptom for those living with RA.
Invisible symptoms affect people living with RA every day. So, when it seems as though you are suffering in silence, remember – you are not alone, and people who can't see your hidden symptoms need to know that your disease is real!
Importance of Assessments – let your voice be heard!
It is important to measure all pain in people living with RA. This can be done with tools like The Health Assessment Questionnaire-Disability Index (HAQ-DI), which is commonly used in clinical trials. It helps healthcare practitioners and researchers to record a participant’s experience of RA related disease, disability and level of functioning. We rely on your self- assessment to gain a full picture of your symptoms and RA.
Managing Your disease
As is the case for most diseases, there is no cure for RA right now. Rather, the symptoms are treated with medicines to help with pain and discomfort, and to prevent the eventual joint destruction. Leading to impaired use of hands, feet and joints we need to maintain active, healthy lives. There are many different options that patients with RA can look to, to impact the effects of their disease, such as:
- medicines,
- physical and occupational therapy,
- diet,
- exercise, and
- heat and cold packs.
Advancing Science Together
We at Lilly are working hard to support people living with Rheumatoid Arthritis. However, the development of new and better medicines is only possible through the help and involvement of our community. To discover new treatments, we need the help of clinical trial volunteers and care partners.
If you are interested in learning more about clinical trials, visit our Rheumatoid Arthritis Research Site
Resources
- RA Facts: What are the Latest Statistics on Rheumatoid Arthritis? - RheumatoidArthritis.org
- Rheumatoid Arthritis and Lung Disease | Arthritis Foundation
- Gastrointestinal Problems When You Have RA (arthritis.org)
- Cognitive dysfunction in patients of rheumatoid arthritis - PMC (nih.gov)
- A multi-modal MRI study of the central response to inflammation in rheumatoid arthritis | Nature Communications