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- Rheumatoid arthritis is a form of arthritis
that causes pain, swelling and stiffening in your joints.
It's mostly seen in small joints
like the fingers, the wrists, the ankles,
but we can also see it in larger joints
like the elbows and knees, shoulders and hips.
RA can affect body parts besides joints
such as your eyes, your lungs,
blood vessels, your heart, your skin.
More women than men get rheumatoid arthritis,
and it often starts in middle age.
Rheumatoid arthritis is different than osteoarthritis,
which is very common.
Osteoarthritis is the result of the wear and tear
of your joint that often comes when you get older.
RA can cause disability if it's not treated properly
because joints can become deformed
and you may lose some of your strength
like being able to hold a fork and a spoon,
being able to lift a gallon of milk.
Fortunately now, medications are available
to prevent this from happening.
Most people with RA live a full and happy life
and they just need to work with their rheumatologist
to find the best treatment.
Rheumatoid arthritis happens when your immune system attacks
the lining of your joints called the synovium.
The synovium can become swollen or inflamed.
And inflammation can eventually destroy the cartilage
and the bone in the joint.
And once destroyed, it cannot be repaired.
The tendons and ligaments that hold the joint together,
they weaken in strength,
and gradually over time,
the joint loses its shape and the ability to function.
Let's talk a little more about what this inflammation is.
Inflammation is a part of your immune system.
Your immune system is there to protect you against infection
or some type of an invader or germ.
And it does this through producing inflammation
against the invader.
For example, you get a cut or a scrape,
and then the inflammation process starts.
The area might be a little red, a little swollen,
and this is a sign of inflammation doing its job.
Inflammation also occurs if you get sick with an infection.
You may get a fever.
You may get swollen glands.
This is our body putting together this inflammation
as a way to fight the infection from happening.
Sometimes your immune system will recognize an invader
and not need to start the process of inflammation.
And this happens with vaccines.
So you may have gotten a vaccine against maybe measles
and your B cells make what's called antibodies.
And then if you get exposed to the measles,
you've got these antibodies built against measles.
So that means your immune system remembers
and you don't come down sick with the measles
and that's called immunity.
So inflammation is a good thing
because we need it to be able to survive.
But in RA, something has gone wrong with the immune system.
Some type of either genetic and environmental factor
seems to cause rheumatoid arthritis
and your body starts to fight an invader
that isn't really there.
It's just yourself.
So it produces inflammation.
It settles in your joints
and this causes the pain, swelling
and stiffness that you feel.
There are many substances in the inflammation itself.
Some are called cytokines and their effects
are mediated through something called Janus kinases.
So cytokines and Janus kinases
send messages back through the inflammatory cycle
that more inflammation is needed to fight the invader.
And so, this becomes a vicious circle.
Other cells that are in the inflamed joint
actually work to damage the joint.
And these are called macrophages, fibroblasts, osteoclasts,
and they actually eat away the cartilage and bone.
So the goal for treatment for RA
is to stop this process of inflammation.
And we'll talk about treatments
and how they work in the next video.
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