Autoimmune arthritis: Types, symptoms, and treatment
When the immune system attacks itself, the result is inflammation in a joint that can cause pain, stiffness, and mobility problems.
This article will take a close look at autoimmune arthritis, identify common symptoms, and outline some of the most common treatments currently available to combat arthritis-related joint inflammation.
Types of autoimmune arthritis
Rheumatoid arthritis most often causes swelling and pain in the wrists, hands, and feet.
While this list is by no means comprehensive, it represents some of the most common forms of autoimmune arthritis:
- Rheumatoid arthritis: This is the most common type of autoimmune arthritis, which usually causes swelling and pain in the hands, feet, and wrists. An estimated 1.3 million Americans have RA, 75 percent of which are women.
- Psoriatic arthritis: Psoriatic arthritis can occur in people with a skin condition called psoriasis. Psoriasis causes scaly, patchy areas to build up on the skin. The affected joint areas can be almost anywhere on the body, including the spine, knees, fingers, toes, or more.
- Reactive arthritis: Reactive arthritis occurs in people who have a history of certain bacterial infections, such as Chlamydia , Salmonella, Shigella, or Campylobacter. Along with joint pain, this can cause eye redness, burning with urination, or a rash on the soles of the feet or palms of the hands.
- Ankylosing spondyloarthritis: Ankylosing spondyloarthritis causes arthritis of the spine, resulting in pain and stiffness in the spinal joints.
- Axial spondyloarthritis: This type affects the pelvic joints and the spine.
- Juvenile arthritis: Juvenile arthritis affects an estimated 300,000 children in the United States. It can cause joint pain, eye inflammation, fevers, and rashes. Other names include juvenile idiopathic arthritis, juvenile chronic arthritis, or juvenile RA.
- Palindromic rheumatism: Palindromic rheumatism is a rare type of arthritis that causes episodes or attacks of joint inflammation that then resolve. Palindromic arthritis often affects the fingers, wrists, and knees. Symptoms include pain, swelling, stiffness, and fever.
Each of these conditions can cause a great deal of discomfort and swelling in the joints.
Symptoms of autoimmune arthritis
While the symptoms of autoimmune arthritis vary depending on the specific underlying arthritis type, some general symptoms associated with autoimmune arthritis include:
- joint pain
The specific symptoms vary between types of autoimmune arthritis.
For example, psoriatic arthritis can cause a condition called enthesitis, which causes tender spots on areas where ligaments and tendons connect to bones. These often occur in the back of the heel and around the elbow.
Smoking and exposure to smoke can increase a person's risk of developing autoimmune arthritis.
Risk factors for autoimmune arthritis depend upon the type of arthritis that a person has. However, genetics and a family history of a specific condition can affect a person's likelihood of developing autoimmune arthritis.
However, environmental factors may also be responsible. Because autoimmune arthritis causes the immune system to attack itself, doctors have tried to identify what environmental factors might contribute to this:
Possible environmental factors that could contribute to autoimmune arthritis include:
- early life exposures to toxins, such as those in cigarette smoke
A person's sex may affect their risk level depending on arthritis type. For example, women are two to three times more likely to get RA than men. However, men get ankylosing spondyloarthritis more often than women.
Specialist doctors called rheumatologists treat autoimmune arthritis.
Rheumatologists study the immune system and are aware of all the available treatments. If a doctor suspects that a person has a type of autoimmune arthritis, they will usually refer them to a rheumatologist.
A doctor will first ask a person about their symptoms, including what makes their symptoms worse and what, if anything, makes them better. They may ask about other medical conditions a person has, as well as what medicines they are taking.
A doctor will likely recommend a range of tests to learn more about a person's health and find out which joints are affected.
Examples of diagnostic tests for autoimmune arthritis may include:
- Imaging scans, such as X-rays, CT scans, or MRI scans to identify areas of joint damage.
- Blood testing, including red blood cell count, rheumatoid factor, antibodies to certain peptide types, and erythrocyte sedimentation rates.
- Tissue samples, which doctors can use to confirm conditions, such as psoriasis.
However, no single test can definitively diagnose an autoimmune arthritis type. Often, diagnosis involves a person undergoing a range of tests to rule out other conditions and other types of arthritis.
Doctors will consider a person's symptoms, the type of arthritis they have, and their overall health when recommending a treatment plan for autoimmune arthritis.
Some people with mild forms of autoimmune arthritis can benefit from taking nonsteroidal anti-inflammatory medications. These include ibuprofen (Advil) and naproxen (Aleve).
For other types of arthritis, a doctor may prescribe medications called disease-modifying antirheumatic drugs (DMARDs).
Examples of DMARDs include:
- cyclosporine (Neoral)
- sulfasalazine (Azulfidine)
- methotrexate (Rheumatrex)
If DMARDs are not effective in treating autoimmune arthritis, a doctor may prescribe biologic response modifiers or "biologic agents." These medications block immune system communications that can lead to the symptoms of autoimmune arthritis.
Examples of biologic agents include:
- abatacept (Orencia)
- tocilizumab (Actemra)
- rituximab (Rituxan)
Sometimes a person may take these medications in combination with DMARDs, especially methotrexate.
Medications can have side effects that cause complications on their own. DMARDs and biologics, for instance, are immunosuppressants that can leave people susceptible to infections.
Regular exercise can help to manage autoimmune forms of arthritis.
In addition to medical treatments for autoimmune arthritis, a doctor will likely recommend lifestyle changes and choices that can benefit a person with an autoimmune disorder.
Examples of lifestyle changes to manage autoimmune forms of arthritis include:
- Regular exercise, especially types that improve the range of motion in joints. Walking, water aerobics, and other low-impact aerobic exercises are especially beneficial.
- Stopping smoking. Smoking can worsen the symptoms of many types of autoimmune arthritis.
- Eating a healthful diet to maintain a healthy weight puts less pressure on painful joints.
A person who has autoimmune arthritis should also talk to their doctor about other steps they can take to improve their overall health.
The long-term effects of autoimmune arthritis can depend on the type a person has.
A person with any type of autoimmune arthritis who experiences frequent bouts of pain and swelling may also have difficulty keeping to a regular schedule of work and socializing.
Sometimes, people with RA may experience such severe joint complications that they require surgery. There is a variety of surgical options available, including spinal fusion for ankylosing spondylitis or a hip replacement for other arthritis types.
Identifying and treating autoimmune arthritis as quickly as possible helps to minimize any complications.
Autoimmune arthritis can have significant effects on a person's life. However, many treatments are available that can help a person with autoimmune arthritis live a healthier, happier life.
People should talk to their doctor about the best approaches for treating autoimmune arthritis, as well as healthful lifestyle changes they can make.