Swelling in rheumatoid arthritis and where it occurs
Fortunately, both at-home and medical treatments are available to help reduce swelling associated with rheumatoid arthritis (RA).
In this article, we take a look at how RA can lead to swelling, the areas it affects, and how best to treat this symptom.
How does RA cause swelling?
Inflammation is a common side effect of rheumatoid arthritis.
RA causes the body's immune system to attack the synovium, which lines the joints. The synovium produces a fluid that helps the joints move more smoothly.
When the immune system attacks the synovium, it often results in inflammation and swelling. Sometimes inflammation of the synovium membrane leads to swelling, other times too much synovial fluid in the joints causes the problem.
Sometimes, swelling can be severe. For example, a person's hand can become so swollen that it looks like a boxing glove. Excessive swelling can cause a reduced range of motion.
Over time, the continued swelling and inflammation can also weaken ligaments in the joints. This weakening can lead to deformities of the feet and hands, such as claw toe or hammer toe. However, these are late symptoms of RA.
What areas does swelling affect?
Swelling caused by RA commonly affects joints in the following areas:
The swelling in RA usually occurs in joints on both sides of the body. This is different from osteoarthritis, which generally affects a single joint.
In 20 percent of cases, foot and ankle symptoms are the first to appear.
Treatments for RA swelling
If the swelling is severe, a doctor may recommend removing excess fluid from the affected joint. This procedure is called joint aspiration and is generally carried out under local anesthetic.
A doctor may also inject a substance called hydrocortisone into the joint. This is an anti-inflammatory medication that can reduce some of the symptoms that lead to swelling.
As well as these more immediate fixes, a doctor may prescribe medications to help a person control their RA.
Some people will take a combination of medications designed to prevent RA flare-ups and slow the disease's progression.
Examples of these medications include:
Disease-modifying antirheumatic drugs (DMARDs)
A doctor may suggest a person takes anti-inflammatory drugs for rheumatoid arthritis symptoms.
These medications help reduce how often symptoms occur as well as slow the disease's progression.
Medications may include:
- methotrexate (Rheumatrex)
- hydroxychloroquine (Plaquenil)
- sulfasalazine (Azulfidine)
Many people will take DMARDs in combination with corticosteroids or non-steroidal anti-inflammatory drugs (NSAIDs), which help to reduce inflammation.
RA symptoms that do not respond to DMARDs may benefit from biologic response modifiers. These medications block immune system signals that can cause inflammation and swelling.
Examples of these medicines include:
Doctors may prescribe biologics alone or in combination with DMARDs.
It is important to note that medications can have side effects that cause complications on their own. For example, DMARDs and biologics are immunosuppressants that can leave people susceptible to infections.
Once damage to a person's joints has occurred, it is irreversible. As a result, management of the disease is essential to a person's quality of life and keeping their joints mobile.
Icing the affected area for up to 20 minutes can help reduce swelling.
A person can use several home remedies to help reduce RA-related swelling. Examples of these include:
- Resting affected joints. Anyone experiencing pain with a particular exercise should avoid doing that exercise until a flare-up improves. Try low-impact exercises that do not place excess strain on the joints, such as cycling or swimming.
- Icing affected areas. Applying a cloth-covered ice pack to an affected area may help minimize swelling. Apply the ice pack for no longer than 20 minutes and repeat between three and four times throughout the day.
- Putting the feet or hands in a cool bath. Placing hands or feet in a tub or pan of cool water can help ease muscle tension and improve movement.
- Taking NSAIDs. These drugs include naproxen and ibuprofen. Anyone who is currently taking other RA medications should check with their doctor that NSAIDs will not interact with them.
Giving the body time to heal and recover after a flare-up is essential for dealing with the swelling and discomfort that can accompany RA.
While some RA flare-ups that cause swelling are unpredictable, others may follow a pattern. Some known triggers of RA include:
- poor sleep habits
Some people may find it helpful to keep a journal of the foods they eat and the activities they do on a daily basis. Anyone who experiences a flare-up can check their journal to look for patterns.
Identifying these patterns may help a person avoid further episodes of RA swelling.
In addition to tracking flares, people with RA should also follow any treatment plans that their doctor recommends. Doing so can help a person manage their RA on a daily basis.
Ideally, a person and their doctor will find the right combination of medications and lifestyle changes that can help reduce swelling flare-ups caused by RA.
If a person has three or more swelling flare-ups in a month, they should see their doctor. They may need to try another type of medication or look at further treatment options.