If you’ve noticed that it’s becoming just a little bit harder to get your body going in the morning, you might need more than an extra cup of coffee. Stiff and swollen joints that linger long after you’ve woken up might be a sign of rheumatoid arthritis; approximately 1.3 million people in the United States are living with this disease.

Rheumatoid arthritis (RA) is a type of chronic arthritis stemming from an autoimmune disease characterized by inflammation of the joint linings.

Rheumatoid arthritis usually affects joints symmetrically, and most often attacks the small joints in the hands and feet. However, it is also common for patients to experience pain in their hips, knees, and elbows. RA may affect organs outside of the joints including the skin, eyes, and lungs. The hallmarks of rheumatoid arthritis are pain, stiffness, and limited mobility. While there is no known cure, great advances have been made in terms of treatment so that for newly diagnosed patients, the outlook is quite positive for this manageable disease.

The immune system is your body’s defense system against disease and injury. It is made up of a network of cells and tissues that communicate and protect you. Any time you cut yourself shaving, or a virus enters your body, the immune system works to seek out and eliminate the problem. In some cases, the immune system makes a mistake and attacks healthy cells, confusing them with invaders. When this occurs it is known as an autoimmune disease.

There are over 80 different types of autoimmune diseases. Many can be classified as organ-specific or non-organ specific. Rheumatoid arthritis is a non-organ-specific disorder that can affect the whole body, not just a single organ.

Rheumatoid arthritis attacks the joints in the body, making movement painful. The reason why joints are so important is because they are the crossroads where two or more bones meet.

There are three types of joints, divided by their range of motion. Fixed joints are areas where the joints do not move, such as the plates in your skull. Joints that have little range of motion are known as cartilaginous joints. An example of this is the spine, which is linked by cartilage and can only move according to how the vertebrae work together. And finally, there are synovial joints, which have dynamic range of motion. This would include the shoulders, wrists, and knees.

There are several types of synovial joints that assist in the varied movement of our body parts. Here are some examples:

• Ball-and-socket joints. The round end of a bone sits inside the “socket” of another. This type of joint allows the most freedom in movement and can be found in the shoulder and hip.

• Hinge joints. Think of hinge joints as the motion of a door opening and closing. These joints only allow movement in one direction, like the bending of a knee, finger, or elbow.

• Pivot joints. Pivot joints allow you to rotate and twist, but are restricted as to how far you can go. Pivot joints are found in the neck.

• Ellipsoidal joints. The wrist is a great example of an ellipsoidal joint. It offers a great range of motion, but cannot make pivotal movements.

Within a joint, there are a number of components that prevent bone on bone contact. Cartilage protects the bone at the joint and reduces friction during movement. In addition, a thin lining known as the synovial membrane cushions the joint, provides nutrients, and produces a lubrication to also reduce friction.

Some joints also need a little help with their movement. Ligaments keep the joint in place and prevent it from moving in certain directions. Tendons attached to a joint are also connected to muscles responsible for moving the joints.

Rheumatoid arthritis is an autoimmune disease that attacks the joints. White blood cells thicken and inflame the synovial membrane, causing a warm feeling, redness, and pain at the joint. The swelling is symmetrical, which means it happens on both sides of the body. So if you experience RA in your left knee, you will also have it in your right. This makes it harder for your joints to do their job and limits your mobility.

How Does Rheumatoid Arthritis Advance?
Once the synovium is inflamed, further stages of RA become more painful and limiting. Enzymes are released that eat away at cartilage and bone surrounding the joint, eventually leading to painful bone-on-bone contact. Bone and cartilage loss weakens the muscles and ligaments that stabilize the joint. This can happen within the first year of rheumatoid arthritis and makes the joints move, deform, and lose a lot of their movement. Daily tasks such as gripping a pen or brushing your teeth become taxing.

There are times when rheumatoid arthritis affects more than the joints. It can also lead to problems with the eyes, lungs, and heart.

Eyes
There are a number of rheumatoid arthritis symptoms related to the eyes. The most common is known as Sjogren’s syndrome. Like RA, it is an autoimmune disease and sometimes accompanies rheumatoid arthritis. It causes dry eyes and dry mouth. Eye problems linked the inflammation are also possible. They include uveitis, which inflames the inside of the eye, scleritis, which inflames the whites of the eyes, and episcleritis, which inflames the membrane surrounding the whites of the eyes. These can be managed with corticosteroid eye drops and anti-inflammatory medication. Swelling around the eye can also lead to glaucoma, a condition that impairs your vision and can lead to blindness.

Lungs
Interstitial lung diseases, or ILD, are the most frequent lung disorders caused by rheumatoid arthritis. ILD is a basic term covering over 200 types of chronic disorders with one thing in common; they all originate from inflammation. Rheumatoid arthritis and ILD affect the lungs by damaging the tissues, inflaming the air sacs, and causing fibrosis, or permanent scarring.

In addition, there’s a connection between RA and pleurisy. Pleurisy is when the membrane around the lungs becomes inflamed. This limits the space between the lungs and the chest cavity, causing friction between the layers of membrane every time you breathe. The result is a sharp pain during each breath.

Heart
Rheumatoid arthritis greatly increases your risk of heart disease. It can cause atherosclerosis, which is the thickening of arteries. Inflammation can swell the arteries, forming plaque on the artery wall. This disrupts blood flow and leads to heart disease. Any number of complications can then arise, including heart attack, stroke, kidney problems, or even the loss of limbs.

In 30 to 50 percent of people with rheumatoid arthritis, pericarditis develops. This is when the membrane surrounding the heart swells and squeezes the heart. This leads to piercing chest pains, especially when taking a deep breath.