Rheumatoid arthritis is a systemic autoimmune disease, where the bodies own immune system attacks itself.. It is not caused by overuse, repetitive activities. It impacts not only joints, but other areas of the body including the heart, eyes, and blood vessels. This condition affects the linings of the joints, not just degeneration of cartilage like in osteoarthritis.

• When immune system attacks the synovium, or joint lining, inflammation occurs and can break down the cartilage, which is the cushion in the joint, between the two bones
• Tendons and ligaments that stabilize the joints stretch and weaken, causing joint deformities

• There are often periods of flaring and periods of remission where symptoms improve or completely disappear
• Warm and swollen joints
• Stiffness in joints, especially in the morning or after decreased or no activity
• Decreased function
• Visual deformity of joints, including “zig-zag deformity” of hands where the wrist shifts towards the thumb (radially), metacarpal phalangeal (MP) joints shift towards the pinky (ulnarly) 
• Early symptoms include stiffness, especially in the morning, fatigue, fever, pain, joint swelling, difficulty sleeping, itchy and inflamed eyes, decreased appetite, and weight loss

• Medications help treat symptoms and slow the progression of Rheumatoid Arthritis including NSAIDs, biologics, steroids, and disease modifying agents 
• Surgery such as synovectomy (removing inflamed synovial fluid), joint fusions, joint replacements, and tendon repairs if needed

• Range of motion exercises
• Modalities such as heat or paraffin to decrease pain and inflammation
• Splinting to prevent deformity and put joints in rested position
• Education on activity modification to reduce pain and due to range of motion and strength deficits
• Education on joint protection principles
• Education on assistive technology such as built up handles for utensils, buttonhooks