Rheumatoid Arthritis: Why Joints Flare up

Most people associate rheumatoid arthritis with getting older. However, age isn’t the cause, and rheumatoid arthritis isn’t a joint problem, even though that’s where it shows up. What is RA, if not a joint problem, and how do you get relief? The answers all come down to supporting a normal immune response.

What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the joints. As the Swiss watch principle states, though, the part of the body mainly affected isn’t the only area impacted. RA, while it targets the joints, also impacts other organs in the body. (1) In RA, the immune system attacks the body’s own tissues, causing inflammation, pain, stiffness, and eventually joint damage. RA typically affects the small joints of the hands, feet, and wrists and can also affect larger joints, such as the shoulders, hips, and knees.

Symptoms of Rheumatoid Arthritis

Rheumatoid arthritis can cause a wide range of symptoms which can vary in severity from person to person. Some common symptoms of RA include:

Joint pain, swelling, and stiffness, particularly in the hands, feet, and wrists
Morning stiffness that lasts at least 30 minutes
Fatigue, weakness, and a general feeling of being unwell
Loss of appetite and weight loss
Fever
Dry mouth and dry eyes
Rheumatoid nodules (firm lumps that develop under the skin)
Joint deformities over time as a result of cartilage and bone damage

Additional symptoms of RA may include fever and inflammation in other regions of the body, such as the lungs and heart. Symptoms of RA can come and go, with flare-ups followed by periods of remission (2).

RA’s Relationship to Other Conditions

Rheumatoid arthritis is associated with an increased risk of developing other conditions, including (1):

Cardiovascular disease: People with RA have a higher risk of heart attack and stroke due to chronic inflammation.
Lung disease: RA can cause inflammation and scarring in the lungs, leading to conditions like interstitial lung disease and pleural disease.
Osteoporosis: Chronic inflammation in RA can lead to bone loss and an increased risk of fractures.
Sjögren’s syndrome: This autoimmune disorder, which causes dry eyes and mouth, is often seen in people with RA.
Depression: People with RA are at an increased risk of depression due to the chronic pain, disability, and social isolation that can result from the disease.
Lymphoma: Although the risk is low, people with RA have a slightly higher risk of developing lymphoma, a type of cancer.

While RA increases the risk of these conditions, they aren’t inevitable.

Who’s Most at Risk For RA?

Rheumatoid arthritis can affect people of all ages, races, and ethnicities, but certain factors can increase the risk of developing the disease. These include:

Gender: Women are two to three times more likely than men to develop RA.
Age: RA can develop at any age but most commonly begins between 30 and 50.
Genetics: Certain genes have been linked to an increased risk of RA, particularly HLA-DRB1.
Environmental factors: Exposure to certain environmental factors may increase the risk of developing RA.
Family history: People with a family history of RA have an increased risk of developing the disease.
Obesity: Obesity increases the risk of developing RA, particularly in women. (3)

While these factors may increase the risk of developing RA, it’s important to note that many people with one or more of these risk factors never develop the disease, and some people with RA have no known risk factors. It’s also possible to develop RA without any of these risk factors.

What’s the Common Denominator?

We’ve been taught that autoimmune disorders are the body making a mistake. That’s how it seems, as the body’s antibody response targets its own tissues rather than foreign invaders. However, the body isn’t making a mistake. When the immune system targets body tissue like this, it’s for a reason. Autoimmune disorders happen because the immune system is stressed. These stressors come from the “3 T’s”: traumas, toxins, and thoughts. Chronic low-level versions of these can be as detrimental as one major event. Here are a few examples:

Traumas: over-exercising, poor posture, a sedentary lifestyle, or a poor-quality mattress
Toxins: food allergies, processed foods, toxic personal care products, poor air quality, using plastics
Thoughts: stressing out over an upcoming test, unforgiveness, loneliness

Finding your body’s triggers and easing the stress on your immune system can be the key to fixing the problem. The symptoms tell you something is out of balance; it’s not a sign something’s inherently wrong with your body.

When you have one autoimmune disease, it’s far more likely for your body to react the same way again, which is why so many people with autoimmune diseases have more than one. Learn more about autoimmunity here.

How Does Mainstream Medicine Address RA?

Mainstream medicine says there’s not yet a cure for RA. However, they do offer various treatments to manage symptoms, reduce joint damage, and improve quality of life. (4) Some common treatments for RA include:

Pharmaceutical drugs: The main goal of medication is to reduce inflammation and pain and slow or halt the progression of joint damage. Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids may reduce pain and inflammation in the short term. Disease-modifying antirheumatic drugs (DMARDs) and biologic agents are often used to slow the progression of joint damage over the long term. However, medications always come with side effects that may cause more health issues in the long run. NSAIDs can ultimately ruin the gut lining, and long-term use of corticosteroids can lead to blood sugar issues, including diabetes.
Chiropractic Care and Physical therapy: Chiropractic care and physical therapy can help improve joint function and reduce pain and stiffness. A chiropractor or physical therapist can help patients improve their range of motion and strengthen their muscles. They may also recommend assistive devices, such as splints or braces, to support affected joints.
Surgery: In severe cases of RA, surgery may be necessary to replace damaged joints.

In addition to these treatments, mainstream medicine acknowledges that lifestyle changes such as regular exercise, a healthy diet, and stress management can also help manage RA. The mainstream medical approach typically involves a combination of drugs, movement, and lifestyle changes.

Common Prescriptions For RA

Several types of medications are used to treat rheumatoid arthritis, and they are often combined to manage symptoms and slow disease progression. Some common medicines used to treat RA include:

Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications can help relieve pain and inflammation, but they don’t slow the progression of the disease. Examples include ibuprofen and naproxen.
Disease-modifying antirheumatic drugs (DMARDs): These drugs can slow the progression of RA by suppressing the immune system. Examples include methotrexate, sulfasalazine, and leflunomide.
Biologic response modifiers: These medications target specific molecules in the immune system to reduce inflammation and joint damage. Examples include adalimumab, etanercept, and infliximab.
Janus kinase (JAK) inhibitors: These medications target a specific protein in the immune system to reduce inflammation and joint damage. Examples include tofacitinib and baricitinib.
Corticosteroids: Steroids can be used to reduce inflammation and relieve pain, but they are typically only used in low doses and for short periods due to the risk of side effects. Examples include prednisone and methylprednisolone.
Non-biologic targeted synthetic DMARDs: These drugs target specific molecules in the immune system to reduce inflammation and joint damage. Examples include tofacitinib, baricitinib, and upadacitinib.

The choice of medication will depend on the severity of the disease, the presence of other medical conditions, and other individual factors.

The Wellness Way Approach to Healthy Joints

At The Wellness Way, we think differently. When we think of the contributing factors leading to RA, we always go back to physical, chemical, and emotional stressors, which we categorize as trauma, toxins, and thoughts (the 3 T’s). Our daily accumulation of stressors “pulls the trigger,” creating dis-ease.

So, what causes Rheumatoid Arthritis? As mentioned above, this joint disorder is an autoimmune situation. Because it’s autoimmune, we need to look at what’s triggering the immune system and causing destruction. Your goal should be to take the best care of your immune system possible, regardless of the autoimmune condition (celiac disease, rheumatoid arthritis, Hashimoto’s, etc.).

What triggers the immune system? Traumas, toxins, and thoughts.

Physical Trauma and RA

Physical trauma does not directly cause rheumatoid arthritis. No one stubs their toe and automatically gets RA. However, physical traumas, such as injuries or surgery, have been shown to have a significant association with RA onset (5). Such risk factors and predispositions include a large amount of stress on the immune system, which may show itself through other autoimmune disorders.

Studies have shown that physical trauma can activate the immune system and trigger an autoimmune response in some people. Furthermore, inflammatory complications are responsible for roughly a third of the nearly ten million trauma-related deaths that occur worldwide yearly (6).

It’s important to note that physical trauma is just one of many potential triggers for RA, and not all people who experience trauma develop the disease. Other factors, such as environmental exposures, thought patterns, and lifestyle factors, may also play a role in the development of RA.

Toxins and RA

There is evidence to suggest that exposure to certain environmental toxins and pollutants may increase the risk of developing rheumatoid arthritis. Some of the environmental factors that have been linked to RA include:

Cigarette smoke: Smoking is a well-established risk factor for RA and has been shown to increase the risk of developing the disease and worsening the symptoms of RA in people who already have it. (7)
Air pollution: Exposure to air pollution, especially particulate matter, has been associated with an increased risk of developing RA, as well as more severe symptoms in people who already have the disease. (8)
Pesticides: Exposure to certain pesticides has been linked to an increased risk of developing RA. This is likely due to the ability of some pesticides to trigger an immune response leading to inflammation and joint damage. (9)
Solvents: Exposure to solvents, such as those used in the manufacturing or construction industries, has also been linked to an increased risk of developing RA. (10)
Heavy metals: Exposure to heavy metals, such as lead and cadmium, has been associated with an increased risk of developing RA. (11)

It’s important to note that the relationship between environmental toxins and RA is complex and multifactorial. Minimizing exposure to these toxins is crucial for reducing your risk of developing RA. Minimizing exposure will also give your immune response a break, allowing the body to heal itself.

Thoughts and RA

Evidence suggests stress may play a role in the development and exacerbation of rheumatoid arthritis (12). Stress is known to trigger an inflammatory response in the body, and this response contributes to inflammation. (13) The inflammation then impacts the development and worsening of RA.

Managing stress through relaxation techniques, exercising the right way, and other stress-reduction strategies may be an important way to reduce the risk of developing or worsening RA.

There is a complex relationship between mental health and rheumatoid arthritis. People with RA are more likely to experience mental health conditions, such as depression and anxiety, than the general population. Conversely, people with mental health conditions may also be more likely to develop RA. (14)

In addition to increasing the risk of developing RA, mental health conditions may also worsen the course of the disease. For example, depression and anxiety have been linked to increased pain, fatigue, and disability in people with RA (15).

Managing mental health conditions is an important part of overall health for people with RA, as it can help to reduce inflammation and improve overall well-being.

Important Tests For RA

You can’t know how to address your health situations, including autoimmune diseases like RA, if you don’t know what’s going on. That’s why testing is crucial.

Food Allergy Test
Gut Health Test
Autoimmune Panel – Important markers are anti-CCP (anti-Cyclic Citrullinated Peptide) and RF (Rheumatoid Factor)

Dietary Changes for Autoimmune Conditions, Including RA

Cut sugar from your diet – Excess sugar contributes to inflammation. It also tends to feed infections and other imbalances.
Personalized Nutrition, based on your food allergy test results
Organic, whole foods
Non-inflammatory
Organ meats, sauerkraut, and microgreens for added nutrition.

Supplementation to Support Gut Health and Immune Balance

D3 & K2 – Vitamin D is important for getting inflammation and autoimmune disease under control. A 2020 study highlighted the role of vitamin D in the health of the mucosal lining of the intestine.
Rehmannia– A study done in 2018 showed Rehmannia to have anti-inflammatory effects, helpful in cases of autoimmune diseases.
Turmeric – This spice is often used in Indian food. The active ingredient, curcumin, has been shown to lower inflammation.
Boswellia – Boswellia has been shown to affect rheumatoid arthritis and significantly lower some relevant markers.
Gut support supplements like Megabiotic, Well-zymes, etc.
Omega-3 supplement – Fish oil is a natural anti-inflammatory that can lower the autoimmune response and help the small intestine heal.

Lifestyle Modifications For RA

Contact a Wellness Way clinic to get adjusted and release the stress on your body
Start somewhere! Get your allergies tested and start to eliminate toxic household and personal care items.
Minimize your toxic exposure through: Beauty Products, Cleaning Products, Lotions, Drinking Water, Clean air
Upgrade your thinking: Healthy Thoughts and Gratitude

Educational Resources for Autoimmune Conditions Like RA

Videos and Webinars Related to Rheumatoid Arthritis

What Causes Rheumatoid Arthritis? | A Different Perspective

Articles to Support Autoimmune Conditions Like RA

Events to Support Autoimmune Conditions Like RA

Inflammation Talk

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