Like the more common form of arthritis known medically as "osteoarthritis," rheumatoid arthritis is a chronic condition that inflicts joint pain and loss of mobility on the sufferer. But rheumatoid arthritis is an altogether different disease than the arthritis that virtually everyone has, at least to some degree, by age seventy-five or so.

Rheumatoid arthritis, also identified by the thankfully brief acronym "RA," strikes the joint linings first. All joints are covered by a thin "synovial membrane" that reduces the friction between adjacent joints. Thanks to the synovial membrane, the surface of a joint is slipperier than a wet ice rink. Without the synovial membrane we would be, like the Tin Man before Dorothy came along, stiff and immobile.

Current medical thinking views rheumatoid arthritis as an "autoimmune disease." In autoimmune diseases, for reasons that are not completely understood, the immune system attacks the body's own tissue as though it were a foreign invader. People with rheumatoid arthritis produce an immunity-related substance called "rheumatoid factor" that targets the synovial membrane. The consequences are severe pain and inflammation, joint disfigurement, and loss of joint movement and function.

As if the destruction rheumatoid arthritis inflicts on joints was not bad enough, other parts of the body suffer as well. The disease can cause a host of other potentially serious conditions including eye inflammation, neurological problems, inflamed blood vessels, disorders of the lymph system, and even heart trouble. One distinguishing feature of RA is the appearance of prominent bony lumps called "nodules" over joints. Rheumatoid arthritis is usually chronic, although people with the disease sometimes go into spontaneous remission.(1)

The chronic inflammation of RA covers the synovial membrane with a mass of tissue called "pannus." Filled with inflammatory cells and erosive substances, pannus eats away the underlying cartilage and bone, leading to destruction of the joint. While the exact cause of rheumatoid arthritis has not been determined, a number of factors can help trigger the inflammatory process including genetics,(2) stress,(3) poor nutrition,(4) and bacterial infection.(5)

Heavy metals such as mercury, cadmium, and lead are possible contributing factors in RA. One study reported that these toxic metals could interfere with the body's ability to manufacture collagen, the tough, fibrous protein that acts like a steel girder in cartilage. Chelation therapy may be helpful for rheumatoid arthritis patients with elevated levels of heavy metals. This therapy consists of a series of treatments using EDTA, a synthetic amino acid that removes heavy metals from the body, administered intravenously. EDTA chelation, though controversial, has been tested and found at least partially beneficial in a number of diseases, including RA.

Stress is an important issue in rheumatoid arthritis. Chronic stress can exact a heavy toll on the immune system. Stress is linked to both the onset and worsening of RA, and flare-ups are often preceded by a stressful event.(3) Stress reduction can help. In one study, RA sufferers who followed a stress management program had less pain and feelings of helplessness, while their coping skills, sense of empowerment and overall health improved. These improvements were still evident 15 months later. This study underscores the value of learning stress management skills for individuals with rheumatoid arthritis.(6)