Rheumatoid Arthritis
Knee Pain Is Burdensome

Rheumatoid arthritis knee sufferers experience pain simply getting dressed, tying shoelaces, or walking to the car. Knee rheumatoid arthritis (RA) is not the “wear and tear” osteoarthritis disease of aging. It’s a systemic chronic autoimmune disease that affects the knee, as well as many other joints, by causing inflammation.  In most cases of knee RA, pain relief can be managed with early and aggressive medical treatment by a combination of drugs and natural supplements.

RA is one of many autoimmune diseases in which, for reasons unknown, the body’s immune system attacks its own tissues. The human immune system uses antibodies to protect against disease and infection. But with RA, the antibodies attack the body’s joints by mistake. This causes joint inflammation and persistent pain of any kind is a warning.

Doctors are not certain what triggers antibodies to attack the joints and cause RA. It may be activated by an infection, or it may be genetic. Environmental factors also may be involved. Experts remain unsure of the exact cause.

In addition to the knees, the joints most commonly affected by rheumatoid arthritis are the hands, wrists, feet, ankles, shoulders, and elbows.

The disease typically causes inflammation symmetrically in the body, meaning the same joints are affected on both sides of the body. However, RA can also affect other parts of your body, such as the lining of your heart and lungs.

What is rheumatoid arthritis knee?

Rheumatoid arthritis of the knee causes the joints to become tender, warm, and swollen. Although knee osteoarthritis causes pain and stiffness, joint pain with knee RA is more severe.

Normally, a small pouch covered with a thin tissue called synovium lies between two pieces of joint cartilage. Cartilage is a material that covers the ends of joint bones. Cartilage helps to keep bones from rubbing against each other during movement.

The synovium secretes a liquid. This liquid helps keep joints lubricated. When joints are well lubricated, they move smoothly and painlessly. RA causes inflammation of the synovium, which leads to damage and permanent destruction of the joint.

What are rheumatoid arthritis knee symptoms?

The hallmark rheumatoid arthritis knee symptom is morning stiffness that lasts for at least an hour (stiffness from osteoarthritis, for instance, usually clears up within half an hour.) The knee joints stiffen due to lack of movement when sleeping. With RA, even after remaining motionless for short durations during the day, the knees can stiffen. Movement becomes easier with resumed activity throughout the day as the knees loosen up again.

A second prevalent symptom is swelling around and below the knee joints. Some people report that the knee joint feels like it may snap and is hot inside. RA is a symmetrical disease. Both knee joints will most likely be affected.

Rheumatoid arthritis knee symptoms may begin suddenly or gradually. The most common rheumatoid arthritis knee symptoms are listed below and typically last six months or more (however each individual may experience symptoms differently):

  1. Painful and swollen knee joints causing difficulty of movement
  2. Stiffness and pain especially after sleeping
  3. Inflammation and warmth around the knee joints
  4. Fever and flu-like symptoms, anemia and weight loss
  5. Fatigue and/or weakness
  6. Fluid accumulation, especially around the ankles
  7. Rheumatoid nodules (hard bumps) just under the skin near the knee joints
  8. Loss of appetite
  9. In rare cases, the joint sac behind the knee accumulates fluid and forms what is known as a Baker cyst, which feels like a tumor and sometimes extends down the back of the calf causing pain.

Who gets rheumatoid arthritis?

Rheumatoid arthritis is a serious type of inflammatory arthritis that affects 1.3 million Americans. RA can affect people of any age, even very young children, called juvenile rheumatoid arthritis.

Anyone can develop RA. For most people, it begins between the ages of 25 and 50 and in 75% of cases, RA affects women. Smokers are also more at risk for developing the disease, as are people who have a history of RA in their families.

Joints of the same type on either side of the body are usually both affected with RA, such as the knees, ankles, feet, hips, elbows and shoulders. It also affects other tissues and organs, such as the heart, skin, and lungs.

Diagnosis of rheumatoid arthritis knee

Swelling and pain in the knee joints must occur for at least 6 weeks before a diagnosis of rheumatoid arthritis is considered. The inflamed joints are usually swollen and often feel warm and spongy when touched.

Only a qualified medical doctor can diagnose rheumatoid arthritis knee joint symptoms as RA. He or she will do a physical exam, ask about your personal and family medical history and perform blood tests to determine if they are positive for the following:

  • Anemia (low red blood cell count)
  • Rheumatoid factor (RF), found in about 70% to 80% of those with RA
  • High erythrocyte sedimentation rate (sed rate), which indicates inflammation
  • Antibodies to cyclic citrullinated peptides (CCP)
  • High levels of C-reactive protein (CRP) The doctor may also order an X-ray of the knee joints. An MRI may also be used to detect evidence of joint damage or destruction.

Your doctor may withdraw a sample of joint fluid (synovial fluid) to analyze. People with RA usually have joint fluid that's filled with inflammatory material.

What's the treatment for rheumatoid arthritis knee pain?

Treatment for rheumatoid arthritis knee symptoms must be tailored to the individual by the rheumatologist. The severity of arthritis and other factors, including lifestyle, are taken into account. Treatment methods focus on relieving pain, reducing inflammation, stopping or slowing joint damage and improving functioning and sense of well-being.

According to the Arthritis Foundation, the main categories of drugs used to treat rheumatoid arthritis knee symptoms are:

  • Non-steroidal Anti-inflammatory Drugs (NSAIDs) to reduce inflammation and relieve pain. NSAIDS include medications such as aspirin, ibuprofen, indomethacin and COX-2 inhibitors such as valdecoxib and celecoxib.
  • Analgesic Drugs—These drugs relieve knee pain, but don’t necessarily have an effect on inflammation, a common symptom of rheumatoid arthritis. Examples of these medications are acetaminophen, propoxyphene, mepeidine and morphine.
  • Clucocorticoids or Prednisone—These are prescribed in low maintenance doses to slow knee joint damage caused by inflammation.
  • Disease Modifying Antirheumatic Drugs (DMARDS)—These are used with NSAIDs and/or prednisone to slow joint destruction caused by RA over time. Examples of these drugs are methotrexate, injectable gold, penicillamine, azathioprine, chloroquine, hydoxychloroquine, sulfasalazine and oral gold.
  • Biologic Response Modifers (BRMs)—These drugs directly modify the immune system by inhibiting proteins, called cytokines, which contribute to inflammation. Examples of these are Enbrel (etanercept), Remicade (infliximab), Humira (adalimumab) and Kineret (anakinra).
  • Protein A Immunoadsorption Therapy—This is not a drug, but a therapy that filters blood to remove antibodies and immune complexes that promote inflammation.
  • Note: DMARDs, particularly methotrexate, have been the standard for aggressively treating RA. Doctors are now prescribing combination drug therapy consisting of DMARDs and BRMs for more aggressive treatment for controlling RA. Studies are continuing concerning dual drug treatments, and it appears that these combination drug therapies might become the new road to follow in treating RA. According to the Arthritis Foundation, the medications your doctor may suggest you combine with methotrexate are lefluonomide (Arava), etanercept (Enbrel), adalimumab (Humira) and infliximab (Remicade).

These drugs all have potentially harmful side effects. In a recent development concerning three of the four drugs named in the paragraph above—Enbrel, Remicade and Humira—the Food and Drug Administration (FDA) on September 4, 2008 issued stronger warnings saying they can raise the risk of possibly fatal fungal infections. The drugs, administered by injection, are known as TNF-alpha blockers that work by suppressing the immune system, which lower the body’s defenses to various kinds of infections.

Is surgery necessary for rheumatoid arthritis knee?

At some point, rheumatoid arthritis knee treatment may call for a total knee joint replacement. This surgery is usually a "last resort" instead of the first treatment option for knee RA. Today's advances in total joint replacement provide a successful outcome in most cases.

Synovectomy is another procedure that's performed in rheumatoid arthritis. With synovectomy, the surgeon removes the inflamed synovium or joint lining. Synovectomy can be done as an open procedure or by arthroscopy. In general, arthroscopic procedures are associated with fewer complications and faster recovery than a more invasive surgery. The relief in knee pain with synovectomy in RA may last up to five years.

What can I do to care for myself if I have rheumatoid arthritis knee pain?

To relieve rheumatoid arthritis knee pain, regular gentle exercise can strengthen the muscles around the knee and helps support the joint and relieve fatigue.

Mild water aerobics or walking are good exercises to start with. Stop if you feel pain in a new joint while exercising. If the pain does not get better, you should call your doctor.

Sometimes physical therapy and occupational therapy are recommended.

Losing weight if you are overweight and eating a healthy diet can also help rheumatoid arthritis knee symptoms.

Devices to assist doing everyday activities can lessen stress on affected joints. A grabbing tool to pick items up is an example. Canes can make walking easier. Ask your doctor about the tools that are available to make your daily life easier.

Apply heat or cold to your painful joints to ease pain. Heat relaxes tense muscle and cold can numb pain. An easy way to apply heat is to take a 15 minute hot shower or bath. Cold packs or soaking joints in cold water are effective ways to apply cold treatment. However, you should not use these methods if you have poor circulation.

Why do some people with rheumatoid arthritis knee pain use dietary supplements?

Increasingly, rheumatoid arthritis knee patients turn to natural dietary supplements to help mitigate painful symptoms. The following are some of the reasons people consider natural supplements for rheumatoid arthritis of the knee:

  • Issues with harmful side effects of drug treatment
  • Because conventional treatment is not working as well as they would like
  • A wish for greater relief of symptoms and/or disability
  • A desire to reduce some of the stress that comes from living with a chronic illness and to cope better
  • A belief that alternative therapies are safer and more "natural"
  • The reality that RA may be lifelong, makes dependency on pharmaceuticals more worrisome regarding their side effects
  • Widespread advertising and attractive claims for many dietary supplement products.

Here are some of the types of supplements people try for RA (these are among those most frequently discussed in scientific literature and inquired about at the U.S. Government NIH NCCAM clearinghouse):

Natural dietary supplements for rheumatoid arthritis knee symptoms

When investing in dietary supplements, consider it first as an investment in your health. This way, you won’t want to waste your money on poorly formulated or synthetic supplements containing artificial colors, sweeteners, binders, fillers, etc. that will not be readily absorbed into your bloodstream.

Instead, you’ll want a high quality dietary supplement with ingredient purity, potency, and guaranteed efficacy that your body’s cells will happily absorb.

My husband and I both suffer from different types of arthritis. Mine is neck arthritis, my husband’s was knee and now shoulder osteoarthritis. To help me find a top-tier manufacturer of natural dietary supplements, I devised a list of 30 questions concerning standards of excellence that led my husband and I to the company referenced in the Landmark Study below. It’s the only one that we trust for nutritional supplementation.

There’s only one natural nutrition company that can claim a 20-year clinical landmark study on its consumers that from blood samples verifies that its supplement users retained normal levels of blood pressure, HDL cholesterol, triglycerides, C-reactive protein and homocysteine.

The 2006 study was conducted in collaboration with researchers from the U.C. Berkeley School of Public Health comparing people who took either no supplements or other brands of multivitamins. For details, go to: The Landmark Study

Three pain supplements for rheumatoid arthritis knee symptoms

Recognized as the #1 natural nutrition company in the U.S., they have been in business since 1956. Their 'beyond organic' products are backed by 100,000 quality tests per year. Unlike other supplement companies, they do not market products without clinical studies to verify efficacy, which is unheard of and

not required by industry regulations.

In 2003, they designed three natural pain relief products targeted for people experiencing discomfort from any source. Patients with rheumatoid arthritis symptoms or symptoms from other types of arthritis and pain disorders have achieved relief from these products.

As osteoarthritis sufferers, we’ve been very happy with their ability to relieve our symptoms.

Recommended plant-based ingredients/supplements for RA knee symptoms

While rheumatoid arthritis is an entirely different arthritis subject, your rheumatologist may feel the same plant-based ingredients in products mentioned below may help improve your flexibility of motion, swelling and stiffness while fighting RA inflammation.

More and more people today choose safer alternatives to treat joint pain due to arthritis. The following six products and their natural ingredients may ease rheumatoid arthritis symptoms and help people lead a more comfortable life.

The bold links for the supplements listed below will take you to the featured product pages for prices and additional information on each:

    Glucosamine & Boswellia Joint Relief

    Clinical studies indicate that glucosamine hydrochloride is most effective when rheumatoid arthritis symptoms are moderate to severe. Glucosamine has the ability to rebuild cartilage for joint health and comfortable movement. Formulated with the addition of clinically proven boswellia, this joint health product provides faster relief in as little as five days as it lubricates and cushions joints to provide enhanced mobility and range of motion.

    Boswellia and Safflower Oil Pain Relief

    When the boswellia herb and oil from the safflower are used in combination, it creates a potent, natural pain relief supplement without gastrointestinal side effects. In studies, these two ingredients together are more effective when combined, that they are separately. Boswellia extract is a very potent 5 Lox inhibitor. The safflower extract contains a potent ingredient that is a very selective Cox 2 inhibitor. Therefore, this product is effective against both the 5 Lox and Cox 2 pain pathways--both of the major pathways--which is the only product on the market of its kind. Its formulation and synergy is so unique that there's a patent pending on this supplement.

    Menthol Pain Relief Rub

    This topical menthol analgesic provides temporary relief (up to four hours) for minor pain associated with backache, arthritis, bruises and sprains. It offers fast absorption and deep penetration to soothe aching joints and muscles on contact. In addition to menthol, it contains a proprietary blend of natural ingredients that targets the source of discomfort and provides quick relief by improving blood circulation in the affected area.

    Fish Oil (EPA) - (Essential Omega-3 Fatty Acids)

    This best fish oil supplement provides a full spectrum of seven ultrapure omega-3 fatty acids, naturally found in cold water fish (tuna, mackerel, halibut, cod, salmon). High in DHA and EPA, it supports joint function due to its anti-inflammatory properties and is easy to digest with low odor and no aftertaste. It also helps to maintain a healthy heart and cardiovascular system.

    GLA and Vitamin E Complex

    Gamma-linolenic acid (GLA) from borage seed oil is used as an anti-inflammatory. GLA helps our bodies form prostaglandins - potent hormone-like substances that help regulate many bodily processes. When combined with Vitamin E and sunflower seed oil, the formula helps maintain cellular integrity.

    Valerian, Passion Flower and Chamomile Sleep Aid

    As a natural alternative, valerian root side effects are few, and minor by comparison to pharmaceutical drugs. In fact for an insomnia remedy it's very tolerable. Most studies suggest that it’s more effective when used continuously rather than as a one-night sleep aid. However many individuals successfully use it on a need-only basis. An advantage of valerian over drugs is the lack of sleepiness on awakening when used at recommended dosages. This supplement also contains a complementary blend of two additional herbs, chamomile and passion flower. Together, they provide a calm state and promotes restful sleep.

Therefore, I am happy to highly recommend all of these very effective products as a safe, natural remedy for treating rheumatoid arthritis knee symptoms.

The first three listed above are also referred to as The Pain Trio (scroll this linked page for My Arthritis Story)

Disclaimer: Health statements on this rheumatoid arthritis knee page have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.

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