Rheumatoid arthritis is caused by the bodies' immune system attacking itself, so it is a much more complex disease than osteoarthritis which is caused by wear and tear.

It also has three stages of progression. The immune system is complex and antibodies are normally released on a "seek and destroy" mission, against infections. Rheumatoid arthritis sufferers' have antibodies in their blood that mistakenly target their own body tissues.

The first stage is inflammation of the lining of the joints; this is followed by the rapid division of cells which causes the lining of the cells to thicken. In its final progressive state the inflamed cells release enzymes which eat into the bone and cartilage surrounding the inflammation, once this stage occurs the joint loses is shape, and becomes twisted.

Once this stage has been reached it is progressive, but sufferers' can have long periods of teem when their condition does not deteriorate.

We can also change our diet to deal naturally with inflammation, there are certain foods that both aggravate and assist the condition. Overall the best diet is the Mediterranean Diet, with lots of whole grains, fresh vegetables and fruit, plenty of fish, and less red meat. White refined flour and sugar do not help inflammation.

Sufferers from inflammation need to be aware that certain members of the deadly nightshade family, such as tomato, potato and aubergine may actually make inflammation worse. Acid is bad for osteoarthritis sufferers, and citrus fruits and tomatoes are not recommended.

Omega 3 oils found in oily fish will reduce inflammation, as will pumpkin seeds, walnuts and flax seeds. Several infections and inflammatory diseases result in changes of blood production.

The red blood cells have a shorter life span than normal; additionally there is a shortage of iron to assist in the manufacture of the new cells. Over a period of time this leads to a load grade or moderate level of anaemia. This condition is often present with juvenile rheumatoid arthritis, rheumatic fever and Crohn's disease.

The exact cause of rheumatoid arthritis is unknown despite decades of aggressive research, as it often occurs in families' it is thought there is a genetic link, but the exact trigger that causes the body to attack itself is unknown. It is a more difficult disease to treat as it is systemic, which means it attacks the whole body not just the joints.

It can attack the lung lining which results in chest pain, or the eyes. It can strike at ant age, children may be affected, but statistically it tends to occur between the ages of 40 and 60, though it is much more common in women.

At the present time there is no cure for rheumatoid arthritis, therefore treatment consists of pain management, as drugs attempt to reduce joint inflammation. A second line of defense is to prevent joint destruction and deformity.

Treatments are by necessity individual, measured against the type of disease activity, the joints affected and the age and life style of the patient. In general they involve a combination of medication, bed rest, joint protection and also strengthening through exercise and education. The education is also geared to family members as well as the patient.

Aspirin, ibuprofen and steroids such as cortisone are the ant inflammatory agents, whilst a second line defense is employed to halt the progression of the disease.

The second line defense drugs are slow acting agents such as gold, methotextrate designed to prevent joint destruction. In some cases the disease can be active for years and then it quietens down as if it has burnt itself out and in these cases anti inflammatory drugs and rest. However in most cases the earlier the second line of defense drugs are employed the better they manage to control the destruction. In some cases surgery is an option.

Aspirin and ibuprofen are in some cases associated with abdominal pain, gastrointestinal bleeding and stomach ulcers. They are not steroids, but they still can have serious side effects.

Cortisones are steroids which are taken orally or they injected into the tissue. They are much more potent than non steroid anti inflammatory agents, but when taken regularly they also have side effects. Weight gain and facial puffiness is normal, the skin becomes very fragile and prone to excessive bruising. In some cases they can destroy large joints such as the hips, and there as increased risk of contracting infections.

To further complicate matters the patient cannot simply stop taking them as those results in withdrawal symptoms; in general it is preferable to wean patients off them slowly. The drugs to prevent joint damage are slow acting and therefore they can take months to have any visible effects.