ACUPRESSURE:   A practice similar to acupuncture that uses applied finger pressure to stimulate the pathways of energy and promote healing.

ACUPUNCTURE:    An ancient Chinese medicine, when tiny needles are inserted into the skin in order to open up pathways of energy to promote healing.

ACUTE: Of abrupt onset, in reference to a disease. Acute often also connotes an illness that is of short duration, rapidly progressive, and in need of urgent care.

ADALIMUMAB: Biologic drug with the brand name Humira that targets one of the cytokines that play a role in Ram TNF-alpha. The drug is injected and approved for adults.

ADD/ADHD (ATTENTION-DEFICIT/HYPERACTIVITY DISORDER):     A chronic condition including attention difficulty, hyperactivity, and impulsiveness.

ADDICTION: The fact or condition of being addicted to a particular substance, thing, or activity.

ADRENEAL GLANDS: Located above each kidney, the adrenal glands secrete steroid hormones and adrenaline, among other chemicals that help control heart rate, blood pressure, food absorption, and other vital functions that play an important role in stress response.

AEROBIC EXERCISE: Brisk exercise that promotes the circulation of oxygen through the blood.  Also called endurance exercise.  Examples are running, swimming, and cycling.

AGGLUTINATION TEST: One of two tests for rheumatoid factor (RF), both of which mix a blood sample with antibodies to measure the response.

ALZHEIMER’S:    A progressive mental deterioration that can occur in middle or old age, due to generalized degeneration of the brain. It is the most common cause of premature senility.

AMYGDALA: An almond-shaped structure in the brain that integrates the stimuli that evoke fear, triggering a physical stress response.

ANA, ANTINUCLEAR ANTIBODY TEST:    A measure of auto-antibodies used in combination with examination, medical history, and other tests in diagnosing RA or determining the type of JRA. It also known as an antibody commonly produced by people who have connective tissue diseases such as RA, Lupus, Scleroderma, Sjögren’s syndrome, and mixed connective tissue disease, ANA’s may also be present in healthy people.

ANAKINRA: A biologic drug, brand name Kineret, that targets cytokine interleukin-1 (IL-1).

ANALGESICS: A category of pain medications that includes over-the-counter acetaminophen and prescription opiates.

ANEMIA OF CHRONIC DISEASE: A complication of RA in which the number of red blood cells is reduced as a result of long-term inflammation.

ANKYLOSING SPONDYLITIS:  An arthritic condition that may be confused with RA that typically begins in young adults in their twenties and thirties.  It is marked early on by pain and stiffness in the lower back and buttocks.

ANTIBODIES: Proteins produced by B cells to fight invading antigens and dispose of them.

ANTI-CCP ANTIBODIES (ANTIBODIES TO CYCLIC CITRULLINE CONTAINING PEPTIDES):   A substance found in the blood, that is used as a diagnostic measure to determine the presence of RA.

ANTIGENS:  Anything in the system without a permanent tag that labels it as a “self” cell, a foreign body or organism such as bacteria or viruses, that trigger an immune response.

ANTIOXIDANTS:  Compounds that help neutralize oxygen-reactive molecules called free radicals that are thought to contribute to disease and tissue damage.  Some antioxidants that appear to reduce inflammation are found in fruits and vegetables.  Vitamins that may counter the joint destructions caused by free-oxygen radicals.  The antioxidant vitamins are vitamin C,E and beta-carotene, which forms vitamin A.

ARAVA:  A DMARD developed for treating RA.  Because the drug may persist for up to two years in the body, it is not appropriate for men or women who may wish to have a child.

ARTHRITIS/SPONDYLITIS ASSOCIATED WITH INFLAMMATORY BOWEL DISEASE:     A condition in which the arthritis, or inflammation of the joints, is accompanied by Crohn’s disease or ulcerative colitis.  Crohn’s disease involves inflammation of the colon or small intestines, and ulcerative colitis is, characterized by ulcers and inflammation of the lining of the colon.

ARTHROCENTESIS: A procedure in which fluid is extracted from the joint using a needle for purposes of examination.

ARTHRODESIS:   A surgery in which the two bones of the joint are joined together, so that they become less flexible.  Also known as joint fusion, the surgery may be recommended when joints become painful and unstable.

ARTHROPLASTY:  A type of surgery that involves replacing the damaged joint by rebuilding it, or resurfacing or relining the ends of the bones where the cartilage has eroded or bone has been destroyed.

ARTHROSCOPY:   A procedure using a very thin tube with a light at the end to see the extent of joint damage.

ASSISTIVE AIDS: Equipment such as shower benches, raised toilet seats, and walking canes that are used by people who need help in daily activities.

AUTISM:   A mental condition, present from early childhood, characterized by difficulty in communicating and forming relationships with other people and in using language and abstract concepts.

AUTOANTIBODIES: Antibodies, called rheumatoid factor (RF), that target a person’s own antibodies as foreign.

AUTOIMMUNE:     A condition in which the immune system attacks its own body cells. 


B CELL LYMPHOCYTES:  Specialized white blood cells that churn out antibodies.  In people who have RA, B lymphocytes may produce an abundance of one particular antibody called the rheumatoid factor.

BIOFEEDBACK:    a technique that uses imagery and/or relaxation in order to control autonomic body functions such as breathing, heart rate, blood pressure, skin temperature, and muscle tension.

BIOLOGIC RESPONSE MODIFIERS (BRM):  Medications created by living cells that interfere with the sequences of events in the immune system that trigger RA.

BMI, BODY MASS INDEX:     A number, calculated with height and weight measurements, that indicates whether or not weight is within a healthy range for most people.

BOUTONNIERE DEFORMITY:    A malformation caused, by RA that occurs when the joint in the middle of a finger sticks up.

BREAST CANCER: Breast cancer is a malignant tumor that starts in the cells of the breast. A malignant tumor is a group of cancer cells that can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. The disease occurs almost entirely in women, but men can get it, too.

BRIDGE THERAPY: In RA, the use of steroids to control inflammation, while waiting for slower-acting DMARDs to take effect.

BURSAE:    Sacs located between or under muscles that allow for smooth muscle movement and shield the joint and muscle from friction as well as external pressure.


CA:  Certified acupuncturist.

CALCIUM:   An essential mineral that, along with phosphorus, makes up the bulk of the deposit in bone and teeth.  In the diet, calcium is available in milk, yogurt, cheese, and broccoli, among other foods.

CAM, COMPLEMENTARY AND ALTERNATIVE MEICINE:    Therapy that is alternative to standard treatment.

CANCER:   The disease that is caused by an uncontrolled division of abnormal cells in a part of the body.  It is a malignant growth or tumor resulting, from the division of abnormal cells.

CARDIOVASCULAR EXERCISES: Activities that strengthen your endurance, heart and lungs.

CARPAL TUNNEL SYNDROME:   A nerve entrapment condition that develops when the median nerve that runs through the wrist becomes compressed due to swelling and pressure inside the joint.  If it occurs at the elbow, it is called ulnar nerve entrapment.

CARTILAGE: A thick tissue covering the ends of bones at movable joints which is nourished through the action of exercise.  Prolonged inflammation in RA causes damage to cartilage.

CAUDATE NUCLEUS:     Tail-shaped masses of gray matter in the brain at the base of each cerebral hemisphere thought to be involved in the reward system as well as in the regulation of voluntary movement.

CBC, COMPETE BLOOD COUNT: The most common blood test, one of the routine test advised for regular monitoring of people with RA, It determines the proportions of red and white blood cells and the possibility of anemia.

CELECOXIB (CELEBREX):     Treats pain, including pain caused by arthritis (osteoarthritis, rheumatoid arthritis, or juvenile rheumatoid arthritis) in children and adults, ankylosing spondylitis, or menstrual cramps. This is a non-steroidal anti-inflammatory medicine (NSAID). 

CELIAC DISEASE: A disease in which the small intestine is hypersensitive to gluten, leading to difficulty in digesting food. An immune reaction to eating gluten, a protein found in wheat, barley, and rye.

CHEMICAL SIGNALS:    Cell communication throughout the body, conducted by transmission of substances.

CHIROPRACTICS:  An ancient healing practice that involves manipulating the spine as a way to improve your health.

CHOLESTEROL: A substance contributing to heart disease, increased by stress. 

CHRONIC:  Continuing for a long time or returning often.  Often with acute.  (of an illness)

CHRONIC FATIGUE SYNDROME: A disease characterized by profound fatigue, sleep abnormalities, pain, and other symptoms that are made worse by exertion.

CHRONIC FATIGUE SYNDROMEPAIN: Chronic pain is pain that lasts a long time. In medicine, the distinction between acute and chronic pain is sometimes determined by an arbitrary interval of time since onset; the two most commonly used markers being 3 months and 6 months since onset, though some theorists and researchers have placed the transition from acute 

CHT, CERTIFIED HAND THERAPIST: Occupational therapist with specialized training in caring for elbows, wrists, and hands.

CLINICAL TRIALS:     Carefully conducted research studies done in human volunteers to answer specific questions about a treatment or therapy.  The trials, also called clinical studies, are done after studies in animals show promising results.

COGNITIVE-BEHAVIORAL THERAPY:  A type of psychotherapy that works by changing the way the patient thinks and behaves.

COGNITIVE PSYCHOLOGY:     A branch of psychotherapy that addresses the mental processes that underlie behavior and teaches that patterns of thought can be changed.

COMPLEMENTS:    Immune complexes in the blood that become clumps of sticky proteins inside the joint and perpetuate further inflammation in the RA joint.

COMPUTERIED AXIAL TOMOGRAPHY (CAT OR CT SCANS):     Advanced X-rays that shoot several X-rays from different vantage points, and which are then viewed on a computer screen.

CONGESTIVE HEART FAILURE: A chronic condition in which the heart doesn’t pump blood as well as it should.  A weakness of the heart, that leads to a buildup of fluid in the lungs and surrounding body tissues.

CONSUMER LAB (CL):   Provides independent testing of herbs, supplements and vitamins, with evaluation available online.

CORTICOSTEROIDS:     Synthetic drugs closely related to cortisol, a hormone naturally produced in the adrenal gland.  Corticosteroids act on the immune system by blocking production of substances that trigger inflammation.  Prednisone is the corticosteroid commonly used to treat RA.  It does not modify the progression of the disease.

CORTISOL:  A hormone secreted by the adrenal glands; in pregnancy it contributes to an altered immune state, which ensures that the fetus is not rejected as foreign, resulting in temporary remission of RA in the mother.

COSTIMULATION BLOCKERS:   A new class of medications that interfere with the autoimmune response in RA.

COX-2 INHIBITORS:    A relatively new category of anti-inflammatory medications that are said to cause less distress to the stomach than traditional non-steroidal anti-inflammatory drugs.  The category includes Celebrex and Bextra.  In 2004, the drugs came under intense scrutiny after Vioxx, another COX-2, was pulled from the market because of a link to cardiovascular disease.  At press time, the drugs were still under scrutiny for the same reason.

C-REACTIVE PROTEIN (CRP): A protein produced in the liver that increases in the presence of inflammation, used to help diagnose RA. 

C-REACTIVE PROTEIN (CRP) TEST: A test, less commonly used than the ESR, used to monitor inflammation in rheumatoid arthritis and other autoimmune conditions.  It can be a positive indicator for patients with no detectable rheumatoid factor.

CRICOARYTENOID JOINT: A joint near the windpipe that may become affected by RA and cause hoarseness and difficulty breathing.

CYCLOOXYGENASE: An enzyme, also called cox, responsible for the production of prostaglandins, intracellular messengers found at high levels in inflammation.    

CYTOKINES: Protein chemical messages that regulate gene activity.  More than twenty-four different cytokines are thought to play a role in RA.  For example, the mix of cytokine messages determines whether T cells will differentiate into cells that promote or diminish inflammation.


DAILY VALUE (DV):    A nutritional reference consolidating previous values with the purpose of decreasing the risk of chronic disease through nutrition.

DEMENTIA:  A chronic or persistent disorder of the mental processes caused by brain disease or injury and marked by memory disorders, personality changes, and impaired reasoning.

DENTAL CARIES:  Tooth decay that, in Sjögren’s syndrome, can be caused by decreased saliva.

DEPRESSION:     A serious mood disorder that may occur in people with RA or any chronic disease that impairs functioning.  The condition is characterized by a persistent sad, anxious, or empty mood, feelings of hopelessness and pessimism and a loss of interest in activities once found pleasurable.

DIABETES: A metabolic disease in which the body’s inability to produce any or enough insulin causes elevated levels of glucose in the blood. 

DIET:     A special course of food to which one restricts oneself, either to lose weight or for medical reasons.

DISEASE: a definite pathological process having a characteristic set of signs and symptoms. It may affect the whole body or any of its parts, and its etiology, pathology, and prognosis may be known or unknown. For specific diseases, see under the specific name.

DMARD, DISEASE-MODIFYING ANTIRHEUMATIC DRUG:   A category of drug that influences the progression of RA, including commonly prescribed methotrexate, as well as biologic drugs.

DOCOSAHEXAENOIC ACID (DHA):     A type of omega-3 fatty acid found in fish oils that has been shown to reduce the number of swollen joints and morning stiffness in RA.

DOPAMINE:  A neurotransmitter associated with elevated feeling.  The reward circuits in the brain are rich in dopamine.

DPM, DOCTOR OF PODIATRIC MEDICINE: Podiatrist or foot specialist.

DRI (DIETARY REFERENCE INTAKES):    A set of four nutritional reference values that have replaced the 1989 Recommended Dietary Allowances (RDAs):  Estimated Average Requirements (EAR), Recommended Dietary Allowances (RDA), Adequate Intakes (AI), and Tolerable Upper Intake Levels, (UL).  They are intended to include nutritional levels that can help prevent cardiovascular disease, osteoporosis, certain cancers, and other diet-related diseases. 


EFFUSION:  A buildup of excess fluid in the joints and around the lung.

EICOSAPENTAENOIC ACID (EPA):   See Docosahexaenoic Acid (DHA)

ELIMINATION DIET:    A technique in which a food suspected of worsening symptoms is removed from the diet, and then gradually reintroduced in small quantities.

ENBRIL:    Brand name for the biologic drug etanercept.

ENDORPHINS:     Proteins naturally produced in the brain that mimic the effects of opiates to block pain by binding to certain neuron receptors.  These natural pain blockers; are known to be released in the presence of hopeful emotional states.

EPISCLERITIS:   A complication of RA that involves inflammation of the connective tissue between the conjunctiva, the transparent tissue that covers the outer surface of the eye, and the sclera, the white of the eye.

ERYTHROCYTE SEDIMENTATION RATE (ESR):     A diagnostic tool, often called the sed rate test, which measures how quickly red blood cells settle in a test tube.  Faster settling is usually an indication of inflammation.

ESTROGEN:  Female sex hormone.  In pregnancy it is one of several hormones contributing to an altered immune state, which ensures that the fetus is not rejected as foreign, resulting in temporary remission of RA in the mother.

ETANERCEPT:     Biologic drug that blocks the cytokines or chemical messenger TNF-alpha that plays a role in RA.  It is the only biologic approved for used with children.


FELTY’S SYNDROME:    A rare complication of RA that causes an enlarged spleen and decrease in white blood cells. 

FIBROMYALGIA:  A condition characterized by widespread musculoskeletal; pain, fatigue, and tenderness, in specific parts of the body, including the neck, spine shoulders and hips.

FIGHT-OR-FLIGHT SYNDROME: The chemical response to stress that, when chronic and unprocessed, can cause health complications.

FLARE:     A worsening of inflammation and other symptoms in RA often connected to stress.

FOLATE/FOLIC ACID:   A B vitamin that affects hemoglobin production as well as other bodily functions that may be reduced in people who take methotrexate.  Folic acid can be found in leafy vegetables, legumes, certain fruits and fortified cereals.


GAMMA LINOLENIC ACID (GLA):     A type of fatty acid, also known as omega-6 acid, that appears to reduce inflammation. GLA is found primarily in supplements, such as evening primrose oil, black currant oil and borage oil.

GASTROPARESIS:  A condition that affects the stomach muscles and prevents proper stomach emptying. It is a stomach disorder in which food is digested more slowly than normal. In a healthy digestive system, strong muscular contractions move food from the stomach through the digestive tract. With gastroparesis, however, the stomach muscles work poorly (or not at all), thus preventing the stomach from emptying properly.

GEL PHENOMENON: Joint stiffness upon waking, a common symptom of RA.  The swelling, caused by accumulation of fluid in inflamed tissues, is gradually absorbed back into the blood when joint start moving.

GENE THERAPY:   A type of treatment that uses genes to deliver new and different ways of encoding information in order to alter substances and processes in the body.

GENETIC MARKER: A recognizable unique location, related to a genetic trait, on a chromosome.

GLUTEN:      A substance present in cereal grains, especially wheat, that is responsible for the elastic texture of dough. A mixture of two proteins, it causes illness in people with celiac disease.    

GLUTEN FREE:    Not containing gluten.   

GOUT:      A painful condition that results from a buildup of needle shaped crystals of uric acid, a substance produced by the body and by the breakdown of certain foods.  The excess uric acid settles in the body’s connective tissue, the joint space between bones or both causing swelling, redness, heat, pain and joint stiffness. 


HASHIMOTO’S DISEASE: An autoimmune disease causing chronic inflammation and consequential failure of the thyroid gland.

HAQ, THE HEALTH ASSESSMENT QUESTIONNAIRE:      The most commonly used patient reporting form for assessing physical function in rheumatoid arthritis trials.

HEMATOCRIT (HCT):    A test that measures the volume of red blood cells, given in a number indicating percentage in total volume of blood.  A low hematocrit can indicate RA, as well as anemia. 

HEMOGLOBIN (HGB):    The oxygen-carrying molecule in red blood cells that gives the blood its red color.  The test by the same name determines the distribution of oxygen throughout the body and is done as part of the CBC.

HIGH BLOOD PRESSURE: A condition in which the force of the blood against the artery walls is too high.

HIPPOCAMPUS:    An area of the brain known to hold memory, as well as to function in the reward circuits in the brain.

HLA, HUMAN LEUKOCYTE ANTIGEN:  A genetic marker composed of proteins found in leukocytes, or white blood cells, that play a role in activating the immune response.

HLA-B27:   A genetic marker often seen in people who suffer from a form of inflammatory arthritis such as ankylosing spondylitis or reactive arthritis.

HLA-DR4 AND DR-1:    Genetic markers found in the surface of specific white blood cells that may indicate susceptibility for RA.  The presence of these markers, however; does not always indicate RA.

HOMEOPATHY:     A healing system developed in the eighteenth century, based on the notion that small amounts of the disease-causing substance can actually trigger a curative response. 

HOMOCYSTEINE:   a chemical secreted into the system in response to stress, which increases the risk of heart disease.

HUMIRA:    Brand name for the biologic drug adalimumab.

HYDROXYCHLOROQUINE SULFATE, PLAQUENIL:    An antimalarial drug containing quinine used for treatment of RA.  It is one of the best tolerate DMARDs, although regular eye exams are required.

HYPERTHYROIDISM:     (overactive thyroid).  The over production of a hormone, that includes the butterfly-shaped gland, in the neck (thyroid). The condition when the thyroid gland produces too much of the hormone thyroxine.

HYPOTHALAMUS:   An area of the brain that stimulates or suppresses release of hormones in the pituitary gland, notably in response to stress, and contributes to control of sleep, body temperature, water retention, appetite, and blood pressure. 

HYPOTHYROIDISM: (underactive thyroid). The condition when the thyroid gland doesn’t produce enough thyroid hormone.


IEP (INDIVIDUAL EDUCATION PLAN):     A specialized school plan provided for by law for children with special needs.  For example, flares in JRA may require a student to have a tutor or extensions on deadlines.

IGG, IMMUNOGLOBULIN G:    An antibody that destroys pathogens.  In RA antibodies are produced that identify IgG as foreign, antiself antibodies called Rheumatoid Factor (RF).

ILLNESS:a disease or period of sickness affecting the body or mind.

IMMUNE COMPLEXES:    Clumps of sticky proteins that form deposits within the joint and attract more white blood cells, thereby cause even more inflammation.

IMMUNOGLOBULIN: Antibodies, which are proteins.  Each of five classes of immunoglobulin has a different role in the immune response.

INFLAMMATORY ARTHRITIS:   A category of arthritis, exclusive of osteoarthritis, that includes infectious arthritis (e.g. Lyme disease) and systemic autoimmune disease (e.g. RA).

INFLIXIMAS:     The biologic brand named Remicade that targets the cytokine TNF alpha.  It is infused intravenously.

INTERLEUKIN-1 (IL-1):      A pro-inflammatory cytokine that occurs in abnormally large amounts in people who have RA that has become a target of therapies.  One of the cytokines that play a role in RA, targeted by the biologic drug anakinra (Kineret).

IRON-DEFICIENCY ANEMIA:   A complication of RA in which the blood becomes low in iron, often caused by taking non-steroidal anti-inflammatory drugs, which can irritate the stomach lining and cause bleeding.

ISOMETRICS:     Strengthening exercises that involve tightening or contracting a specific muscle without moving your joints.  Isometrics are most helpful during early stages of RA and during a painful flare-up.

ISOTONICS: A form of strength training exercise that combines joint movements with muscle resistance.  Examples of resistance include weights, exercise machines, elastic bands and your own body weight.


JOINT:     The point where two bones meet that allows for various movements. The human body has about seventy movable joints, including those in the hips, shoulders, fingers, writs, elbows and knees.

JOINT CAPSULE:  A covering of the entire joint that is lined with a type of tissue called synovium.

JUVENILE RHEUMATOID ARTHRITIS (JRA):      An arthritic condition that affects children under sixteen and is characterized by joint inflammation as well as pain, swelling and stiffness.  Long-lasting cases of JRA can result in joint damage and altered growth of the bones.


KERATITIS: A complication of RA that involves inflammation or irritation of the cornea.

KINERET:  The brand name for the biologic drug anakinra.


LAC: Licensed acupuncturist.

LEFLUNOMIDE, ARAVA:  A DMARD developed for treating RA.  Because the drug may persist for up to two years in the body, it is not appropriated for men or women who may wish to have a child.

LEUKOCYTE: White blood cell or immune cell; there are six types of leukocyte active in the immune system.

LEUKOCYTOSIS:   An overproduction of white blood cells that may occur in RA 

LEUKOTRIENES:   Substances produced by cytokines in the inflammatory process that promote pain and inflammation.

LIGAMENT:  The connective tissue between the two bones of a joint.

LUPUS: An inflammatory disease caused when the immune system attacks its own tissues.  Any of various diseases or conditions marked by inflammation of the skin, especially lupus vulgaris or lupus erythematosus.

LYMPHATIC SYSTEM:    The tissues and organs, that produces and store leukocytes for fighting infection.  They include the bone marrow, spleen, thymus and lymph nodes of which there are hundreds under the arms in the groin in the neck.

LYMPHOMA:  A form of cancer that affects the body’s lymphatic system, which together with blood forms the body’s immune system

LPN: Licensed practical nurse.  A state licensed title granted by examination to those who have graduated from an accredited course in practical nursing a shorter training than that required for registered nurses.


MACROPHAGES:    White blood cells that ingest and destroy cell debris, bacterial invaders and diseased cells.

MAGNETIC RESONANCE IMAGING (MRI):    An imaging study that uses a magnet to create vibrations in a target area in order to produce a detailed image on a computer.  MRIs are considerably more sensitive than X-rays but also more costly.

MASSAGE:   The manual manipulation of soft body tissues that typically involves rubbing, kneading, rolling and pressing.

MEDITATION:    The act or process of spending time in quiet though : the act or process of meditating: an expression of a person’s thoughts on something.

METACARPOPHALANGEAL (MCP) JOINTS:   The first row of knuckles down from the wrist. 

METATARSOPHALANGEAL (MTP) JOINTS:   The first row of joints on the toes down from the ankle.

METHOTREXATE:   The DMARD most often prescribed for RA originally used for cancer in much higher does.  It works as a decoy, fitting into the same cell receptor as folic acid and diminishing the activity of the immune system.  It is often prescribed in combination with a biologic drug.

MHC, MAJOR HISTOCOMPATHIBILITY COMPLEX:  Proteins that tag the cells of the body as self cells.

MUSCLES:   Supportive tissue in the body that gives the joints the strength to move.


NEPHELOMETRY TEST:   One of two test for rheumatoid factor (RF).

NEUTROPENIA:   An abnormally low count of a type of white blood cell (neutrophils).  The presence of abnormally, few neutrophils in the blood, leading to increased susceptibility to infection. It is an undesirable side effect of some cancer treatments. 

NEUTROPHILS:    The most common leukocytes (white blood cells) and the first to respond to infection.  Billions are produced daily in the bone marrow and live about a day, moving through the system to detect antigens, which they destroy.

NP:   Nurse practitioner.  A registered, nurse with a master’s or doctoral degree licensed to diagnose and mange illness usually in partnership, with a doctor.  In many states, nurse practitioners are allowed to prescribe medication.

NSAID:     Non-steroidal anti-inflammatory drugs, which are of two types; non-selective NSAIDs include numerous prescription and non-prescription drugs, such as aspirin, selective NSAIDs, cod-2 inhibitors, newer drugs designed to avoid gastrointestinal side effects of nonselective NSAIDs have been found to have an adverse effect on the heart. 


OCCUPATIONAL THERAPIST:   A health-care professional who helps you relearn how to perform how to perform activities in your daily routine so that they cause less pain and pose less risk to you joints.

OMEGA-3 FATTY ACIDS: Nutrients found in fish oils that have been linked to a reduction in swollen joints and morning stiffness in RA as well as other health benefits.

OPHTHALMOLOGIST:     A medical doctor who can prescribe medications and perform surgeries in the treatment of eye disorders. 

ORTHOPEDIC SURGEON:  A medical doctor who is trained to evaluate and treat disorders and disease of the bones, joints, tendons and ligaments.

OSTEOARTHRITIS: A condition caused by the destruction of cartilage in the bone that typically occurs over time and with age.

OSTEOPAROSIS:   A disease, which bones become increasingly thin and brittle.  People who have had RA for a long time, or who take corticosteroid medication such as prednisone are at greater risk for osteoporosis.

OSTEOTOMY: A type of surgery, also called a bone resection, that involves cutting and repositioning the bone in order to improve alignment and compensate for deformity.


PANNUS:    A thick mass caused, by the abnormal growth of synovium cells in the synovial membrane of RA.

PARVO B19 VIRUS:     A viral disease that can mimic RA.

PERICARDITIS:  A rare complication of RA that involves inflammation of the pericardium, the thin membrane that surrounds the heart and the roots of the great blood vessels.

PHOSPHORUS:     An essential mineral that, along with calcium, makes up the bulk of the mineral deposit in bones and teeth.  Phosphorus can be found in virtually all foods but is most prevalent in protein rich foods such as milk, meat, poultry, fish, eggs, legumes and nuts.

PHYSICAL THERAPIST:  A health care professional who devises individualized physical treatment plans for patients in pain or who need help with physical recovery.

PITUITARY GLAND:     A small oval shaped endocrine gland situated at the base of the rain that regulates growth and metabolism.  It also plays a role in stimulating the adrenal gland to produce cortisol and adrenaline in the stress response.

PLACEBO:   A dummy drug, thought to be inert when used as a control in studies.  It has since been shown that belief can account for a measurable change in brain chemistry.

PLASMA CELLS:   B cells produce antibodies by generating plasma cells factories that produce about two thousand specific antibodies per second over a few days.

PLEURAL EFFUSION:    A rare complication of RA that occurs when excess fluid accumulated between the layers of the pleura. 

PLEURISY:  A complication that occurs when the pleura, or membrane that lines the chest cavity and surrounds each lungs, becomes inflamed.  This condition occurs in 10 to 20 percent of people whom have RA.

POLYGENIC SUSCEPTIBILITY: Inclination for a disease to develop under the influence of several genes, each of which alone carries only a small risk.  When certain genes occur together in the same individual the risk for developing RA is increased. 

POLYUNSATURATED FATS:     Fats recommended to be eaten only rarely because of their association with heart disease, for example, corn, soybean, safflower and cottonseed oils.

PREFRONTAL CORTEX:   An area of the brain involved with the reward circuit and which is rich in dopamine, a neurotransmitter associated with elevated feeling. 

PROGRESSIVE MUSCLE RELAXATION: A foot to head technique that involves progressively tensing up different body parts and then relaxing them as a way to control pain.

PROGESTIN: A hormone increased in pregnancy and involved with an altered immune state to ensure that the fetus is not rejected as foreign.  Progestin prompts the multiplication of regulatory T cells and may cause remission of RA in the mother that lasts for the duration of the pregnancy.

PROSORBA COLUMN:     A treatment option for people with severe RA.  The treatment involves cleaning the blood of destructive antibodies that cause the effects of RA. 

PROSTAGLANDINS: Proteins in the body that promote pain and inflammation, but that also protect the lining of the stomach.

PROXIMAL INTERPHALANGEAL JOINTS (PIP):    The second row of joints in the fingers.

PSORIATIC ARTHRITIS: A joint condition that can be seen in people with psoriasis, a skin disorder characterized by a scaly rash that occurs on the scalp, elbows, knees and/or the lower end of the spine.  The skin disease may precede the arthritis by a number of years, or the arthritis may come before the skin disease.  In some cases, they may occur simultaneously.

PULMONARY FIBROSIS:  A cluster of conditions; officially known as diffuse interstitial pulmonary fibrosis in which inflammation and scarring of the air sacs, in the lungs cause a reduction in lung function. 

PSYCHOLOGIST:   A licensed professional counselor treating personality and cognitive functioning, including adjustment to disability.

PSYCHIATRIST:  A medical doctor who specializes in the treatment of mental disorders by therapy that can include medication.


RANGE-OF-MOTION EXERCISES:     Movements that involve moving each joint as far as it can go in each possible direction, and which enhance flexibility, sustain joint mobility and reduce stiffness.

RAYNAUD’S SYNDROME:  A condition common in people with RA in which blood vessels in the hands and feet or tips of the nose and ears develop vasospasms in response to the cold or stress. 

REACTIVE ARTHRITIS:  A condition that may be confused with RA that is sometimes called Reiter’s syndrome.  It usually affects the joints of the knees, ankles and toes and occasionally those in the hands and arms.

REGISTERED DIETITIAN:     A health care professional who is trained to understand the chemistry of food and nutrition and can help create a custom eating plan.  The R.D. at the end of the person’s name means that he or she has met the standards set by the American Dietetic Association and passed a national credentialing exam.

REMICADE: The brand name for he biologic drug infliximab                                                  

REMISSION: The absence of active disease.

RHEUMATIC DISORDERS: Conditions that affect the connective tissues in the body and are characterized by inflammation and/or pain in the muscles joints or fibrous tissue namely the body’s supportive framework and organs.  In addition to RA other rheumatic conditions include lupus, scleroderma and fibromyalgia.

RHEUMATOID ARTHRITIS:      An autoimmune disease that causes inflammation in the lining of he joints, resulting in the decrease in the range of motion of he affected joints.   The condition also causes swelling, pain and warmth.  In extreme cases the disease can spread elsewhere and affect major organs.

RHEUMATOID CACHEXIA: A metabolic change found in rheumatoid arthritis patients accompanied by a loss of muscle, resulting in a lower than normal body cell mass.  It has been determined that the condition is a result o lower levels of exercise.

RHEUMATOID FACTOR:   Antiself antibodies generated in people with RA, that identify some of he body’s own antibodies (specifically IgG) as foreign.  Many but not all people with the disease test positive for RF

RHEUMATOID NODULES:  Tiny bumps that appear under the skin in approximately 30 percent of people with RA.  The nodules are not attached to anything but are free floating lumps usually found in the back of the elbow.

RHEUMATOLOGIST: A medical doctor who specializes in the diagnosis and treatment of arthritis, certain autoimmune disorders, conditions involving musculoskeletal pain and osteoporosis.

RN:  Registered nurse.  A nurse licensed by state examination who has graduated from a nursing program with an associate or bachelor’s degree.


SARCOPENIA:    Loss of muscle mass through the aging process.

SATURATED FATS: Fats of a type associated with heart disease and recommended to be eaten in small amounts.  They are mainly animal fats in whole milk, butter, cheese and meats but some are found in plant foods such as coconut oil and palm kernel oil.

SCLERITIS: Inflammation of the whites of the eyes, sometimes a symptom of RA.

SEROTONIN: A hormone and neurotransmitter associated with elevated mood.

SJÖGREN’S SYNDROME:  An immunologic disorder that affects moisture producing glands and occurs in some people with RA most of them female.  The resulting dryness in the eyes, nose, mouth and vagina needs to be lubricated in the eyes to prevent damage to the corneas and in the mouth to prevent dental caries.

SPLINT:    A device made of plastic and fabric that helps immobilize a joint and ensures it has maximal rest.  Splints can improve function and lessen pain and inflammation.

STEM CELLS:     Undifferentiated cells found in embryos and adult tissue that have not been assigned a specific task and that may be used to generated new healthy cells.

STRENGTH TRAINING:   Weight bearing exercise important in building muscle mass to support joints, strengthen the heart and lungs, enhance sleep and lessen pain, fatigue inflammation and stress.

STRESS HORMONE: The hormone cortisol is released in the body in response to stressful environmental stimuli.  A chain response, beginning with a chemical signal from the hypothalamus to the pituitary which then signals the adrenal gland which results in the release of cortisol to prepare the body for fight or flight. 

SULFASALAZINE:  A DMARD designed for RA, which appears to help retard progression of the disease, both alone and in combination with other drugs.  It includes an antibacterial agent (sulfapyridine) and an anti-inflammatory agent (salicylic acid).

SWAN NECK DEFORMITY: A malformation in the middle joint of the finger in which the middle of the finger bends down and the joint nearest the tip of the finger bends up, creating the appearance of a swan’s neck.

SYNOVECTOMY:    A surgical procedure that involves removing the inflamed joint lining.

SYNOVIAL FLUID: A lubricating substance produced by the synovium that nourishes the cartilage and bones inside the joint capsule that allows the joint to move smoothly.

SYNOVIAL JOINTS:     The seventy movable joints in the body which have a joint capsule or cavity containing synovial fluid, a lining of synovial membrane and cartilage covering the opposing bony surfaces.

SYNOVIAL SAC:  The joint capsule or sac lined with a thin membrane the synovium.  The viscous fluid in the sac lubricates the joints and nourishes the cartilage. 

SYNOVIUM:  A thin layer of cells inside the joint capsule that is also called the synovial membrane.

SYSTEMIC AUTIMMUNE ARTHRITIS:  A category of arthritis that includes rheumatoid arthritis ankylosing spondylitis, lupus and gout among other diverse diseases.  It does not include osteoarthritis, which is local rather than systemic.

SYSTEMIC LUPUS ERYTHEMATOSUS (SLS): A autoimmune condition in which the body’s immune system turns on its own healthy tissues and cause symptoms that may include painful or swollen joints, fatigue, unexplained fever, skin rashes and kidney problem’s.

SYSTEMIC ONSET JUVENILE RHEUMATOID ARTHRITIS: One of three types of JRA, also called Still’s disease, characterized by fever, rash and a possible spread of inflammation to internal organs, causing lymph nodes to swell and sometimes involving the heart.


TAI CHI:   A martial art that uses gentle, flowing motions and deep breathing and concentration.  It has been found to improve the range of motion in the joints of the legs and ankles.

TARGET HEART RATE:   The heart rate or the number of times your heart beats in a given time period, that provides maximal cardiovascular benefits.  It is calculated by subtracting your age from 220 then multiplying that number by 0.70 or 70% of your maximal rate.

T CELL LYMPHOCYTES:  White blood cells that contribute to the release of cytokines and cause the synovial cells to multiply abnormally significantly increase the bulk of the synovium.  In people with RA, the most common T cells are the TH1 helper cells, which promote inflammation.

TENDON:    A type of tissue that attaches muscles to bones.

TENDON SHEATH: An encasement around the tendon that helps it moves smoothly. 

TENDON TRANSFER AND RECONSTRUCTION: A surgical procedure in which a tendon is borrowed from one site and used to replace another tendon. 

TENOSYNOVECTOMY:  A type of surgery that involves removing inflamed tendons.

THROMBOCYTOSIS: Excessive production of blood platelets, the substance responsible for clotting.

THYMUS GLANDS: Bilateral lymph glands situated under the breastbone, where a new lymphocyte (white blood cell), that has been generated in the bone marrow differentiates into a specialized T cell.

TRAN FATS: The fats most closely identified with health problems, usually found in solid form at room temperature and found most often in fast foods, commercial baking, shortening and margarine.  From partially, hydrogenated oil.

TRIGLYCERIDES:  Storage of fats associated with high cholesterol, released in the stress response.

TUMOR NECROSIS FACTOR (TNF):   A pro-inflammatory cytokine that occurs in abnormally large amounts in people who have RA.  It has become a target of therapies. 

TYPE 2 DIABETIES:    A condition in which production or use of insulin is inhibited, affecting conversion of blood glucose to energy.  The same inflammatory chemicals associated with RA can block insulin receptors, raising the risk of type 2 diabetes.


ULNAR DEVIATION:     A deformity in which the finger bends toward the outer part of the arm, where the ulnar bone is located.

ULTRASOUND:    An imaging technique that uses high frequency sound waves to produce images on a monitor.

UNDIFFERENTIATED SPONDYLOARTHROPATHY:     A diagnosis made when the patient has a mix of signs and symptoms of various rheumatic conditions affecting the spine, but they don’t seem to fit in one category.

USDA:      United States Department of Agriculture, the agency responsible for the dietary guidelines now called My Pyramid. 

USP: United States Pharmacopeia, a nonprofit organization that sets standards for drugs and supplements manufactured in the U.S.  When a product is tested the USP mark appears on a label of ingredients stated on the label are present in the declared amount, nutrients are effectively released when it dissolves and in it free of harmful contaminants.  USP does not test for efficacy.

UVEITIS:  Inflammation of the inner eye, found in Sjögren’s Syndrome, an autoimmune condition of the moisture producing glands, as well as in pauciarticular juvenile rheumatoid arthritis.


VASCULITIS:    The inflammation of a blood vessel or blood vessels.

VITAMIN B6:     A B vitamin that may be reduced by inflammation.  Studies have found that low levels of vitamin B6 have bee associated with increase activity, severity and pain. Vitamin B6 supports a range of physiological functions and prevents certain disorders and disease.

VITAMIN D: A fat-soluble vitamin essential for the absorption of calcium and phosphorus; it can be found in fortified milk and sunlight. Any of a group of vitamins found in liver and fish oils, essential for the absorption of calcium and the prevention of rickets in children and osteomalacia in adults.


WATER RESISTANCE TRAINING:      Exercises that use the resistance of water to help build muscle strength, while providing support to the joints. 


X-RAYS:    Radiographic exams used to view the damage to joints, bones and cartilage.

XYLITOL:  A natural sweetener found in plants, fruits and vegetables; which is also produced in the body by normal metabolism.  It has no known toxicity and us used in products such as syrup, toothpaste and mouthwash.  Xylitol gum is recommended to help produce saliva in a dry mouth.


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