What is rheumatoid arthritis (RA)?
Rheumatoid arthritis is the most debilitating type of arthritis because it can cause deformity and disability. It is an autoimmune disease, meaning that the body's immune system turns against itself and attacks healthy tissues. RA affects mostly the joints, and in the spine, RA usually affects the joints in the neck (cervical spine).

What causes RA?
The medical community hasn't pinpointed the exact cause of rheumatoid arthritis, although they have some leads, including:

• heredity: RA can't be inherited, but researchers have noticed that a certain genetic marker, HLA-DR4, is often present in people who develop RA. However, the presence of this genetic marker doesn't guarantee the development of RA.
• gender: Women are three times more likely to develop RA than men.
• infection: Some researchers think that something—such as an infection—has to happen to "turn on" the effects of RA (to cause the immune system to turn against itself). They aren't sure exactly what that is, but they're researching this to try to pinpoint what infection (by a virus or bacteria) can trigger RA.

What are the nonsurgical treatment options for rheumatoid arthritis?
Most patients with rheumatoid arthritis can be treated nonsurgically. A treatment plan is designed to control the disease, alleviate pain, maintain function (activities of daily living), and maximize quality of life.

There is no cure for rheumatoid arthritis, although there are medications that can relieve symptoms and slow disease progression. You can read more about the specifics of these medications here.

A physical therapy (PT) program can help restore muscle strength, flexibility, improve mobility, coordination, and maintain body functions through exercise. Massage, hydrotherapy, and other modalities can help relieve pain.

For people with rheumatoid arthritis, it's important to maintain a healthy lifestyle. This includes eating a good diet, exercising (when your body allows it), and resting. It's not that a healthy lifestyle will cure rheumatoid arthritis; rather, a healthy lifestyle will help you get through each day better and help you better deal with the effects of RA.

It is helpful to keep a medical diary noting medications that work, drug side effects, severity of symptoms, flare-ups, and remissions.

Will I need surgery?
For some patients, surgery may be an option to treat cervical rheumatoid arthritis. Surgery is usually recommended for patients who have nerve problems caused by the effects of RA. For example, inflammation and changes in the joints can affect the surrounding nerves.

You can read a more in-depth explanation of possible surgeries for RA here.