What is the cause of RA?
No one knows for sure exactly what causes RA. Several possibilities have been contemplated over the years, including such infections as the Epstein-Barr virus, parvovirus, Lyme disease, and malaria. However, while these infections may produce symptoms similar to RA, none seems to be the actual cause.

What is Lyme disease?
Lyme disease is an arthritic illness that mimics RA and is caused by a spirochete (a corkscrew-shaped bacterium) called Borrelia burgdorferi, which is usually transmitted by deer ticks.

What is parvovirus?
Parvovirus is a type of DNA virus and is the cause of a childhood infection called “fifth disease” or the “slapped cheek” syndrome. In adults, this condition may cause joint pain that may last for weeks or even months. Though these conditions symptoms may mimic RA, parvovirus is not the same disorder nor does it cause RA.

What is the Epstein-Barr virus?
Epstein-Barr virus is the herpes virus that causes infectious mononucleosis. It has also been suspected as the cause of chronic fatigue, though there is little evidence to support this notion.

Is RA caused by any infection?
Scientists have considered infection as a possible cause; in fact, trials of treatment with the antibiotic tetracycline seemed to help alleviate the symptoms of rheumatoid arthritis in some patients. But there is far too little research in this area thus far, and results have been inconclusive. Scientists are also trying to determine if perhaps some type of bacteria may be the cause.


Muscles are important contributors to joint function and stability. They serve as stabilizers and protectors of joints in addition to being the source of power for all movement. As you might expect, muscles provide the strength required to allow movement to take place at the joint. Combinations of muscles acting in unison can result in a wide range of motions. This is how we can use the same joint (the shoulder) to reach behind our back, across our chest, and over our head. We do so by activating different muscle groups.
In addition to movement, the muscles also provide stability for a joint in a given position. For instance, if you raise your arms to comb your hair, certain muscle groups contract to lift your arms above your head. After your arms are raised, the muscles continue to work to keep your arms elevated while you use your hands and wrists to comb your hair. Similarly, when you are standing in line without moving, your muscles are contracting to allow your body to stand erect without collapsing at the hips or knees. Even without movement, then, muscles are critical: they allow us to retain the stationary position of our joints.
Lastly, the muscles automatically protect the joints during movement without requiring conscious thought on our part. As an illustration of this property of muscles, recall the last time you unexpectedly missed a step while walking down a set of stairs. Your muscles did not expect or prepare for the missed step and your knee or hip felt the jolt of unprotected movement. If the step had been anticipated, the appropriate muscles would have contracted, acting much like a shock absorber on a car to protect the joints for the step. This automatic protection function of the muscles results in a reduction of the impact on the joints in the course of daily living.
Muscles are attached to bone by tendons, which are similar to ligaments except that they connect muscle to bone instead of bone to bone. Because the tendons are located at the end of muscles, they move when muscles tighten, or contract. To demonstrate this to yourself, “make a muscle” by bending your arm at your elbow. At the same time, feel the area on the inside of your elbow for a ropelike structure at the end of the biceps muscle. This is a tendon.
The tendon is surrounded by an envelope known as the tendon sheath, in which the tendon slides back and forth. This sheath has a lining (similar to the synovial membrane) which permits easy gliding. When muscle tendons are in good health, they provide excellent support for the joint, much as ligaments do. Tendons and their tendon sheath can become inflamed, however, from overuse (producing a condition called tendinitis) or from RA (producing a condition called tenosynovitis).
Another structure located near the joints which help the tendons and muscles move smoothly over bone is the bursa. Bursae are sacs located between or under muscles which help the muscles slide without resistance or friction. If these structures become inflamed they can become filled with fluid, a condition known as bursitis.

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