Rheumatoid Arthritis | Arthritis Foundation (2022)

Rheumatoid Arthritis: Causes, Symptoms, Treatments and More

This inflammatory form of arthritis causes joint pain, swelling and damage. Learn more about RA and how to treat it.

Updated Oct, 15, 2021

Rheumatoid arthritis (RA) causes joint inflammation and pain. It happens when the immune system doesn’t work properly and attacks the lining of the joints, called the synovium. The disease commonly affects the hands, knees or ankles, and usually the same joint on both sides of the body, such as both hands or both knees. But sometimesRA causes problems in other parts of the body as well, such as the eyes, heart and circulatory system and/or the lungs.

For unknown reasons, more women than men get RA, and it usually develops in middle age. Having a family member with RA increases the odds of developing RA.

Causes

In a healthy person, the immune system fights invaders, such as bacteria and viruses. With an autoimmune disease like RA, the immune system mistakes the body’s cells for foreign invaders and releases inflammatory chemicals that attack those cells. Tn RA, it attacks the synovium, the tissue lining around a joint that produces a fluid to help the joint move smoothly. The inflamed synovium gets thicker and makes the joint area feel painful and tender andlook red and swollen, and moving the joint may be difficult.

Researchers aren’t sure why people develop RA. They believe these individuals may have certain genes that are activated by a trigger in the environment, such as a virus or bacteria, physical or emotional stress or some other external factor.

(Video) Live Yes! Rheumatoid Arthritis Webinar

Symptoms

In the early stages, people with RA may not see redness or swelling in the joints, but they may experience tenderness and pain.
These symptoms are clues to RA:

  • Joint pain, tenderness, swelling or stiffness that lasts for six weeks or longer.
  • Morning stiffness that lasts for 30 minutes or longer.
  • More than one joint is affected.
  • Small joints (wrists, certain joints in the hands and feet) are typically affected first.
  • The same joints on both sides of the body are affected.

Many people with RA get very tired (fatigue) and some may have a low-grade fever. RA symptoms may come and go. Having a lot of inflammation and other symptoms is called a flare. A flare can last for days or months.

Health Effects

  • Eyes.Dryness, pain, inflammation, redness, sensitivity to light and trouble seeing properly.
  • Mouth.Dryness and gum inflammation, irritation or infection.
  • Skin.Rheumatoid nodules —small lumps under the skin over bony areas.
  • Lungs.Inflammation and scarring that can lead to shortness of breath and lung disease.
  • Blood vessels.Inflammation of blood vessels that can lead to damage in the nerves, skin and other organs.
  • Blood.A lower than normal number of red blood cells.
  • Heart.Inflammation can damage the heart muscle and the surrounding areas.
  • Painful joints also make it hard toexercise, leading toweight gain. Being overweight may make people with RA more likely to develop high cholesterol, diabetes, heart disease and high blood pressure.

Diagnosis

Getting an accurate diagnosis as soon as possible is the first step to treating RA effectively. A doctor with specialized training in treating arthritis (called a rheumatologist) is the best person to make a correct diagnosis, using medical history, a physical examination and lab tests.

Medical history. The doctor will ask about joint symptoms (pain, tenderness, stiffness, difficulty moving), when they started, if they come and go, how severe they are, what actions make them better or worse and whether family members have RA or another autoimmune disease.
Physical examination. The doctor will look for joint tenderness, swelling, warmth and painful or limited movement, bumps under the skin or a low-grade fever.
Blood tests. The blood tests look for inflammation and blood proteins (antibodies) that are linked to RA:

  • Erythrocyte sedimentation rate (ESR, or “sed rate”) and C-reactive protein (CRP) levels are markers for inflammation. A high ESR or CRP combined with other clues to RA helps make the diagnosis.
  • Rheumatoid factor (RF) is an antibody found (eventually) in about 80 percent of people with RA. Antibodies to cyclic citrullinated peptide (CCP) are found in 60 to 70 percent of people with RA. However, they are also found in people without RA.

Imaging tests. RA can cause the ends of the bones within a joint to wear down (erosions). An X-ray, ultrasound, or MRI (magnetic resonance imaging) scan can look for erosions. But if they don’t show up on the first tests that could mean RA is in an early stage and hasn’t damaged bone yet. Imaging results can also show how well treatment is working.

(Video) Battling Rheumatoid Arthritis

Treatment

The goals of RA treatment are to:

  • Stop inflammation or reduce it to the lowest possible level (put disease in remission).
  • Relieve symptoms.
  • Prevent joint and organ damage.
  • Improve function and overall well-being.
  • Reduce long-term complications.

To meet these goals, the doctor will follow these strategies:

  • Early, aggressive treatment to reduce or stop inflammation as quickly as possible.
  • Targeting remission or another goal (called "treat-to-target")towork toward few or no signs or symptoms of active inflammation.
  • Tight control to keep inflammation at the lowest level possible.

Search arthritis.org to learn about medications your doctor prescribes for your rheumatoid arthritis.

Rheumatoid Arthritis

1.5M

People in the United States who have rheumatoid arthritis.

3X

(Video) Live Yes! Rheumatoid Arthritis Webinar

Women are three times more likely than men to develop RA.

30

In women, RA most commonly begins between ages 30 and 60.

45

RA is rare in men under the age of 45.

Self-Care

Working with your doctor to ensure you get appropriate medical treatment is essential, but you can also take measures on your own to manage your RA and ease pain and fatigue. Diet, exercise, smoking cessation and mental health are all key to good health overall and controlling RA. Get help setting health goals and managing pain with the free Vim app.

Healthy Eating.A balanced, nutritiousdietconsisting of the recommended amounts of all the food groups helps promote wellness and makes it easier to maintain ahealthy weight.

(Video) Rheumatoid Arthritis and Diet

Daily movement.Even when you don’t have time to exercise, try to make movement part of your everyday routine. Use the stairs instead of taking the elevator. Park in a spot that makes you walk a bit to enter a building. Take the longer way to a meeting in your office.

Balancing activity with rest. It's important to try to stay physically active even during a flare, but rest is also especially important when RA is activeand joints feel painful, swollen or stiff. Rest helps reduce inflammation and fatigue that can come with a flare. Taking breaks throughout the day protects joints and preserves energy.

Hot and cold treatments.Heat treatments, such as heat pads or warm baths, tend to work best for soothing stiff joints and tired muscles. Cold is best for acute pain and swollen joints. It can numb painful areas and reduce inflammation.

Topical products.These creams, gels or stick-on patches can ease the pain in a joint or muscle. Some contain the medicine that you can get in a pill, and others use ingredients that irritate your nerves to distract from pain.

Stress Reduction and Complementary Therapies.There are different ways to relax and stop focusing on pain. They includemeditation, deep breathing, and thinking about images in your mind that make you feel happy.Massagecan help reduce pain, relax sore muscles and easestressoranxiety. Acupuncture involves inserting fine needles into the body along special points to relieve pain. If you don’t like needles, acupressure uses firm pressure instead.

Supplements.Studies show that curcumin/turmeric and omega-3 fish oil supplements may help with rheumatoid arthritis pain and morning stiffness. However, talk with a doctor before taking any supplement to discuss side effects and how it may affect other medicines you are taking.

Positive Attitude and Support System.Cultivate a network of friends, family members and co-workers who can help provide emotional support. Take time to do things that you enjoy to lift your mood, which can help relieve pain.

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FAQs

What are the 3 types of rheumatoid arthritis? ›

Types of Rheumatoid Arthritis – Seropositive or Seronegative RA
  • Rheumatoid Factor Positive (Seropositive) RA. ...
  • Rheumatoid Factor Negative (Seronegative) RA. ...
  • Overlapping Conditions.
11 Feb 2016

What is the best thing to do if you have rheumatoid arthritis? ›

Products and Services
  • Exercise regularly. Gentle exercise can help strengthen the muscles around your joints, and it can help reduce fatigue you might feel. ...
  • Apply heat or cold. Heat can help ease your pain and relax tense, painful muscles. ...
  • Relax. Find ways to cope with pain by reducing stress in your life.
18 May 2021

Are you classed as disabled if you have rheumatoid arthritis? ›

The Social Security Administration (SSA) considers rheumatoid arthritis, or RA, a qualifying disability, but it must be advanced RA to meet the SSA's eligibility requirements. That means that you your rheumatoid arthritis has to be so severe that you will be out of work for at least 12 months.

What foods aggravate rheumatoid arthritis? ›

Foods You Should Avoid with Rheumatoid Arthritis
  • Grilled, broiled, or fried meats (and other fried foods). ...
  • Fatty foods full of omega-6 fatty acids. ...
  • Sugars and refined carbohydrates. ...
  • Gluten. ...
  • Preservatives and flavor enhancers. ...
  • Alcohol.
26 Sept 2018

What is the most painful type of arthritis? ›

Rheumatoid arthritis can be one of the most painful types of arthritis; it affects joints as well as other surrounding tissues, including organs. This inflammatory, autoimmune disease attacks healthy cells by mistake, causing painful swelling in the joints, like hands, wrists and knees.

What is the main cause of rheumatoid arthritis? ›

Rheumatoid arthritis is an autoimmune condition, which means it's caused by the immune system attacking healthy body tissue. However, it's not yet known what triggers this. Your immune system normally makes antibodies that attack bacteria and viruses, helping to fight infection.

What should you not do if you have rheumatoid arthritis? ›

  1. Not Seeing a Rheumatologist. Your regular doctor may have diagnosed your RA. ...
  2. Too Much Couch Time. You need rest, just not too much. ...
  3. Canceling Doctor Appointments. When you feel good, do you stop seeing your doctor? ...
  4. Not Taking All Your Medications. ...
  5. Skipping Medication When You Feel Good. ...
  6. Overlooking Your Mood.
20 Jan 2022

What's the best painkiller for arthritis? ›

NSAIDs are the most effective oral medicines for OA. They include ibuprofen (Motrin, Advil) naproxen (Aleve) and diclofenac (Voltaren, others). All work by blocking enzymes that cause pain and swelling. The problem is that some of those enzymes also help blood to clot and protect the lining of your stomach.

What is the latest treatment for rheumatoid arthritis? ›

New Treatments for Rheumatoid Arthritis - Latest FDA Approvals
DrugDrug Class
abatacept (Orencia)selective T cell costimulation modulator
adalimumab (Humira)tumor necrosis factor (TNF) blocker
anakinra (Kineret)interleukin-1 receptor antagonist
infliximab (Remicade)tumor necrosis factor (TNF) blocker
12 more rows
11 May 2022

Can I get a blue badge with rheumatoid arthritis? ›

You may be eligible for a blue badge, meaning you can park closer to where you need to go. If you claim benefits like Attendance Allowance or Personal Independence Payment, or you have difficulty getting around because of your arthritis, then this will support your application.

How does rheumatoid arthritis affect the brain? ›

People with RA are more likely to have narrowed or blocked arteries in the brain – the result of systemic inflammation. This can cause problems with memory, thinking and reasoning.

Why does rheumatoid arthritis make you tired? ›

People with rheumatoid arthritis typically have several permanently inflamed joints. The inflammation inside the body can lead to general physical weakness, drowsiness and exhaustion. This feeling of extreme tiredness is also called "fatigue." Some people find this to be the worst symptom of the disease.

Is banana good for rheumatoid arthritis? ›

Bananas are not a typical choice for people with arthritis, but the antioxidant and anti-inflammatory properties in them may aid in protecting the body against certain oxidative stress.

Is banana good for arthritis? ›

Bananas and Plantains are high in magnesium and potassium that can increase bone density. Magnesium may also alleviate arthritis symptoms.

What fruit should you avoid if you have arthritis? ›

Citrus fruits cause inflammation

In fact, citrus fruits have anti-inflammatory benefits, as well as being rich in vitamin C and antioxidants. Grapefruit juice can, however, interact with some medicines that doctors use to treat arthritis.

Which is worse -- rheumatoid arthritis or osteoarthritis? ›

The two conditions can cause similar symptoms, but they have different causes and treatments. OA usually affects fewer joints, and its symptoms are generally limited to the joints. The progression of RA is more difficult to predict, and it can cause more widespread symptoms.

How can I tell if I have osteoarthritis or rheumatoid arthritis? ›

The main difference between osteoarthritis and rheumatoid arthritis is the cause behind the joint symptoms. Osteoarthritis is caused by mechanical wear and tear on joints. Rheumatoid arthritis is an autoimmune disease in which the body's own immune system attacks the body's joints.

What does RA pain feel like? ›

A person with RA may feel intense pain in their joints during flares. This may feel like sustained pressure, a burning sensation, or a sharp pain. However, people with RA may also experience periods of remission when they feel few to no symptoms. In addition to causing pain in the joints, RA can affect the whole body.

Is RA caused by stress? ›

Rheumatoid arthritis (RA) is a chronic inflammatory joint condition and an autoimmune disease that can be caused by stress, according to research. Stress triggers rheumatoid arthritis by setting off the immune system's inflammatory response in which cytokines are released.

How do you slow down rheumatoid arthritis? ›

How Can I Slow Down the Progression of Rheumatoid Arthritis?
  1. Quit smoking, cut down on drinking.
  2. Avoid putting strain on the joints.
  3. Develop a light but regular exercise routine.
  4. Follow an anti-inflammatory diet plan.
  5. Maintain a healthy weight.
  6. Get plenty of rest and sleep.
25 May 2021

What is the safest drug for rheumatoid arthritis? ›

Methotrexate is widely regarded as one of the safest of all arthritis drugs, though it carries some potential downsides. Gastrointestinal symptoms such as nausea and vomiting are its most frequent side effects.

What worsens rheumatoid arthritis? ›

Certain foods and additives are believed to increase inflammation in the body, such as sugar, saturated fats, trans fats, omega-6 fatty acids, refined carbohydrates, monosodium glutamate (MSG), gluten, aspartame, and alcohol.

What is a good breakfast for rheumatoid arthritis? ›

Hot and cold cereals are good options. They are quick ways to get a serving of fiber-full whole grains that can help reduce inflammation. While oatmeal may be your go-to grain, there are several nutritious cereals made from corn, brown rice, quinoa, hemp, buckwheat and kamut.

Does RA affect your teeth? ›

In addition to general health complications, RA can cause you to develop serious oral conditions, such as: Gingivitis, a mild form of gum disease that causes swollen and tender gums. Periodontitis, an inflammatory condition affecting the bone and tissue supporting the teeth.

Is CBD oil good for arthritis? ›

One medical study published in Cannabis and Cannabinoid Research found that, of the respondents who used CBD to treat medical conditions (including arthritis and/or joint pain), 36% found it to be effective. CBD may also help reduce inflammation and symptoms of anxiety and PTSD, among other conditions.

What is better for arthritis heat or cold? ›

For an acute injury, such as a pulled muscle or injured tendon, the usual recommendation is to start by applying ice to reduce inflammation and dull pain. Once inflammation has gone down, heat can be used to ease stiffness. For a chronic pain condition, such as osteoarthritis, heat seems to work best.

What do most doctors prescribe for arthritis? ›

Commonly used arthritis medications include:
  • NSAIDs . Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. ...
  • Counterirritants. ...
  • Steroids. ...
  • Disease-modifying antirheumatic drugs (DMARDs).
15 Sept 2021

What can I take instead of methotrexate for RA? ›

In elderly patients with RA who are unable to tolerate methotrexate, the alternatives are hydroxychloroquine or sulfasalazine for mild-to-moderate disease and cyclosporin or leflunomide for severe disease, given in combination with low-dose oral corticosteroids.

Does Voltaren work for RA? ›

Like other NSAIDs, Voltaren (diclofenac) works by reducing inflammation in the body. When taken in oral form, it's used to treat pain related to such forms of arthritis as osteoarthrtis, rheumatoid arthritis, and ankylosing spondylitis. The oral version of this drug is still available only by prescription.

Can you manage rheumatoid arthritis without medication? ›

You'll need to keep up with your usual medical care, but some natural remedies might help relieve pain and stiffness from rheumatoid arthritis (RA). Many of them are simple, like using heat and ice packs. Others, like acupuncture, need a trained pro.

Can I claim PIP for rheumatoid arthritis? ›

Personal Independence Payment (PIP) is one of the benefits most commonly claimed by people with RA. It is not means tested and covers two areas of life commonly affected by RA: daily living and mobility.

Are you allowed to drive with rheumatoid arthritis? ›

Never drive tired, when your joints may naturally be more sore. Try to keep your driving to an hour maximum, and plan rest breaks on long journeys to avoid stiffness. Discuss your medication with your doctor and ensure you're safe to drive when taking it.

What benefits can I claim with rheumatoid arthritis UK? ›

if you're caring for someone with rheumatoid arthritis, you may be entitled to Carer's Allowance.
...
You're also entitled to free prescriptions if you're 60 or over, or if you receive either:
  • Income Support.
  • income-based Jobseeker's Allowance.
  • income-related Employment and Support Allowance.

Can RA give you dementia? ›

Besides, the inflammation associated with RA reduced blood flow to vital body organs, which increases the risk of developing dementia. Additionally, the study revealed that medications used by RA patients increase the risk of developing dementia.

Does RA affect your eyes? ›

Rheumatoid arthritis is a chronic inflammatory disease that primarily affects the joints. However, rheumatoid arthritis occasionally affects other parts of the body — including the eyes. The most common eye-related symptom of rheumatoid arthritis is dryness.

Is rheumatoid arthritis Linked to dementia? ›

RA patients had a 1.2 times higher risk of dementia than controls (adjusted hazard ratio [aHR] 1.19, 95% CI 1.16–1.23). In patients with RA, the aHR for Alzheimer's disease (AD) was 1.21 (95% CI 1.67-1.25) and the aHR for vascular dementia (VD) was 1.10 (95% CI 0.99-1.21).

What medication helps with RA fatigue? ›

Sometimes a medication can both relieve fatigue associated with disease activity and induce fatigue. For example, methotrexate (Rheumatrex, Trexall, Otrexup) is used to help bring active RA under control, leading to a reduction in disease-related fatigue.

Does rest help rheumatoid arthritis? ›

Fatigue, a frequent and often prominent symptom of rheumatoid arthritis, is a guide to therapy. Sufficient rest to prevent fatigue combined with appropriate physical therapy would be expected to improve the treatment of rheumatoid arthritis.

Does RA cause hair loss? ›

People with autoimmune conditions, such as rheumatoid arthritis (RA) and lupus, can experience hair loss as a troubling symptom of their disease. Other times though, the cause of the shedding locks could be the medications used to treat the disease.

What are first signs of rheumatoid arthritis? ›

Signs and symptoms of rheumatoid arthritis may include: Tender, warm, swollen joints. Joint stiffness that is usually worse in the mornings and after inactivity. Fatigue, fever and loss of appetite.

What are the 4 stages of rheumatoid arthritis? ›

The four stages of rheumatoid arthritis are known as synovitis, pannus, fibrous ankylosis, and bony ankylosis.
  • Stage I: Synovitis. During stage I, you may start having mild symptoms, including joint pain and joint stiffness. ...
  • Stage II: Pannus. ...
  • Stage III: Fibrous Ankylosis. ...
  • Stage IV: Bony Ankylosis.
12 Oct 2021

What parts of body does rheumatoid arthritis affect? ›

The joints most often affected by RA are in the hands, wrists, feet, ankles, knees, shoulders, and elbows. Symptoms may include joint pain, stiffness, and swelling; decreased and painful movement; bumps over small joints; and fatigue or fever.

How would you describe rheumatoid arthritis pain? ›

A person with RA may feel intense pain in their joints during flares. This may feel like sustained pressure, a burning sensation, or a sharp pain. However, people with RA may also experience periods of remission when they feel few to no symptoms. In addition to causing pain in the joints, RA can affect the whole body.

What blood test shows rheumatoid arthritis? ›

No blood test can definitively prove or rule out a diagnosis of rheumatoid arthritis, but several tests can show indications of the condition. Some of the main blood tests used include: erythrocyte sedimentation rate (ESR) – which can help assess levels of inflammation in the body.

Where does RA usually start? ›

The most commonly affected areas during the onset of RA are the small joints in your hands and feet. This is where you may first feel stiffness and an ache. It's also possible for RA inflammation to affect your knees and hips.

How do you slow down rheumatoid arthritis? ›

Disease-modifying anti-rheumatic drugs (DMARDs) If you've been diagnosed with rheumatoid arthritis, you'll usually be offered a combination of DMARD tablets as part of your initial treatment. These medicines ease the symptoms of the condition and slow down its progression.

Can you stop rheumatoid arthritis from progressing? ›

Rheumatoid arthritis (RA) is a chronic condition for which there is no cure. But even though the disease is progressive, newer disease-modifying drugs may actually be able to slow or even halt it getting worse.

What is the latest treatment for rheumatoid arthritis? ›

New Treatments for Rheumatoid Arthritis - Latest FDA Approvals
DrugDrug Class
abatacept (Orencia)selective T cell costimulation modulator
adalimumab (Humira)tumor necrosis factor (TNF) blocker
anakinra (Kineret)interleukin-1 receptor antagonist
infliximab (Remicade)tumor necrosis factor (TNF) blocker
12 more rows
11 May 2022

Can you have RA for 20 years and not know it? ›

In a few people with RA -- about 5% to 10% -- the disease starts suddenly, and then they have no symptoms for many years, even decades. Symptoms that come and go. This happens to about 15% of people with rheumatoid arthritis. You may have periods of few or no problems that can last months between flare-ups.

Does RA affect your teeth? ›

In addition to general health complications, RA can cause you to develop serious oral conditions, such as: Gingivitis, a mild form of gum disease that causes swollen and tender gums. Periodontitis, an inflammatory condition affecting the bone and tissue supporting the teeth.

Does rheumatoid arthritis hurt all day? ›

In addition to pain, this disease causes stiffness in the affected joints. You may have difficulty getting out of bed or walking in the morning because of stiff and painful ankles, knees, or feet. This stiffness is usually worse in the mornings and can last for 45 minutes or more.

What does rheumatoid pain feel like? ›

The joint pain associated with rheumatoid arthritis is usually a throbbing and aching pain. It is often worse in the mornings and after a period of inactivity.

What is the safest drug for rheumatoid arthritis? ›

Methotrexate is widely regarded as one of the safest of all arthritis drugs, though it carries some potential downsides. Gastrointestinal symptoms such as nausea and vomiting are its most frequent side effects.

How do doctors test for rheumatoid arthritis? ›

A doctor will use blood tests, X-rays, and ultrasound to determine if you have RA. The blood tests look for high levels of inflammation or specific antibodies present in most people with RA. An abnormal blood test may show: elevated erythrocyte sedimentation rate to confirm inflammation.

How can I tell if I have osteoarthritis or rheumatoid arthritis? ›

The main difference between osteoarthritis and rheumatoid arthritis is the cause behind the joint symptoms. Osteoarthritis is caused by mechanical wear and tear on joints. Rheumatoid arthritis is an autoimmune disease in which the body's own immune system attacks the body's joints.

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