Rheumatoid Arthritis
Sources consulted
This article is original patient-education content.
- NICE—Rheumatoid arthritis. NG100(2023)
- NHS—Rheumatoid arthritis(2023)
- WHO—Rheumatoid arthritis(2023)
- ACR—American College of Rheumatology guidelines(2021)
Based on international clinical guidelines
Overview
Rheumatoid arthritis is a long-term condition where the immune system mistakenly attacks the joints, causing pain, swelling, and stiffness. It is an autoimmune disease, meaning the body's defence system turns against itself.
Key facts
- Rheumatoid arthritis mainly affects joints on both sides of the body, like the hands, wrists, and feet.
- It can also affect other parts of the body, such as the skin, eyes, and lungs.
- Early diagnosis and treatment can help manage symptoms and reduce joint damage.
Rheumatoid arthritis affects about 1 in every 100 people worldwide. It is one of the most common autoimmune diseases.
Rheumatoid arthritis can start at any age, but it most often begins between the ages of 40 and 60. It is two to three times more common in women than in men. It can also affect children and older adults.
Symptoms
- Sudden, severe chest pain or difficulty breathing (could be a sign of a heart attack or lung inflammation).
- Sudden vision changes or eye pain.
- Signs of a stroke, such as sudden numbness, weakness on one side of the body, or trouble speaking.
- ⚠A very high fever (over 38°C) that does not go down with paracetamol.
- ⚠Severe joint pain that makes it impossible to move the joint.
- ⚠New or worsening shortness of breath.
- ⚠Sudden, severe headache or stiff neck.
Common symptoms
- Pain and swelling in the joints, especially in the hands, wrists, and feet.
- Stiffness in the morning that lasts for more than 30 minutes.
- Tiredness (fatigue) that does not get better with rest.
- Warmth and redness around the joints.
- Difficulty moving joints, especially after rest.
Symptoms in children
- Pain and swelling in larger joints, like the knees, ankles, and elbows.
- High fever that comes and goes, often with a rash.
- Growing pains that are worse in the morning.
- Limping or avoiding using a limb.
Symptoms in older adults
- Joint pain and stiffness that may be less severe than in younger people.
- More general symptoms, such as weight loss, low-grade fever, and feeling unwell.
- Difficulty with daily activities due to stiffness and pain.
Causes
Main causes
- The immune system attacks the lining of the joints, causing inflammation and pain.
- It is not fully understood why this happens, but it is likely a combination of genes and environmental triggers.
Risk factors
- Having a family history of rheumatoid arthritis or other autoimmune diseases.
- Being a woman (the condition is more common in women).
- Smoking cigarettes, which is a major trigger.
- Having certain infections, such as the Epstein-Barr virus, may increase risk.
When to see a doctor
See a doctor urgently if:
- If you have sudden, severe joint pain and swelling that does not improve with rest or over-the-counter pain relievers (like ibuprofen).
- If you have a fever along with joint pain and swelling.
Book a routine appointment if:
- If you have joint pain and stiffness that lasts for more than a few weeks, especially if it is worse in the morning.
- If you feel very tired and have joint pain without a clear reason.
Diagnosis
Doctors diagnose rheumatoid arthritis based on your symptoms, a physical exam, and tests that check for inflammation and antibodies. They may also use imaging scans to look at joint damage.
Tests that may be done
- Blood tests for rheumatoid factor (RF) and anti-CCP antibodies.
- Blood tests to check for inflammation, like CRP (C-reactive protein) and ESR (erythrocyte sedimentation rate).
- X-rays, ultrasound, or MRI scans to see joint damage.
What to expect at your appointment
Your doctor will ask about your symptoms and family history. They will examine your joints for swelling, warmth, and tenderness. You may have to get blood drawn and possibly have an imaging test. The process can take a few visits, but it is important to get a clear diagnosis.
Treatment
Treatment aims to reduce pain and inflammation, prevent joint damage, and improve quality of life. It usually includes a combination of medications, physical therapy, and lifestyle changes.
Self-care at home
- Rest your joints when they are painful or swollen.
- Apply heat (like a warm towel) to loosen stiff joints, or cold packs to reduce swelling.
- Do gentle exercises, such as stretching or swimming, to keep joints moving.
- Use assistive devices like jar openers or button hooks to make daily tasks easier.
Medical treatments
Doctors may prescribe disease-modifying anti-rheumatic drugs (DMARDs) to slow disease progression. They may also use biologics, which are targeted treatments given by injection or infusion. Non-steroidal anti-inflammatory drugs (NSAIDs) and steroids can help with pain and swelling but are usually used for short periods. Always follow your doctor's advice and do not stop medications without talking to them.
When is surgery considered?
If joint damage is severe and other treatments have not helped, surgery such as joint replacement (for example, hip or knee) or joint fusion may be considered. Your doctor will discuss the options if needed.
Living with this condition
Living with rheumatoid arthritis means managing ups and downs. Some days you may feel good, and other days you may have more pain. It helps to pace yourself: balance rest and activity, and ask for help when you need it.
Lifestyle tips
- Get enough sleep and rest to fight fatigue.
- Stop smoking – it can make the disease worse.
- Learn stress management techniques like deep breathing or mindfulness.
- Stay active with low-impact exercises like walking, swimming, or cycling.
Diet and exercise
No special diet cures rheumatoid arthritis, but eating a balanced diet rich in fruits, vegetables, whole grains, and healthy fats can help reduce inflammation. Some people find that avoiding certain foods (like red meat or processed foods) helps. Regular exercise, especially water-based activities, can improve joint flexibility and strength without putting too much stress on joints.
Mental health and emotional wellbeing
Living with chronic pain can be emotionally challenging. It is common to feel frustrated, sad, or anxious. If you are struggling, talk to your doctor or a mental health professional. You are not alone, and support is available.
Prevention
Rheumatoid arthritis cannot be prevented completely, but you can reduce your risk by not smoking and by having a healthy lifestyle. If you have early symptoms, getting treatment quickly can help prevent joint damage.
Vaccines
There are no vaccines to prevent rheumatoid arthritis, but staying up to date with recommended vaccines (like for flu and pneumonia) is important because the disease and some treatments can increase infection risk.
Screening programmes
There is no routine screening for rheumatoid arthritis in the general population. If you have a family history or symptoms, talk to your doctor.
Complications
If left untreated
- Permanent joint damage and deformity.
- Increased risk of heart disease and stroke.
- Lung inflammation or scarring (pulmonary fibrosis).
- Eye inflammation that can affect vision.
- Osteoporosis (weak bones) due to inflammation and steroid use.
Long-term outlook
With early and effective treatment, most people with rheumatoid arthritis can lead active lives. Treatment has improved greatly in recent years, and many people achieve remission (few or no symptoms). It is important to work with your healthcare team and stay positive. While there is no cure, you can manage the condition well.
Find support
International organisations
Local organisations
- Versus Arthritis (UK) ↗ · United Kingdom
- Arthritis Society (Canada) ↗ · Canada
Helplines
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.