Get to Know Rheumatoid Arthritis

Medically reviewed in June 2019

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Rheumatoid arthritis (RA) is an autoimmune disease that causes pain, swelling and stiffness in the joints. While RA can attack joints throughout the body, it is most common in the hands, wrists, elbows, feet, ankles and knees. Left untreated, it can damage cartilage and bones, causing joints to become damaged or misshapen. Since joint damage cannot be reversed, it’s important to get diagnosed and treated as soon as you notice the first signs and symptoms of the disease.

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Who Has RA?

According to the Arthritis Foundation, 1.5 million Americans are currently living with rheumatoid arthritis. The disease is two to three times more common in women than in men. It often begins in women between ages 30 and 60, whereas men are more likely to be diagnosed later in life. Teenagers and young adults also can develop RA.

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Are You at Risk?

While scientists cannot pinpoint an exact cause of the disease, there are some genetic, environmental and hormonal factors that may increase RA risk.

Family History. Genetics may predispose you to the disease, but most people diagnosed with RA have no family history of it.

Environment. Many experts believe that some infections or environmental factors may trigger the disease. Several factors have been studied—Epstein-Barr virus, smoking, stress and insecticides are a few—but none have yet been confirmed.

Hormonal. Contraceptives have been linked to an increased risk of the disease, and breastfeeding and giving birth may trigger flare-ups.

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Rheumatoid Arthritis Symptoms

Symptoms include joint pain, tenderness and stiffness. The stiffness may last 30 minutes or longer after you wake up or sit for a long time. The joints may be warm, red and swollen. People may also have other symptoms, such as fatigue, a low-grade fever and weight loss.

Rheumatoid arthritis usually affects the smaller joints first, and spreads to larger ones as it progresses. For example, the disease may start in the fingers and wrists, then spread to the elbows and shoulders. In most cases, symptoms occur in the same joints on both sides of your body.

RA symptoms vary in intensity and may come and go, but flare-ups can last for days or even months. 

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Complications of RA

Some people with RA experience complications in places other than their joints, such as:

Osteoporosis. RA and steroids can up the risk of osteoporosis, a condition where bones are more fragile and prone to breaks.

Anemia. RA inflammation, as well as some RA meds, may cause anemia, a decrease in red blood cell count.

Other complications include neck pain, dry eyes and mouth, as well as inflammation of the blood vessels, the lining of the lungs or the sac around the heart. Your best defense against RA complications is to get early treatment. 

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Getting a Diagnosis

Researchers believe that RA causes bone damage as early as the first or second year of the disease, which is why early diagnosis is important. If you’re experiencing signs and symptoms of RA, your primary care physician may refer you to a rheumatologist. He or she will take your medical history and examine your joints, looking out for tenderness, redness, swelling and painful or limited movement. Blood tests alone cannot diagnose RA, but they can measure inflammation levels and look for certain markers linked to the disease. Your doctor may also order imaging tests such as an X-ray, ultrasound or magnetic resonance imaging scan to check for joint damage and track the progress of the disease.

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Treating Rheumatoid Arthritis

There is no cure for RA, so the goal of treatment is to relieve symptoms, decrease inflammation and prevent further joint damage. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may ease pain and inflammation. Doctors sometimes prescribe short-term use of low-dose corticosteroids to reduce inflammation quickly. Disease-modifying antirheumatic drugs (DMARDS) are an important part of treatment, because they slow the course of the disease. However, if RA has caused permanent damage, your doctor may suggest joint replacement surgery.

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Living with Rheumatoid Arthritis

Rheumatoid arthritis isn’t just about chronic pain. Sufferers know that RA can affect every aspect of their lives, causing depression, anxiety, feelings of helplessness and low self-esteem. Take care of your RA through:

Exercise. A little movement can soothe sore joints and boost energy levels. Try these moves.

Thermotherapy. Docs recommend cold packs to treat acute RA flare-ups and heat to ease stiffness. Here are 8 more ways to relieve pain. 

Diet. Some foods may reduce inflammation and improve RA symptoms. Try these diet do’s and don’ts.  

Friends. Surround yourself with loved ones to help keep your mind off the pain and help you with daily activities.

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