Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the joints but can also impact other organs and systems in the body. Unlike osteoarthritis, which is caused by wear and tear, RA results from an overactive immune system attacking healthy tissues, particularly the synovium—the lining of the joints.

Rheumatoid arthritis is more than just joint pain—it is a systemic condition that can significantly reduce quality of life if not properly managed. This comprehensive guide explains what rheumatoid arthritis is, how it develops, what symptoms to look for, and how it can be diagnosed and treated.

What is Rheumatoid Arthritis?

Rheumatoid arthritis is an autoimmune and inflammatory disease where the immune system mistakenly attacks the body’s tissues, especially the synovial membrane that lines the joints. This results in chronic inflammation, leading to swelling, pain, and joint deformity over time.

RA commonly affects the hands, wrists, knees, and feet, and it usually occurs symmetrically, meaning the same joints on both sides of the body are affected. Over time, the inflammation can lead to joint erosion, cartilage destruction, and loss of function.

How Common is Rheumatoid Arthritis?

• Affects about 1% of the global population.

• Women are 2 to 3 times more likely to develop RA than men.

• Typically begins between ages 30 to 60, but can occur at any age.

Causes of Rheumatoid Arthritis

The exact cause of RA is unknown, but several factors may contribute to its onset:

1. Genetics

Certain genes like HLA-DR4 are linked to a higher risk of RA. However, not everyone with these genes will develop the disease.

2. Environmental Triggers

• Smoking

• Infections (viral or bacterial)

• Air pollution
  These may trigger autoimmune activity in genetically susceptible individuals.

3. Hormones

The higher prevalence in women suggests a role for estrogen and other hormones.

4. Immune Dysfunction

In RA, the immune system mistakenly attacks healthy tissues, causing chronic inflammation.

Symptoms of Rheumatoid Arthritis

Rheumatoid arthritis symptoms often begin gradually and may vary in severity. Common signs and symptoms include:

🔸 Joint Symptoms

• Pain in joints (especially small joints in hands and feet)

• Swelling and warmth

• Stiffness, especially in the morning or after inactivity

• Redness

• Reduced range of motion

• Joint deformities (in advanced cases)

🔸 Systemic Symptoms

• Fatigue

• Low-grade fever

• Loss of appetite

• Weight loss

• Anemia

🔸 Extra-Articular Manifestations (outside the joints)

• Rheumatoid nodules (firm lumps under the skin)

• Lung involvement (e.g., interstitial lung disease)

• Heart problems

• Dry eyes and mouth (Sjögren’s syndrome)

• Skin vasculitis

• Neuropathy

Early Signs to Watch Out For

• Morning stiffness lasting more than 30 minutes

• Swollen joints on both sides of the body

• General feeling of malaise and tiredness

• Persistent joint discomfort without obvious injury

Diagnosis of Rheumatoid Arthritis

Diagnosing RA involves a combination of physical exams, lab tests, and imaging studies.

1. Medical History & Physical Exam

• Symmetrical joint swelling

• Duration of symptoms (typically >6 weeks)

• Presence of nodules or deformities

2. Blood Tests

• Rheumatoid factor (RF) – Present in 70–80% of RA patients

• Anti-CCP antibodies – More specific than RF

• ESR (Erythrocyte Sedimentation Rate) – Indicates inflammation

• CRP (C-reactive protein) – Elevated in active inflammation

• Complete blood count (CBC) – May show anemia

3. Imaging Studies

• X-rays – Show joint damage or erosion

• Ultrasound or MRI – Detect inflammation earlier than X-rays

4. Classification Criteria

The American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) use a scoring system to classify RA based on symptoms, serology, duration, and joint involvement.

Stages of Rheumatoid Arthritis

RA progresses through four stages:

1. Stage 1 – Early RA

• Joint swelling and pain without visible damage

• Fatigue may start

2. Stage 2 – Moderate RA

• Inflammation damages cartilage

• Restricted movement starts

3. Stage 3 – Severe RA

• Bone erosion, cartilage damage

• Joint deformities develop

4. Stage 4 – End-Stage RA

• Joints no longer function

• Severe pain and loss of mobility

Treatment of Rheumatoid Arthritis

While there is no cure for RA, early and aggressive treatment can slow or even halt disease progression.

1. Medications

A. Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

• Methotrexate (first-line)

• Leflunomide

• Sulfasalazine

• Hydroxychloroquine

These drugs suppress the immune response and slow disease progression.

B. Biologic DMARDs

Target specific parts of the immune system.

• TNF inhibitors: Adalimumab, Etanercept

• IL-6 inhibitors: Tocilizumab

• B-cell depleters: Rituximab

C. Janus Kinase (JAK) Inhibitors

• Tofacitinib, Baricitinib – oral immunomodulators

D. NSAIDs and Corticosteroids

• Help control pain and inflammation but do not alter disease progression.

2. Non-Medication Therapies

A. Physical Therapy

Improves joint flexibility and muscle strength.

B. Occupational Therapy

Helps patients adapt to daily activities and prevent strain on joints.

C. Surgery

May be required in severe cases:

• Joint replacement

• Tendon repair

• Joint fusion

Lifestyle and Home Remedies

Living with RA requires active self-management. Here are key lifestyle strategies:

✅ Diet and Nutrition

• Anti-inflammatory diet: Omega-3s, fruits, veggies, whole grains

• Avoid: Processed foods, red meat, sugar

✅ Exercise

• Low-impact workouts: Walking, swimming, yoga

• Helps reduce stiffness and maintain joint function

✅ Stress Management

• Meditation, breathing exercises, therapy

• Reduces flare-up frequency

✅ Weight Management

• Excess weight stresses joints and worsens symptoms

✅ Joint Protection

• Use assistive devices

• Avoid repetitive strain

• Alternate activity with rest

Complications of Rheumatoid Arthritis

Without treatment, RA can lead to:

• Permanent joint deformity

• Disability

• Cardiovascular disease

• Lung problems

• Osteoporosis

• Eye inflammation

• Infections (from immunosuppressive therapy)

Rheumatoid Arthritis vs. Osteoarthritis

Living with Rheumatoid Arthritis

Rheumatoid arthritis is a lifelong condition, but many people live full, active lives by following treatment protocols and lifestyle changes. Regular follow-ups with a rheumatologist, blood tests, and imaging studies are crucial for monitoring disease activity and treatment efficacy.

Tools for Managing RA:

• Symptom trackers

• Mobile apps

• Pain journals

• Support groups

FAQs about Rheumatoid Arthritis

❓ Is rheumatoid arthritis curable?

No, but it is manageable with medications and lifestyle adjustments.

❓ Can RA affect organs?

Yes—lungs, heart, eyes, and skin can be involved in systemic RA.

❓ Does RA go into remission?

Yes. Many patients experience remission with early treatment.

❓ Can diet help with RA?

Yes, an anti-inflammatory diet can support symptom relief.

❓ What happens if RA is left untreated?

Uncontrolled RA can cause irreversible joint damage, disability, and organ complications.

When to See a Doctor

Consult a healthcare provider if you notice:

• Persistent joint pain or swelling

• Morning stiffness lasting more than 30 minutes

• Fatigue or unexplained weight loss

• Symmetrical joint symptoms

Early diagnosis and intervention can prevent joint damage and improve quality of life.

Rheumatoid arthritis is a complex autoimmune disease that impacts more than just your joints. While there is no cure, advances in treatment have made it possible to live a full life with RA. A combination of medications, physical therapy, dietary changes, and supportive care can significantly slow disease progression and relieve symptoms.

If you suspect RA or are struggling with chronic joint pain, early medical attention is key. Don’t wait—consult a rheumatologist and take control of your health today.

The Sparsh Department of Rheumatology specializes in providing comprehensive diagnosis and treatment for various kinds of musculoskeletal diseases and systemic autoimmune conditions. Call our helpline number 9830117733 to make an appointment now.

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Disclaimer:

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.