What is rheumatoid arthritis?
Rheumatoid arthritis (RA) is a long-term autoimmune condition that causes inflammation in the joints, leading to pain, swelling, stiffness, and potential joint damage. Unlike osteoarthritis, which is caused by wear and tear, RA occurs when the immune system mistakenly attacks the lining of the joints.
RA commonly affects the hands, wrists, and feet, but it can involve any joint and sometimes other parts of the body.
Symptoms
- Pain, swelling, and stiffness in multiple joints
- Morning stiffness lasting more than 30 minutes
- Fatigue and general feeling of being unwell
- Warmth and redness around affected joints
- Flare-ups where symptoms worsen temporarily
Causes and risk factors
- The exact cause is unknown, but it involves an autoimmune response
- Risk factors include:
- Genetics
- Smoking
- Female sex (more common in women)
- Age (often starts between 40 to 60 years old)
Diagnosis
RA is diagnosed through:
- Medical history and physical examination
- Blood tests (e.g. rheumatoid factor, anti-CCP antibodies, ESR, CRP)
- Imaging (X-rays, ultrasound, or MRI) to assess joint condition
Early diagnosis and treatment are crucial to prevent joint damage and disability.
Treatment
There is no cure for RA, but early and effective treatment can control symptoms and prevent joint damage.
1. Medications
- DMARDs (Disease-Modifying Anti-Rheumatic Drugs): e.g. methotrexate
- Biologic therapies: e.g. etanercept (for moderate to severe RA)
- NSAIDs: for pain and inflammation
- Steroids: short-term relief during flare-ups
2. Lifestyle and Self-Management
- Regular exercise to maintain joint flexibility and strength
- Healthy diet and weight management
- Stop Smoking
- Stress management and pacing activities
3. Multidisciplinary support
Depending on your individual needs, none, some or all of the professionals below could be involved in your care:
- MSK Rehabilitation: to improve mobility and strength
- Occupational therapy: to support daily activities
- Podiatry: for foot care
- Clinical nurse specialists: for ongoing support and education
When to seek medical advice
Contact your GP or rheumatology team if:
- You experience new or worsening joint pain or swelling
- You have side effects from medication
- You notice signs of infection (especially if on immunosuppressive treatment)
Outlook
With early diagnosis and modern treatments, many people with RA can lead active, fulfilling lives. Ongoing monitoring and lifestyle changes are key to managing the condition effectively.