It is important for your overall care and health to be informed about rheumatoid arthritis (RA).
The more you know about RA, the better you can work with your rheumatologist and other care providers to manage it. It is your condition, and you should understand it. Use this information as a stepping stone to have informed and empowered conversations with your doctor to take part in shared decision-making.
Rheumatoid arthritis (RA) is a chronic inflammatory disorder in which the body’s own immune system attacks your own body, including the lining that surrounds the joints. According to the American College of Rheumatology, RA is the most common type of autoimmune arthritis, affecting more than 1.3 million Americans – 75 percent of whom are women. The disease usually strikes first between the ages of 30 and 50. However, RA is not just a joint disease. Inflammation from immune system overactivity can affect many other parts of the body.
Symptoms of RA may be obvious or not, and can sometimes mimic and be mistaken for other conditions, especially in the early stages. The most common symptoms of RA — such as pain, swelling, and tenderness around the joints — tend to come on gradually. While it may take a while to suspect that RA is the cause of your symptoms, recognizing your symptoms is the first step to managing them.
Symptoms of RA can be different for each person, but there are common symptoms that affect nearly all patients. Some are specific to the joints, while others are more systemic. Consider joining ArthritisPower, a patient research registry and symptom tracker that allows you to track your symptoms to discuss with your doctor.
RA symptoms that directly affect the joints:
Symmetry (pain felt in the same joint on both sides of the body)
Red or discolored joints
Joints that feel warm to the touch
Numbness and tingling in hands or feet
Nodules, lumps under the skin near affected joints
Non-joint symptoms of RA:
Low-grade fever and malaise
Difficulty with daily tasks
Dry eyes and mouth
Depression and mood changes
There’s no single cause of rheumatoid arthritis. As with other inflammatory and autoimmune conditions, it’s generally considered to result from a combination of genetic and environmental factors. Here’s a look at some of the most important RA risk factors.
Rheumatoid arthritis can be tricky to diagnose, as there is no single test to diagnose RA. To figure out what’s causing your symptoms and whether you have RA, your doctor will likely consider the areas listed below. The more information you can supply your doctor about your symptoms and medical history, the better.
Your doctor might ask you about the onset of your symptoms, when they get better or worse, if you have other inflammatory conditions, and if there is a family history of relatives with RA or other inflammatory or autoimmune conditions.
Your doctor will be looking for signs of inflammation, tenderness, and limited range of motion in your joints. They may physically feel for tenderness and swelling in certain joints and places around your body.
Your doctor may order various blood tests for a more complete picture of your RA. Some include:
X-rays can help in detecting RA joint damage but may be normal earlier in the disease. MRI or ultrasound scanning can be done to help confirm and/or judge the severity of your RA.
While there is no cure for RA, there are a variety of very effective treatments available to reduce inflammation, relieve symptoms, and help you function better in everyday life. Early treatment for RA is key to avoid permanent joint damage. Many patients will require a combination of medications and may go through a trial and error process to find the right ones for them. Many patients will also need to change their treatment regimen over time.
Here’s a look at how different kinds of RA medications work to help manage your disease:
Nonsteroidal anti-inflammatory (NSAIDs) like ibuprofen (Motrin, Advil) and naproxen sodium (Aleve) can be used for pain relief but don’t prevent joint damage.
DMARDs, or disease-modifying antirheumatic drugs, help stop the underlying disease process driving RA inflammation. The most commonly used DMARD for RA is methotrexate. Other DMARDs you may be prescribed include hydroxychloroquine (Plaquenil), leflunomide (Arava), and sulfasalazine (Azulfidine).
Janus kinase (JAK) inhibitors are known as small molecule medications (oral pills) that work by decreasing the immune system’s ability to make certain enzymes that can lead to RA pain. Common JAK inhibitors include baricitinib (Olumiant), tofacitinib (Xeljanz), and upadacitinib (Rinvoq).
Glucocorticoids (steroids), also called corticosteroids or “steroids,” can be used short-term for relief of pain and/or swelling during RA flares or as a bridge between disease-modifying treatments. Careful conversation with your rheumatologist is recommended to evaluate the risk and benefit of long-term use of glucocorticoids for RA.
TNFi biologics can reduce inflammation and pain by targeting tumor necrosis factor proteins (TNF) is a messenger that signals to your body to turn on inflammation. TNFi biologics include adalimumab (Humira), certolizumab pegol (Cimzia), etanercept (Enbrel), golimumab (Simponi, Simponi Aria), and infliximab (Remicade).
Non-TNFi biologics block other immune system signals that turn on inflammation and pain. For RA, these medications include abatacept (Orencia), rituximab (Rituxan), and sarilumab (Kevzara), tocilizumab (Actemra).
Learn more about all rheumatic disease medications from the American College of Rheumatology
Learn more about rheumatoid arthritis medications from the American College of Rheumatology
Here are some additional articles to help you understand the symptoms, causes, diagnosis, and treatment for rheumatoid arthritis.