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Rheumatoid Arthritis

Authors:
  • Cynthia M. Johnson, MA
Publication Type:

Condition

Rheumatoid Arthritis

(RA; Arthritis, Rheumatoid)

Definition

Rheumatoid arthritis (RA) is a disorder that results in pain, swelling, stiffness, and loss of function in the joints.

Rheumatoid Arthritis.

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Causes

RA happens when the immune system attacks healthy tissue. It is not clear what makes this happen.

Some causes may be:

  • A specific genetic defect
  • Problems with the immune system may stop immune cells from recognizing the body’s own tissues
  • Infection with specific viruses or bacteria may start an abnormal immune response
  • Chemical or hormonal imbalances in the body

Risk Factors

RA is more common in women. It often starts in people who are between 30 to 60 years of age.

Other things that may raise the risk are:

  • Having other family members with RA
  • Heavy or long-term smoking

Symptoms

Pain and swelling usually happens in smaller joints, such as the hands, wrists, and feet. It affects similar joints on both sides of the body, such as both hands or wrists.

Other problems may be:

  • Pain, stiffness, and swelling in the morning and after inactivity that lasts more than 30 minutes
  • Red, warm joints
  • Deformed, misshapen joints
  • Lack of energy
  • Weight loss
  • Muscle aches
  • Small lumps under the skin

Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done. There are many diseases that have symptoms that are similar to RA. Tests will be done to rule out other health problems.

Blood tests may be done to look for inflammation and blood proteins linked to RA.

X-rays may be taken to look for tissue swelling and changes in bone. The doctor may also order an ultrasound or an MRI scan.

Samples may be taken of fluid and tissues to look for signs of RA. This can be done with:

  • Arthrocentesis—the removal and testing of fluid from a joint
  • Synovial biopsy—the removal and testing of a piece of the lining of a joint

Treatment

There is no cure for RA. The goal is to manage the disease by slowing damage, easing pain, and improving movement. Choices are:

Prevention

There are no guidelines to prevent RA.

Medicine

Medicine can help to stop or slow inflammation that causes damage to the joints. It may change over time and include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and COX-2 inhibitors
  • Disease-modifying anti-rheumatic drugs (DMARDs) that suppress inflammation caused by immune system
  • Corticosteroids (less common)
RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • Aletaha D, Smolen JS. Diagnosis and Management of Rheumatoid Arthritis: A Review. JAMA. 2018 Oct 2;320(13);1360-1372.
  • Fraenkel L, Bathon JM, et al. 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheumatol 2021;73(7):1108-1123 https://doi.org/10.1002/art.41752.
  • Radu A-F, Bungau SG. Management of Rheumatoid Arthritis: An Overview. Cells. 2021; 10(11):2857. https://doi.org/10.3390/cells10112857
  • Rheumatoid arthritis. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/joint-disorders/rheumatoid-arthritis-ra.
  • Rheumatoid arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: niams.nih.gov/health-topics/rheumatoid-arthritis.
  • Rheumatoid arthritis: causes, symptoms, treatments, and more. Arthritis Foundation website. Available at: https://www.arthritis.org/diseases/rheumatoid-arthritis.
  • Rheumatoid arthritis (RA). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/rheumatoid-arthritis-ra.
  • Singh JA, Saag KG, et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheumatol. 2016;68(1):1-26.

Contributors

  • Laura Lei-Rivera, PT, DPT
Last Updated:
2023-06-01

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.