Rheumatoid arthritis

Rheumatoid arthritis, also called RA, is a common inflammatory form of arthritis that causes painful, stiff, and swollen joints. The immune system usually protects the body from infection and damage. In rheumatoid arthritis, your immune system attacks healthy tissue by mistake, causing inflammation and joint damage. Rheumatoid arthritis is an autoimmune disease, so can also affect other parts of the body not just your joints.

Symptoms are often symmetrical (on both sides of the body), usually starting with hands and feet, then neck and knees. Symptoms vary and can come and go but often include: 

• Joint pain  
• Joint swelling  
• Stiffness  
• Fatigue  
• Feeling low  
• Depression

Your doctor will ask you questions about your symptoms and then physically examine the areas of painful joints. For rheumatoid arthritis they will usually do blood tests. They may also do an X-ray or other imaging. If your doctor suspects rheumatoid arthritis you should be referred to a rheumatologist.

The pain and unpredictable nature of rheumatoid arthritis can be hard on you mentally and emotionally. It is natural to feel scared, sad and angry. Acknowledging your feelings and seeking support early is important for your health and wellbeing. 

Lifestyle choices are an important part of managing symptoms, improving wellbeing and reducing flares, including: 

• Exercise to prevent muscle weakness and fatigue
• Joint protection: to reduce the risk of damaging a joint
• Manage fatigue: do the most important tasks first, plan a rest during the day
• Relaxation, stress, and sleep management
• Eat a healthy, balanced diet by choosing lots of fruits, vegetables, and fish, especially oily fish like tuna or salmon. Try and fill half your plate with vegetables before adding your protein and carbs
• Quit smoking: smoking is a known trigger for RA, smoking can impact how some arthritis medicines work, smoking increases the risk of many other diseases
• Seek support from family, friends, your health team, and support groups

Be prepared for your specialist appointments so you gain the most benefit from seeing the rheumatologist. Write down any questions you have. Here are some to start with:

• How long will the medication take to work?
• How do I know if it is working?
• What are the side effects?
• Are there any ongoing blood tests required?
• What do I do if I have a flare-up?

• Rheumatoid arthritis affects women three times more often than men
• Most commonly starts between the ages of 25 to 50 years

Your GP or rheumatologist will usually suggest medications to help you. These might include pain relief (like anti-inflammatory medications) and disease-modifying anti-rheumatic drugs (DMARDs). The DMARDs slow the progression of your rheumatoid arthritis. Depending on how your body responds to these medications, there might be a few changes of DMARDs and potentially a biological medicine. Biologics copy some of the naturally occurring chemicals in your body to try and reduce the amount of inflammation you have.

• Rheumatoid arthritis is an autoimmune disease where your own immune system starts to attack your joints and sometimes other body parts like skin or eyes. The sooner you are diagnosed and started on the correct medicines, the better your chances of reducing the damage being done to your body by this disease
• Make sure you are prepared before going for your specialist appointments. Write down any questions or concerns you have before you go to your appointment
• Exercise will strengthen your muscles to protect your joints
• Diet and lifestyle can make a huge difference to how you feel and how much you can achieve in your day

Clinically reviewed in 2024.