What Is Rheumatoid Arthritis (RA)?

Rheumatoid arthritis (RA) is a chronic (long-term) disease characterized by inflammation, joint pain, stiffness, and swelling. RA is only one of over one hundred different types of arthritis. All types of arthritis cause joint pain, but they have different causes and treatments.1

What causes RA?

Inflammation and joint damage in RA are caused by an immune system response. Inflammation can be a good sign that our immune system is fighting invasion by things that may be harmful to our bodies. However, in RA, joint inflammation and damage happen when our immune system attacks healthy tissue. This immune system reaction makes rheumatoid arthritis an autoimmune disease.2

RA affects a type of joint called synovial joints. Synovial joints connect bones that are highly mobile (move a lot). Joints typically affected by RA include but are not limited to:3

Who gets RA?

Women are 3 times more likely than men to develop RA. RA can begin at any age, but it develops more often as you age. Children can develop a type of arthritis known as juvenile idiopathic arthritis (JIA). Smoking and obesity also increase the risk for developing RA.1

Diagnosis

Medical history, physical exams, imaging, and blood tests are used to diagnose RA. Your doctor will likely use a blood test to look for high levels of the antibodies rheumatoid factor (RF) and anti-cyclic citrullinated peptides (anti-CCP). Antibodies are proteins the immune system makes to fight foreign substances like infections. However, not everyone with RA will have high levels of RF or anti-CCP.2

Your doctor may also use an imaging test like an X-ray, ultrasound, or MRI. RA can cause the ends of your bones that face a joint to wear down, causing erosions. Your doctor will be able to see this wear from an imaging test. Diagnosing RA early can be important in treating it.2

Treatment

The goal of treating RA is to reduce inflammation, improve symptoms, and prevent joint and organ damage. Catching RA early and proper treatment may reduce the risk of long-term complications.2

RA is usually treated with drugs and self-management strategies. RA drugs may include a traditional disease-modifying anti-rheumatic drug (DMARD). The most common traditional DMARD is methotrexate. This drug was first used as a cancer-fighting drug but is now a first-line treatment for RA.3

Biologic DMARDs (commonly knowns as biologics) are drugs made from living cells. These cells can come from parts of the blood, proteins, viruses, or tissue. This process turns the cells into drugs that can prevent, treat, and cure disease. DMARDs can help to slow or prevent joint damage and provide relief from many of the symptoms of RA.1

Self-management strategies are steps people can take to manage their RA. These may include:1

  • Staying active, if possible
  • Managing your weight
  • Stopping smoking
  • Regularly visiting your doctor

Symptoms and complications

RA can have different symptoms or complications depending on which parts of the body are affected. RA can cause swollen, stiff, and painful joints, which can make it difficult to move. RA also may damage bones, muscles, and tendons. People with RA may feel very tired or have low fevers.4

Serious RA complications are usually caused by inflammation in organs like the lungs or heart. Inflammation in the lungs can cause shortness of breath or lung disease.2

People with RA are also at high risk for developing heart disease. This is caused by several factors:1

  • Inflammation from RA can damage the heart.
  • People with RA are at risk for gaining weight because movement and exercise can be painful. Weight gain can increase the risk of heart disease.

RA symptoms may come and go but are very unpredictable. Sometimes people have a lot of symptoms and inflammation at once. This is called a flare. A flare can last a few days or even months.2

RA can be a daunting diagnosis. However, advancements in medicine have created more options for treatment. Managing RA with drugs and healthy choices is key in reducing complications and improving quality of life.5

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Written by: Juliette Daily │Last reviewed: April 2021