Rheumatoid arthritis (RA) is a long-term condition in which the body’s immune system mistakenly attacks the joints. This causes swelling, pain, stiffness and joint damage over time.

Overview

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is a long-term condition in which the body’s immune system mistakenly attacks the joints. This causes swelling, pain, stiffness and joint damage over time.

RA is different from ‘wear-and-tear’ arthritis (osteoarthritis). It is an inflammatory disease, meaning the body’s defence system causes ongoing inflammation inside the joints.

Why is it important?

RA can interfere with daily activities such as walking, dressing, writing, cooking or opening jars. If not treated early, it may lead to permanent joint damage and disability. Early diagnosis and proper treatment can help control symptoms, reduce joint damage and improve quality of life.

Who is commonly affected?

• RA can affect people of any age
• It most commonly begins between 30 and 60 years of age
• Women are affected more often than men
• People with a family history of RA or other autoimmune diseases have a higher risk
• Certain lifestyle and health factors may increase risk, including:
• Smoking
• Obesity
• Certain infections

Causes/Why it Happens

The exact cause of RA is not fully understood. Doctors believe it happens because of a combination of factors.

Not everyone with these risk factors develops RA, and some people develop RA without any known cause.

Signs and Symptoms

Common Symptoms

• Joint pain
• Swelling in joints
• Morning stiffness lasting more than 30 minutes
• Warm or tender joints
• Tiredness or low energy
• Mild fever
• Loss of appetite

Warning Signs

Seek medical advice if you notice:

• Persistent joint swelling
• Difficulty moving joints
• Severe morning stiffness
• Unexplained fatigue
• Symptoms lasting for several weeks
• Trouble performing daily activities

RA usually affects the same joints on both sides of the body. For example, both wrists or both knees may be affected. Early treatment can help prevent joint damage.

Diagnosis and Investigations

Clinical Evaluation

A doctor will ask about symptoms, medical history, family history and daily difficulties caused by joint pain.

Tests

There is no single test for RA. Doctors may use a combination of blood tests and imaging tests.

Treatment Options

Treatment aims to:

• Reduce pain and swelling
• Prevent joint damage
• Improve movement
• Help patients stay active and independent

Medications

• Pain relief: Paracetamol or anti-inflammatory medicines help manage pain and swelling
• Disease-modifying medicines: These slow joint damage and control the disease. Examples include Methotrexate, Sulfasalazine and Hydroxychloroquine
• Biologics: Advanced treatments used if standard medicines are not effective

Doctors will regularly monitor your response to treatment and check for any side effects.

Lifestyle changes

Healthy habits can help manage RA symptoms.

Non-surgical options

• Physiotherapy: Physiotherapists can teach exercises that improve movement and reduce stiffness
• Occupational therapy: Occupational therapists can suggest ways to protect joints during daily activities
• Joint supports: Braces, splints or supportive footwear may help reduce strain on joints
• Hot and cold therapy: Warm packs may relax stiff joints, while cold packs may reduce swelling

When is a procedure or surgery needed?

Surgery may be considered if:

• Severe joint damage develops
• Pain becomes difficult to control
• Movement becomes very limited

Procedures may include:

• Joint repair
• Tendon repair
• Joint replacement surgery

Not all patients need surgery. Many people do well with medicines and lifestyle changes.

Myths and Facts

Frequently Asked Questions (FAQs)