Rheumatoid Arthritis: Risk Factors, Causes, Symptoms and Treatment

Rheumatoid arthritis (RA) is a form of arthritis that causes pain, swelling and stiffness in the joints. It is an autoimmune disease: the immune system can attack the tissue of any joint, though the wrists and fingers are most common. The inflammation (swelling) that comes with it can also cause problems in the eyes, skin, heart, nerves, blood or lungs.

RA is different from osteoarthritis, a common arthritis that often comes with age. RA affects the lining of the joints and damages the tissue covering the ends of the bones, which over time can make joints work less well. There is no cure, but early treatment can help manage symptoms, limit joint damage and allow a productive life.

Who is more likely to get it

RA can start at any age, but the risk rises as you get older. It is also higher if:

• you are a woman — women get RA more often than men;
• someone in your family has RA;
• you smoke — long-term smoking raises both the risk and how severe the disease can be;
• you have other conditions that may raise the risk, such as obesity, gum disease or lung disease.

Causes

No one knows what causes RA. Factors that may play a part include:

• genes — certain genes may raise the risk, though not everyone who has them gets RA;
• the environment — things such as cigarette smoke sometimes trigger symptoms;
• hormones — researchers think sex hormones may play a role, since women are more likely to get RA and symptoms can change during and after pregnancy.

Symptoms

The immune system may begin attacking the joints years before symptoms appear, and RA varies from person to person: it may last only a short time, come and go, or, in its severe form, be lifelong. Symptoms can include:

• joint pain or stiffness when moving, usually worse in the morning or after inactivity;
• the same joints affected on both sides — if one hand or knee is involved, so is the other;
• tender, red, warm joints;
• swelling that makes everyday tasks like combing hair, buttoning clothes or bending the knees hard;
• fatigue, fever and loss of appetite;
• hard bumps under the skin near the joints, called rheumatoid nodules.

Diagnosis

There is no single test for RA, and because it develops gradually, with few symptoms at first, it can be hard to diagnose early. Your provider may:

• ask about your medical history and symptoms, and whether relatives have had RA;
• examine you, checking your joints, looking for rashes or nodules and listening to your chest for signs of lung inflammation;
• order blood tests or imaging such as x-rays or ultrasound to rule out other conditions that can look similar;
• refer you to a rheumatologist, a doctor who specializes in arthritis.

Treatment and self-care

Early treatment can keep symptoms from worsening and protect the joints. Treatment can combine medicine, lifestyle changes and surgery, which may slow or stop joint damage and ease pain and swelling, and it may change as symptoms change. You can also help manage RA by:

• staying physically active;
• keeping a healthy weight;
• avoiding joint injuries and repetitive motions, such as bending the knee over and over;
• quitting smoking, or never starting.

Sources

Based on "Rheumatoid Arthritis", MedlinePlus, U.S. National Library of Medicine, drawing on the National Institute of Arthritis and Musculoskeletal and Skin Diseases; a work of the United States government in the public domain.