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Rheumatoid arthritis (RA) is a chronic, or long-lasting, inflammatory autoimmune condition in which the body’s immune system attacks the joints. This causes symptoms like joint pain, swelling, and sometimes deformity. Although there’s currently no cure for RA, treatments can help manage symptoms and slow disease progression.
Rheumatoid arthritis is an autoimmune disorder where the immune system mistakenly attacks the joints in the same way that the immune system would normally fight viruses or bacteria. RA most often affects the hands, feet, wrists, elbows, ankles, and knees.
A key feature of RA is that it usually impacts joints symmetrically — damage tends to happen on both sides of the body. For example, if one knee is affected, the other often is too.
The exact cause of RA is unknown, but scientists believe it comes from a mix of both hereditary and environmental risk factors. Some of the environmental factors that increase the risk of RA include cigarette smoking and obesity. Read more about the causes of RA.
Rheumatoid arthritis symptoms can ease for a while and then worsen suddenly, known as flares. Common triggers of flares include:
Evidence of rheumatoid arthritis is believed to go back thousands of years. As early as 1500 B.C.E., a disease similar to RA was described in the Ebers Papyrus, an ancient Egyptian scroll that listed information about medical herbs. Possible evidence of RA has also been found in Indian Ayuverdic texts dating as far back as 300 B.C.E. and even in early paintings.
The Greek doctor Galen used the word “rheumatismus,” which means “to suffer from a flux,” in the second century C.E. In 1819, English surgeon Sir Benjamin Collins Brodie described how RA affects the joints and tendons, noting how the disease worsens over time. The term “rheumatoid arthritis” was first used by British physician Dr. Alfred Baring Garrod in 1858.
At first, scientists thought RA was caused by an infection, and they tried treatments such as gold and sulfasalazine. Over time, scientists learned that RA is an autoimmune condition, and treatment evolved from the use of aspirin and corticosteroids to disease-modifying antirheumatic drugs (DMARDs) like methotrexate in the mid-20th century. In the late 1990s, targeted biologic therapies were introduced, targeting specific inflammatory molecules and revolutionizing RA management. Today, new DMARDs continue to be developed.
Rheumatoid arthritis is the most common type of inflammatory arthritis, affecting more than 1.5 million people in the U.S. Rheumatoid arthritis is about three times more common in women than men, according to the Arthritis Foundation, and usually develops between the ages of 30 and 60.
Rheumatoid arthritis affects each person a little differently. Symptoms depend on the stage of the condition and can come and go at any time. The condition mostly affects the joints, usually on both sides of the body. Symptoms are often worse during flares and may improve during periods of remission.
The most common symptoms of RA include:
Many people with RA also experience weight loss and depression, which is common in people living with chronic illness. Read more about rheumatoid arthritis symptoms.
As part of the evaluation for rheumatoid arthritis, doctors use blood tests to check for levels of inflammation, rheumatoid factor, and anti-cyclic citrullinated peptide (anti-CCP) antibodies.
Around 60 percent to 80 percent of people diagnosed with RA test positive for anti-CCP antibodies — antibodies (proteins made by the immune system) that attack the joints.
If you test positive for anti-CCP, it’s called seropositive RA. If you test negative, it’s called seronegative RA, which is sometimes milder.
Your blood may also be tested for rheumatoid factor, another autoantibody. Rheumatoid factor can also be found in people with other conditions, so it’s less useful as a test to diagnose RA. High levels of C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) in the blood mean there is inflammation in the body. This may support a diagnosis of RA or another autoimmune condition, such as psoriatic arthritis.
If the doctor thinks you might have RA, they may perform a physical exam to check for synovitis (joint inflammation) and rheumatoid nodules (firm lumps under the skin), as well as order X-rays to assess joint damage.
When children are diagnosed with RA, it’s called juvenile RA or juvenile idiopathic arthritis.
Read more about the types of RA.
Rheumatoid arthritis is usually diagnosed and treated by a rheumatologist. RA can also be treated by an internal medicine specialist.
The main goals of RA treatment are to calm inflammation, reduce autoimmune attacks on the joints, and ease symptoms (such as pain and swelling). Some RA treatment options are taken by mouth, while others are given by injection.
Mild joint pain and swelling may be relieved with over-the-counter treatments such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen. Steroids may also be used for joint pain and inflammation.
There are several classes of disease-modifying antirheumatic drugs (DMARDs) prescribed for RA that can help reduce disease activity and prevent damage. If RA has badly damaged your joints, surgery, such as joint replacement, may help you move again. Occupational or physical therapy can help with mobility, strength, and daily activities.
Read more about rheumatoid arthritis treatments.
There isn’t one specific diet that works for everyone with RA. Still, a healthy diet that focuses on anti-inflammatory foods can support a balanced weight, lower the risk of heart disease (which is higher in people with RA), and help fight inflammation.
There is currently no cure for RA. Symptoms may flare (get worse) at times and then go into remission (calm down), but RA does not go fully away. The good news is that effective treatments can help manage many of the symptoms of rheumatoid arthritis and help slow or even stop joint damage.
Rheumatoid arthritis is not considered a fatal disease. However, severe or uncontrolled RA can lead to lung disease and heart complications, which may raise health risks over time.
On myRAteam, people share their experiences with rheumatoid arthritis, get advice, and find support from others who understand.
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This was a great article. Am new diagnosed RA. I am still figuring it out. I also have OA and PMR. So not too many good days. I have a basket of autoimmune conditions and it is a guess knowing which… read more
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