What to know about rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease, which occur when your body’s immune system attacks healthy cells. RA typically causes joint pain, swelling, and damage, but it often doesn’t stop there. It can also affect organs like your skin, heart, and lungs.

About 1.5 million adults in the United States are thought to have RA. Women are up to three times more likely to develop the disease than men. While it’s understood that certain factors increase risk, the exact causes of RA aren’t clear.

The good news? Treatment advancements have greatly improved, especially for people who are diagnosed and treated early, says Stephen Gelfand, MD, a rheumatologist in Myrtle Beach, South Carolina.

With that in mind, here’s what to know about RA symptoms, diagnosis, risk factors, treatment, and more.

Diagnosing rheumatoid arthritis

RA may be tricky to diagnose because its symptoms can look like those of other conditions, like gout and psoriatic arthritis. So, doctors use a combination of exams to ensure an accurate diagnosis.

A rheumatologist is a doctor who specializes in autoimmune conditions and diseases of the muscles and bones. To diagnose RA, a rheumatologist will first perform a physical exam to check for joint symptoms such as warmth, stiffness, swelling, and pain. They’ll also look at location—whether these symptoms affect joints on one or both sides of the body. Other signs of RA might include weight loss, fatigue, and fever.

Blood tests can also help check for RA. These include:

• Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP), which look for certain antibodies, or proteins in your blood
• Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), which measure inflammation in your blood

If you have swelling in three or more joints, or symptoms that last at least six weeks, you may have RA. A positive or abnormal RF or CCP test further supports a diagnosis.

X-rays may be used after diagnosis to determine how the disease is progressing. Other imaging tests, such as magnetic resonance imaging (MRI) or ultrasound, can show the extent of joint damage.

Rheumatoid arthritis risk factors

In addition to your sex at birth, the following may increase your risk of RA:

• Age: RA can occur at any age, but people who are 60 and older are also more likely to have it.
• Other health conditions: High cholesterol, high blood pressure, heart disease, kidney failure, and diabetes may increase your RA risk, says Dr. Gelfand.
• Smoking status: Smoking can increase your chances of developing the disease, worsen symptoms, and reduce the effectiveness of your treatments.

If you’re at risk for RA, talk with a rheumatologist about your options.

Treatment of rheumatoid arthritis

If you’re diagnosed with RA, early treatment can help you manage symptoms, reduce joint damage, and slow disease progression. Here are some of the most common medical treatments.

Steroids

Your rheumatologist may recommend a very low dose of glucocorticoids, or corticosteroids. “Steroids are very effective for reducing inflammation. They work as what we call bridge therapy, a therapy that will be effective until more specific drugs for rheumatoid arthritis take effect,” says Gelfand.

DMARDs

Non-biologic disease-modifying antirheumatic drugs, or DMARDs, are preferably prescribed within three months of diagnosis, says Gelfand. These medications are used to slow down the inflammatory process and reduce pain. The most common DMARDs for RA include methotrexate, leflunomide, hydroxychloroquine, and sulfasalazine.

Biologics

For more severe cases of RA, your rheumatologist may prescribe biologic drugs that target the immune system. Specifically, they’ll work on processes that lead to inflammation, and joint and tissue damage.

“We have a whole group of drugs that have been developed over the last 20 years. These drugs have really revolutionized the treatment of rheumatoid arthritis because they are so effective in slowing down or stopping the inflammatory process in people who have progressive RA,” says Gelfand.

For RA treatment, the FDA has approved biologic drugs like adalimumab, etanercept, infliximab, and abatacept, among others.

How to help manage rheumatoid arthritis at home

In addition to medical treatments, you can make healthy lifestyle changes to help manage your RA symptoms at home. These include:

Exercise

While you may be tempted to go easy when you’re in pain, it’s important to understand that physical activity can have significant benefits for people with RA. Among other benefits, it can increase range of motion, strengthen joints, boost mood, improve sleep, and lower inflammation. Low-impact workouts like walking, swimming and water aerobics are excellent choices for those with RA, says Gelfand.

Talk to a rheumatologist or other healthcare provider before you start any new exercise routine. They can recommend activities that best fit your abilities and lifestyle.

Try hot and cold therapy

Both cold and hot pressure may reduce your pain and stiffness. Cold treatments include ice packs, ice massages, and gel cold wraps. Heated treatments include warm baths or showers, paraffin or wax baths, and heating pads. Heat treatments are especially helpful for patients who have hand and wrist stiffness, says Gelfand.

Note that pack treatments should be applied for no longer than 20 minutes at a time. Leaving them for an extended time may lead to skin damage.

Eat a healthy diet

Some research suggests a healthy diet may help control weight, lower inflammation, and contribute to less RA pain. People with joint conditions should try to eat plenty of fruits and vegetables, whole grains, beans, nuts, and healthy fats, such as olive oil and avocado. Fatty fish such as salmon and tuna are also wise choices. For good health in general, try to limit or avoid foods high in saturated fat, trans fats, and added sugars.

Manage your weight

Being overweight or obese can worsen RA symptoms, says Gelfand. But maintaining a weight that’s healthy for your body may ease pain, swelling and other issues. Start by eating a healthy diet and getting physical activity each day. Talk to a healthcare provider for advice and other ways to lose extra pounds. “Recent studies have found that RA patients who are morbidly obese and have bariatric surgery, see improvements in their RA symptoms,” Gelfand says.

Learn about RA

For a better chance at successful treatment, people with RA should try to learn as much as possible about the disease. Among other benefits, it helps you understand how your body responds to different triggers and medications, and you can make more informed decisions about your care. It can also improve medication adherence (how closely a prescription is followed), says Gelfand.

Importance of early action

While treatment can ease RA symptoms and sometimes even stop them all together, avoiding care can cause more problems. Inflammation can eat away at the cartilage and bone on either side of the joint, which can cause significant limitation of motion and pain, says Gelfand.

If you notice RA symptoms or suspect you might have the disease, talk to a healthcare provider sooner rather than later. Early action can prevent or relieve RA joint pain and damage, leading to a healthier, happier life.