Rheumatoid arthritis (RA) is an autoimmune disease. It causes pain, swelling, stiffness, and loss of function in the joints.
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RA is caused by a combination of genetic and environmental factors that trigger an abnormal immune response. Possible causes include:
RA is more common in women, and in people between the ages of 30 and 60. Other factors that may increase your chance of developing RA include:
RA usually presents with joint symptoms
RA may also cause:
Inflammation may also occur in
You will be asked about your symptoms and medical history. A physical exam will be done. RA is sometimes difficult to diagnose because there are several diseases with similar symptoms. Part of diagnosing RA is to rule out other diseases.
The American College of Rheumatology and the European League Against Rheumatism have created a system for diagnosing RA. To start, symptoms need to be present for 6 weeks or more. The system then uses a 10-point scale assessing specific symptoms. The higher the score, the more likely RA is present. Considered factors include:
There is no cure for RA. The goals of treatment are to:
There are a variety of medications to treat the pain and inflammation of RA. In some cases, medications may be used in combination. These may include:
Rest reduces active joint inflammation and pain and fights fatigue. Exercise is important for maintaining muscle strength and flexibility. It also preserves joint mobility.
These steps may help relieve stiffness, weakness, and reduce inflammation:
Splints applied to painful joints may reduce pain. Devices that help with daily activities can also reduce stress on joints. Devices include:
Stress reduction can ease the difficulties of living with a chronic, painful disease. Participating in an exercise program or joining a support group are 2 strategies you can use to reduce stress. Cognitive behavioral therapy , a form of talk therapy, and meditation may also offer benefits in reducing your pain and improving your ability to cope with RA.
Joint replacement and tendon reconstruction help relieve severe joint damage.
American College of Rheumatology
Canadian Rheumatology Association
The Arthritis Society
Rheumatoid arthritis. Arthritis Foundation website. Available at: http://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis. Accessed May 13, 2016.
Rheumatoid arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Rheumatic_Disease/default.asp. Updated February 2016. Accessed May 13, 2016.
Rheumatoid arthritis (RA). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115261/Rheumatoid-arthritis-RA. Updated September 2, 2016. Accessed September 12, 2016.
Tanaka E, Saito A, Kamitsuji S, et al. Impact of shoulder, elbow, and knee joint involvement on assessment of rheumatoid arthritis using the American College of Rheumatology Core Data Set. Arthritis Rheum. 2005;53(3):864-871.
Verstappen SM, Bijlsma JW, Verkleij H, et al. Overview of work disability in rheumatoid arthritis patients as observed in cross-sectional and longitudinal surveys. Arthritis Rheum. 2004;51(3):488-497.
4/16/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed. Zautra AJ, Davis MC, Reich JW, et al. Comparison of cognitive behavioral and mindfulness meditation interventions on adaptation to rheumatoid arthritis for patients with and without history of recurrent depression. J Consult Clin Psychol. 2008;76(3):408-421.
1/4/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Anis A, Zhang W, Emery P, et al. The effect of etanercept on work productivity in patients with early active rheumatoid arthritis: results from the COMET study. Rheumatology (Oxford). 2009;48(10):1283-1289.
1/4/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Aletaha D, Neogi T, Silman AJ, Funovits J, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2010;69(9):1580-1588.
4/24/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Wise JN, Weissman BN, Appel M, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at: https://acsearch.acr.org/docs/69424/Narrative. Updated 2013. Accessed May 13, 2016.
Last reviewed May 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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