Understanding the intricacies of rheumatoid arthritis

Rheumatoid Arthritis Symptoms and treatment

It can be annoying to learn that the body's immune system is attacking the joints instead of protecting them, which can cause pain that can persist for a lifetime. This chronic autoimmune disease is called rheumatoid arthritis (RA). It is an autoimmune inflammatory disease characterized by chronic inflammation that primarily affects the synovium, which is the lining of the joints. The disease can affect any joint in the body because the immune system sends mixed signals to the immune cells, ultimately damaging the joint tissues. 

If left untreated, RA can result in joint destruction due to the erosion of cartilage and bone. According to the Global Burden of Disease 2019 study, 18 million people worldwide were living with RA, with approximately 70% of them being women, and 55% being older than 55 years of age. 

Signs and symptoms 

The early signs and symptoms of RA typically start in the wrists, knuckles, the balls of the feet, and knees. Joint inflammation tends to worsen in the morning and may persist for up to an hour after getting out of bed. In addition to painful joints, symptoms include inflammation, swelling, stiffness, as well as fever, fatigue, anemia, and weight loss.  If kept untreated or undertreated, it may lead to long-term joint distortion, resulting in disability, poor quality of life, and increased mortality. It can also cause serious complications in the lungs, skin, eyes, and heart.  Some studies have reported a 60% increased risk of heart attack one year after the diagnosis. 

Causes of RA 

The specific causes of the disease remain unknown. However, certain risk factors have been identified, including modifiable lifestyle factors such as smoking and obesity, as well as non-modifiable factors like genetics, gender (with women being more susceptible), and aging. Individuals with a family history of RA have an increased risk of developing the condition. Although RA can affect people of all ages, it commonly starts between the ages of 30 and 60. Another significant contributing factor to the development of RA is smoking. Some studies suggest that obesity increases the risk of RA and may also limit the extent to which this condition can be improved. 

Diagnosis and treatment of RA 

RA is challenging to diagnose in its early stages, as it can resemble many diseases that cause joint stiffness and inflammation. Rheumatologists gather a detailed medical history regarding the signs and symptoms, followed by conducting physical examinations. During these examinations, they observe joint movements, such as walking and bending, and check for skin rashes or nodules. They also assess the chest for signs of lung inflammation. Generally, recommended laboratory tests include rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (anti-CCP), complete blood count, and erythrocyte sedimentation rate. Clinicians may also recommend imaging tests like X-rays, magnetic resonance imaging (MRI), and ultrasounds to evaluate joint damage. 

While RA has no known cure, prompt treatment, and support, including medication, lifestyle changes, supportive therapies, and surgery, can help minimize the impact of the condition and reduce the risk of joint damage. Early diagnosis of RA is challenging, but with timely and appropriate treatment, it is possible to prevent it from worsening and slow down the disruption it causes in a patient's life. Treatment typically involves medications, such as non-steroidal anti-inflammatory drugs, steroids, and conventional disease-modifying antirheumatic drugs (DMARDs), non-pharmacological approaches like physiotherapy, and surgery. The severity of inflammation and disease progression determines the course of treatment. 


RA is a complex disease that demands meticulous management and a deep understanding of its complexities. Early diagnosis, suitable treatment, and physiotherapy play pivotal roles in achieving a better quality of life with RA. It is advisable to lead a healthy lifestyle by consuming nutritious food, maintaining proper body weight, and staying physically active to effectively manage the symptoms of RA.