Understanding RA
Rheumatoid arthritis (RA) is a chronic autoimmune disease that mostly affects joints. An autoimmune disorder occurs when the immune system malfunctions and attacks and causes damage to a part of the body. In RA, tissue in the joints is attacked, causing pain, swelling, stiffness, and loss of joint function. Rheumatoid arthritis (RA) is the most common type of autoimmune arthritis and is one of the most disabling types of arthritis. Risk factors include age (RA can happen at any age but risk increases with older age), gender (more common in women than men), family history and genetics, smoking, obesity, gum disease, and lung diseases.
Symptoms of RA
RA can affect any joint in the body, but it is most commonly found in the wrists, hands, and feet. The symptoms typically appear symmetrically, meaning they affect both sides of the body. For example, if RA is present in the right hand, the left hand may also be affected. The effect of RA varies from person to person. In some, it begins with mild to moderate inflammation in just a few joints. However, without proper treatment or if treatments are ineffective, the condition can worsen, leading to the involvement of more joints and potentially causing greater damage and disability.
RA symptoms can flare up periodically, often triggered by factors such as stress, environmental influences (like cigarette smoke or viral infections), excessive physical activity, or abruptly discontinuing medication. In some cases, there are no specific triggers.
Common symptoms of RA include: joint pain at rest and when moving, tenderness, swelling, and warmth of the joint; joint stiffness that lasts longer than 30 minutes, usually after waking in the morning or after resting for a long period of time; joint swelling that interferes with daily activities (such as difficulty making a fist, combing hair, buttoning clothes, or bending knees); feeling unusually tired or having low energy; occasional low-grade fever; loss of appetite.
Diagnosing RA
It can be difficult to diagnose RA when it is in the early stages because RA develops over time, and only a few symptoms may be present. There is no single test for RA. Symptoms vary from person to person and can be similar to those of other types of arthritis and joint conditions. Because of these factors, healthcare providers use various means to diagnose RA and rule out other conditions. RA is diagnosed by reviewing symptoms, conducting a physical examination, and performing X-rays and blood tests. Blood tests often show elevated inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), along with rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies.
Treatment of RA
Treatment options include medications, physical therapy and occupational therapy, surgery, routine monitoring and ongoing care. Regardless of the treatment plan, the goal is to relieve pain; decrease inflammation and swelling; prevent, slow, or stop joint and organ damage; and improve daily activities of living.
There are many medications used to treat RA, including anti-inflammatory medications, corticosteroids, and various classes of disease-modifying antirheumatic drugs (DMARDs).
Some FDA-approved biologic DMARDs include infliximab (e.g., Inflectra®, Remicade®) administered into the blood stream intravenously, golimumab (Simponi Aria®), administered into the blood stream intravenously, golimumab (Simponi®) administered under the skin subcutaneously, and tocilizumab (Actemra®), administered intravenously or subcutaneously.
Resources:
References:
- National Institute of Arthritis and Musculoskeletal and Skin Diseases
- Rheumatoid arthritis – Symptoms and Causes | Mayo Clinic
Last reviewed 12/16/2025
