Rheumatoid Arthritis


Rheumatoid arthritis (RA) is the most common autoimmune type of arthritis. In RA, your body’s immune system begins to react against its own tissues, causing significant inflammation in your joints and various other organs. This can cause joint pain, stiffness, swelling and decreased flexibility of the joints. RA often strikes small joints in your wrists, hands and feet but can also affect larger joints and other organs such as the eyes and lungs. About 75% of RA patients are women. Symptoms usually start between ages 30 and 50 but can happen to people at any age. RA is a chronic condition and there is no cure currently however there are many ways to treat and manage symptoms. Early diagnosis and the right treatments can ease symptoms and prevent joint damage or disability.

What Are the Signs/Symptoms?

Stiffness in your joints in the morning is a clue that you may have RA, as this is not common in other conditions. It may last one to two hours (or even the whole day) but generally improves with movement of the joints. Swelling and pain in the small joints of the hands and feet which have lasted for greater than 6 weeks can also be a sign of a persistent inflammatory disease. Diagnosing RA requires a physical exam, blood tests and scans like X-ray, MRI, or ultrasound. Once diagnosed, treatments for RA aim to lower inflammation, ease symptoms like pain or swelling, and prevent long-term joint damage.

What Are Common Treatments?

A disease-modifying anti-rheumatic drug (DMARD) is usually the first treatment usually prescribed for RA. Common DMARDs include methotrexate, leflunomide, hydroxychloroquine, and sulfasalazine. If DMARDs alone don’t control RA inflammation, a rheumatologist may prescribe a biologic drug such as abatacept, adalimumab, etanercept, tocilizumab, or medications such as tofacitinib or upadacitinib. No single treatment works for all patients, and many people may change their treatment at least once during their lifetime. A rheumatologist will help find a treatment plan that is best for you.

Living with RA

Regular follow up with your rheumatologist is key to proper disease control and reduced risk of joint damage. Take all medications as prescribed, and notify your doctor if drugs cause any side effects or problems. Do low-impact aerobic exercises, such as walking, and exercises to boost muscle strength. Smoking cessation is also highly important if you’re a smoker since there is a known association of tobacco use and rheumatoid arthritis. Certain supplements such as omega-3 have also been shown to improve pain in patients with RA.

Updated February 2023 by Bhakti Shah, MD, and reviewed by the American College of Rheumatology Committee on Communications and Marketing. This page is updated biannualy.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.

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