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Am Fam Physician. 2005;72(6):1049-1050

See related article on rheumatoid arthritis.

What is rheumatoid arthritis?

Rheumatoid (say: ROO-mah-toyd) arthritis is an autoimmune disease. Usually, your immune system keeps you from getting sick. But if you have an autoimmune disease, your immune system attacks your own body’s cells. Joints between bones usually are attacked first. Later, other parts of the body also may be affected.

Who gets rheumatoid arthritis and why?

About one out of every 100 adults has rheumatoid arthritis. For most people, it begins between 30 and 50 years of age. Women are more likely to get rheumatoid arthritis than men. Smokers are more likely to get rheumatoid arthritis than nonsmokers. No one knows what causes rheumatoid arthritis. Some infections may cause it, and it may run in families.

How can I tell if I have rheumatoid arthritis?

Symptoms of rheumatoid arthritis usually start slowly, over weeks or months. If you have rheumatoid arthritis, you may notice different joints hurting, especially your wrists or the base of your fingers. You may have pain in the same joints on both sides of your body.

Your joints might feel warm, but they usually will not look red. They may be harder to move for about 45 minutes after you get up in the morning. Your hands may feel “puffy,” because more blood flows to the sore hand joints.

You might find swollen glands in your underarms, neck, or elbows. Some people also have a mild fever or body aches, or do not want to eat.

Is there a test to be sure I have rheumatoid arthritis?

There is no simple test that shows you have rheumatoid arthritis. Blood tests and x-rays may help your doctor decide.

How is rheumatoid arthritis treated?

Your doctor might give you an anti-inflammatory medicine such as ibuprofen (brand name: Advil) and or naproxen (brand name: Naprosyn or Aleve). These medicines help with pain and swelling. They do not slow the damage to your joints. Your doctor will watch you closely for side effects such as bleeding in your stomach.

If you have only a few sore joints, your doctor may give you a shot of steroids into those joints. When a lot of joints are sore, steroid pills may be used. Steroids can cause side effects such as changes in your blood sugar, acne, lower bone density, and eye problems.

Antirheumatic (say: Anti-ROO-mat-ick) medicines are medicines that can help fight rheumatoid arthritis. If these medicines are started early enough, they can slow the damage to your joints. These medicines start working over days to months. Your doctor may do a blood test to make sure these medicines are safe for you. Some of these medicines should not be taken if you are pregnant because they can hurt the baby. Your doctor may talk to you about birth control before you use any of these medicines.

Other treatments are important, too. Physical therapy and occupational therapy can help. Eating foods that are high in certain fatty acids also might help. These include some types of fish and fish oil capsules, flaxseed and flax oil, walnuts, and green leafy vegetables.

Can rheumatoid arthritis be cured?

Rheumatoid arthritis is a lifelong disease. Sometimes it can go away for a while with treatment. It is important to see your doctor as soon as you have symptoms.

What other problems might I have?

Rheumatoid arthritis can cause many other health problems. Your hands may become bent or twisted. You may find lumps in the backs of your arms or other areas. Lung and heart problems also can happen. Talk to your doctor about any new symptoms you notice.

Where can I get more information?

National Institute of Arthritis and Musculoskeletal and Skin Diseases

Arthritis Foundation

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