Rheumatoid Arthritis (RA): Symptoms, Treatments, Causes, And More

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Key takeaways

Rheumatoid arthritis (RA) is an autoimmune condition that causes inflammation and pain in the joints. It typically affects the hands and feet first, but can impact other body parts.
Symptoms of RA include joint pain, stiffness, and swelling. People can manage RA through medications, therapy, and self-care strategies.
Diagnosis usually involves physical exams, blood tests, and imaging to differentiate RA from other conditions. Early treatment is crucial to help minimize long-term joint and organ damage.

RA usually affects the hands and feet first, but it can occur in any joint. It usually involves the same joints on both sides of the body.

Common symptoms include stiff joints, especially when getting up after sleeping or after sitting down for a while. Some people experience fatigue and a general feeling of being unwell.

The Rheumatoid Arthritis Support Network estimates that RA affects up to 1% of the world’s population and over 1.3 million Americans.

The incidence of RA has increased globally over the past decades and will continue to increase in the coming years.

What is rheumatoid arthritis?

RA is an autoimmune disease, which means that a person’s immune system mistakes the body’s healthy tissues for foreign invaders. It is also a systemic disease that can affect the whole body.

As the immune system responds, inflammation occurs in the target tissue or organ. This can include the joints, lungs, eyes, and heart in RA.

Signs and symptoms

Signs and symptoms of RA usually occur in the wrists, hands, or feet and include:

pain, swelling, and stiffness in more than one joint
a low-grade fever
appetite loss
weight loss
tiredness
dry eyes
chest pain

The following images show how RA can present physically:

According to the Centers for Disease Control and Prevention (CDC), people most often experience the onset of RA in their 60s. Symptoms may start slowly and often worsen gradually with time.

People with RA usually experience periods when their symptoms get worse, known as flares. RA symptoms may flare up due to stress, overactivity, or stopping medications.

Sometimes, a person with RA can go into remission if their symptoms go away or are mild. Most people continue to experience flares and remissions throughout their lives.

RA usually affects the same joints on both sides of the body. Pain and stiffness tend to worsen after periods of inactivity.

Severe RA can lead to other complications throughout the body and cause joint damage that may lead to disability. Treatment can help manage the severity of symptoms and may reduce the likelihood of experiencing complications.

How does RA affect different parts of the body?

Causes

Nobody knows exactly what causes the immune system to malfunction, which leads to RA.

It’s thought to be a combination of genetics and environmental factors.

In RA, the immune system attacks the synovium, the membrane lining of joints. When this happens, the synovial cells proliferate, which leads to synovial thickening. Pain and inflammation result.

Eventually, if left untreated, the inflammation can invade and destroy cartilage — the connective tissue that cushions the ends of the bones. The tendons and ligaments that hold the joint together can also weaken and stretch. The joint can eventually lose its shape and configuration, and the damage can be severe.

Learn more about genetic and hereditary RA here.

Rheumatoid arthritis vs. osteoarthritis

RA is an autoimmune disease that causes inflammation in the joints, leading to pain, stiffness, and swelling. Osteoarthritis leads to many of the same symptoms as RA but is due to the typical wear and tear of the joints.

While RA usually affects the same joints on both sides of the body, osteoarthritis may only affect one side.

Although other symptoms can help a person figure out if they are experiencing RA or osteoarthritis, only a doctor can diagnose these conditions.

Risk factors

The CDC notes that people with a higher risk of developing RA may include those who:

are 60 years or older
are female
have specific genetic traits
have never given birth
have obesity
smoke tobacco or whose parents smoked when they were children

Learn more about the risk factors for RA here.

Diagnosis

It may be difficult for a doctor to diagnose RA in its early stages, as it can resemble other conditions such as lupus (SLE) or psoriatic arthritis (PsA).

The CDC recommends getting a diagnosis within six months of the onset of symptoms so that treatment can begin as soon as possible.

A doctor will look at the person’s clinical signs of inflammation and ask how long the person has experienced them and how severe their symptoms are. They will also perform a physical examination to check for swelling, functional limitations, or other unusual presentations.

They also may recommend some tests, including:

Blood tests

Several blood tests can help diagnose RA and rule out other conditions. They include:

anti-CCP
rheumatoid factor
erythrocyte sedimentation rate (ESR or sed rate)
C-reactive protein (CRP)

Imaging scans and X-rays

An X-ray or MRI of a joint can help a doctor identify what type of arthritis is present and monitor the progress of a person’s RA over time.

Learn what arthritis looks like on an MRI.

Diagnostic criteria

Guidelines recommend the following criteria for diagnosing RA:

number and location of affected joints
blood tests indicate the presence of RA
symptom duration
inflammation indicators, or acute phase reactants

Treatment

If a person has a diagnosis of RA, a doctor may refer them to a specialist known as a rheumatologist, who will advise on treatment options.

Treatment will aim to:

prevent flares and reduce their severity if they occur
reduce inflammation in the joints
relieve pain
minimize any loss of function caused by pain, joint damage, or deformity
slow down or prevent damage to joints and organs

Options include medications, physical therapy, occupational therapy, counseling, and surgery.

Medications to manage symptoms

Some drugs can help relieve symptoms and slow the disease’s progression.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are available from pharmacies over the counter (OTC). Examples include Motrin, Advil, and Aleve.

Long-term use and high doses can lead to side effects, including:

bruising
gastric ulcers
high blood pressure
kidney and liver problems

Corticosteroids reduce pain and inflammation and may help slow joint damage, but they cannot cure RA.

If NSAIDs do not work, a doctor may inject a steroid into the joint. Relief is usually rapid, but the effect is variable. It can last a few weeks or months, depending on the severity of the symptoms.

This can help with acute symptoms or short-term flare-ups. However, a doctor will limit steroid injections to no more than three times per year because of their impact on the soft tissue structures around the joints. More frequent injections can potentially damage these structures or cause them to tear off from where they attach to bone.

Disease-modifying antirheumatic drugs (DMARDs)

DMARDs affect how the immune system works. They can slow the progression of RA and prevent permanent damage to joints and other tissues by interfering with an overactive immune system. A person usually takes DMARDs for life.

These types of medications are most effective if a person uses them in the early stages of RA, but it can take several weeks to a couple of months to fully experience their benefits. Some people may have to try different types of DMARDs before finding the most suitable one.

Side effects can include:

liver damage
immune-related disorders
an increased risk of infections
hair loss
mouth ulcers
nausea and loose stool
abnormal blood counts

Biologic treatments

Biologic treatments, such as tumor necrosis factor-alpha (TNF-alpha) inhibitors, also change how the immune system works. When the human body faces an infection or other threat, it produces TNF-alpha, an inflammatory substance. TNF-alpha inhibitors suppress this substance and help prevent inflammation.

TNF-alpha inhibitors can reduce pain, morning stiffness, and swollen or tender joints. People usually notice an improvement two weeks after starting treatment.

Examples include:

adalimumab (Humira)
certolizumab pegol (Cimzia)
etanercept (Enbrel)
golimumab (Simponi)
infliximab (Remicade)

Possible side effects include:

a higher risk of infection
lupus
congestive heart failure
demyelinating diseases
lymphoma
skin reactions

JAK inhibitors

Janus kinase (JAK) inhibitors are a newer subtype of DMARD medications. These include:

tofacitinib (Xeljanz)
baricitinib (Olumiant)
upadacitinib (Rinvoq)

While traditional DMARDs stop the immune system from producing immune cells that cause RA to develop, JAK inhibitors target specific signaling molecules. This helps prevent the cellular process that causes RA to progress.

For the 20–30% of people living with rheumatoid arthritis who do not respond to traditional DMARDs or biologics, JAK inhibitors have proven to be an effective option.

Occupational or physical therapy

An occupational therapist can help a person learn new and effective ways of carrying out daily tasks. This can minimize stress on painful joints. For example, a person with painful fingers might learn to use a specially devised gripping and grabbing tool.

A physical therapist can advise people about using assistive devices, such as a cane, and help individuals develop a suitable exercise plan.

Which exercises can help people with RA?

Surgery

In some cases, a doctor may recommend surgery to:

repair damaged joints
correct deformities
reduce pain

The following procedures are possible:

arthroscopic surgery, a procedure to remove inflamed joint tissue
surgery to release tendons responsible for unusual bending in the fingers
carpal tunnel release to relieve nerve compression in the hand and wrist
arthroplasty, a total joint replacement surgery

Learn why RA affects the hand joints.

Self-care

Finding time to practice self-care can help a person cope with the day-to-day challenges that RA brings. Several strategies that may help a person manage their condition include.

getting plenty of rest, especially during an RA flare
low impact exercises, such as swimming, boost overall health and mobility
managing weight, which can prevent additional stress on joints
eating a balanced diet, such as a Mediterranean diet, which focuses on inflammation-fighting foods
applying heat or cold packs
meditation, guided imagery, deep breathing, or muscle relaxation to relieve stress
trying other natural remedies and complementary therapies, such as acupuncture and Swedish massage, to relieve pain

Frequently asked questions

What are the stages of rheumatoid arthritis?

RA generally develops in four stages:

Stage 1: An X-ray will not show any bone or joint destruction.

Stage 2: An X-ray will show the impact on the bone.

Stage 3: An X-ray will show a particular kind of erosion of the cartilage and bone that a doctor can recognize as resulting from RA and deformities in the affected joints.

Stage 4: The person will experience ankylosis, which is when a joint becomes stiff and fuses with the bone.

Learn more about the four stages of RA here.

Is rheumatoid arthritis hereditary?

Research has determined that there are genes that make developing RA more likely.

One theory is that bacteria or viruses trigger RA in people who have these genes. One of the genes that may be responsible is HLA-DR4, and it is common in people of European ancestry.

However, this may not fully explain why some people get RA and others do not. There are likely environmental triggers also.

Can a person prevent rheumatoid arthritis?

Rheumatoid arthritis (RA) cannot be completely prevented, as its exact cause is not fully understood and involves a combination of genetic, environmental, and possibly hormonal factors.

However, a person can reduce their risk and potentially delay the onset of RA by taking several steps that include but are not limited to:

stopping smoking
reducing exposure to inhaled silica, dust, and occupational risks
maintaining a healthy weight
increasing leisure time physical activity

Learn more about smoking and RA here.

What is the life expectancy of a person with rheumatoid arthritis?

According to a 2015 study, people with RA might have a 54% higher risk of mortality compared with people who do not have the condition.

RA patients often face additional chronic medical conditions and complications, severely impacting their health outcomes.

Notably, there is a strong association between RA and atherosclerotic cardiovascular disease, leading to accelerated coronary artery disease.

However, it is difficult to predict a person’s life expectancy as the course of the disease differs significantly among individuals.

With the right treatment, many people can live past the age of 80 or even 90 years while experiencing relatively mild symptoms and only minor limitations in day-to-day life.

Summary

Rheumatoid arthritis is a painful chronic autoimmune condition that can cause joint damage and make it difficult for a person to carry out their daily tasks. It can affect joints but can also lead to inflammation throughout the body.

Anyone who experiences pain and swelling in two or more joints not caused by trauma should see a doctor, as early treatment can reduce the risk of long-term problems.

“”

Rheumatoid Arthritis
Immune System / Vaccines
Pain / Anesthetics

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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Medically reviewed by Nancy Carteron, M.D., FACR — Written by Yvette Brazier — Updated on July 16, 2025

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Key takeaways

What is rheumatoid arthritis?

Signs and symptoms

Causes

Rheumatoid arthritis vs. osteoarthritis

Risk factors

Diagnosis

Blood tests

Imaging scans and X-rays

Diagnostic criteria

Treatment

Medications to manage symptoms

Disease-modifying antirheumatic drugs (DMARDs)

Biologic treatments

JAK inhibitors

Occupational or physical therapy

Surgery

Self-care

Frequently asked questions

What are the stages of rheumatoid arthritis?

Is rheumatoid arthritis hereditary?

Can a person prevent rheumatoid arthritis?

What is the life expectancy of a person with rheumatoid arthritis?

Summary

How we reviewed this article:

Latest news

Popular in: Rheumatoid Arthritis

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