Rheumatoid Arthritis

Rheumatoid arthritis is a chronic autoimmune condition in which the immune system mistakenly attacks the lining of the joints, causing inflammation, pain, and, over time, joint damage if left untreated.

• Joint pain, swelling, and warmth, typically affecting several joints symmetrically (the same joints on both sides of the body), commonly starting in the hands, wrists, or feet
• Morning stiffness in the joints lasting more than about 30 minutes
• Fatigue
• Low-grade fever and general malaise in some people
• Over time, joint deformity can develop if the disease is not adequately controlled

• Results from an autoimmune process in which the immune system attacks the lining of the joints, though the exact trigger is not fully understood.
• Genetic factors contribute to risk, and rheumatoid arthritis is more common in women.
• Smoking is an established risk factor and can also make the disease more difficult to control once diagnosed.

• Diagnosed based on the pattern of joint symptoms (particularly symmetrical small joint involvement with morning stiffness) together with blood tests for inflammatory markers and specific antibodies associated with rheumatoid arthritis.
• X-rays or other imaging may be used to assess for joint damage, particularly to monitor disease over time.
• Early diagnosis and referral are important, as early treatment significantly improves long-term joint outcomes.

Disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, are the cornerstone of treatment, aiming to reduce inflammation and prevent long-term joint damage, and are typically started as soon as the diagnosis is confirmed.

A short course of corticosteroids or an NSAID may be used to help control pain and inflammation while DMARDs take full effect, as these medicines can take some weeks to work.

For people who do not respond adequately to standard DMARDs, additional targeted biologic medicines may be considered at specialist level.

Physiotherapy and occupational therapy support joint function and help people adapt daily activities to protect affected joints.

Regular monitoring is needed both to assess disease control and to watch for medicine side effects.

• Avoid smoking, as it increases the risk of developing rheumatoid arthritis and can reduce treatment effectiveness.
• Engage in regular, joint-appropriate physical activity to maintain strength and flexibility.
• Seek early medical assessment for persistent joint swelling and morning stiffness, since early treatment improves long-term outcomes.
• Attend regular follow-up and take DMARD medicine consistently once prescribed, as stopping early can allow disease activity to return.