Rheumatoid arthritis

Symptoms of rheumatoid arthritis 

Rheumatoid arthritis mainly affects the joints, although it can cause problems in other parts of the body too. The hands, feet and wrists are commonly affected,

The symptoms of rheumatoid arthritis often develop gradually over several weeks. However, some cases can progress quickly over a number of days. The symptoms vary from person to person.

Symptoms affecting the joints

Pain

The joint pain associated with rheumatoid arthritis is usually a throbbing and aching pain. It is often worse in the mornings and after a period of inactivity.

Stiffness

Joints affected by rheumatoid arthritis can feel stiff. For example, if your hands are affected, you may not be able to fully bend your fingers or form a fist.

Like joint pain, the stiffness is often more severe in the morning or after a period of inactivity. Morning stiffness associated with other types of arthritis usually will wear off within 30 minutes of getting up. However, rheumatoid arthritis morning stiffness usually lasts longer than this.

Swelling, warmth and redness

When rheumatoid arthritis affects a joint, the lining of that joint becomes inflamed. This can cause the joints to swell and become hot and tender to touch.

In some people, firm swellings called rheumatoid nodules can also develop under the skin around affected joints.

Additional symptoms

As well as problems affecting the joints, some people with rheumatoid arthritis experience a range of more general symptoms, such as:

• tiredness and a lack of energy
• a high temperature (fever)
• sweating
• a poor appetite
• weight loss

The inflammation associated with rheumatoid arthritis can also sometimes cause problems affecting other areas of the body. For example, dry eyes if the eyes are affected and chest pain if the heart or lungs are affected.

Treating rheumatoid arthritis 

There is no cure for rheumatoid arthritis. However, early diagnosis and appropriate treatment enables many people with rheumatoid arthritis to have periods of months or even years between flares and to be able to lead full lives and continue regular employment.

The main treatment options include:

• medication that is taken in the long-term to relieve symptoms and slow the progress of the condition
• supportive treatments, such as physiotherapy and occupational therapy, to help keep you mobile and find ways around any problems you have with daily activities
• surgery to correct any joint problems that develop

When to seek medical advice 

You should see your GP if you think you have symptoms of rheumatoid arthritis. This will help your GP identify the underlying cause.

Diagnosing rheumatoid arthritis quickly is important because early treatment can help stop the condition getting worse. It can also help to reduce the risk of further problems such as joint damage.

Causes of rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease. This means that your immune system – which usually fights infection – attacks the cells that line your joints by mistake. This makes your joints swollen, stiff and painful.

Over time, this can damage the joint itself, the cartilage and nearby bone.

It's not clear what triggers this problem with the immune system. You are at an increased risk if you:

• are a woman
• have a family history of rheumatoid arthritis
• smoke

Living with rheumatoid arthritis 

Rheumatoid arthritis can be life-changing. You may need long-term treatment to control your symptoms and reduce joint damage.

Depending on how much pain and stiffness you feel and how much joint damage you have, you may have to adapt the way you carry out simple daily tasks. These can become difficult or take longer to complete.

Some things you can do to help keep the condition under control include:

Self-care

Self-care includes what you do every day to stay fit and maintain good physical and mental health, prevent illness or accidents and care more effectively for minor ailments and long-term conditions.

Take your medication

It is important to take your medication as prescribed, even if you start to feel better. Medication can help prevent flare-ups and reduce the risk of further problems such as joint damage.

If you have any questions or concerns about the medication you are taking or side effects, talk to your pharmacist, or the nurses and doctors involved in your care.

Regular reviews

As rheumatoid arthritis is a long-term condition, you'll be in contact with your healthcare team regularly so they can check to  make sure your condition is under good control and your treatment is right for you.

Keeping well

If you have rheumatoid arthritis, you may be advised to have a yearly flu jab to protect against flu. You may also be advised to have a pneumococcal vaccination, a one-off injection that protects against a specific serious chest infection called pneumococcal pneumonia.

Healthy eating and exercise

Regular exercise and a healthy diet are recommended for everyone, not just people with rheumatoid arthritis. They can help prevent many conditions, including heart disease and many forms of cancer.

Exercise can also help you lose weight if you are overweight, which can put extra strain on your joints.

However, it’s important to strike a balance between rest and exercise. Rest will make inflamed joints feel more comfortable, but without movement your joints will stiffen and your muscles will become weaker. You need to find out the best activities and the right balance for you.

• Rheumatoid arthritis

More useful links

• How to use your health services
• Versus Arthritis Northern Ireland