Rheumatoid Arthritis

RA can occur at any age, but it commonly develops in mid-life, usually after age 30.

You may be more likely to get rheumatoid arthritis if a close relative also has the condition.

Researchers have identified gene mutations associated with immune system function that may increase your risk of developing RA.

Bacterial infections, such as periodontitis, and viral infections may increase the risk of developing RA.

Excess weight may make you more prone to developing rheumatoid arthritis and interfere with the effectiveness of treatments.

Women are more than twice as likely to develop RA than men and people assigned male at birth.

Smoking causes inflammation and other damage throughout the body that has been linked to rheumatoid arthritis. People who smoke have a higher risk of developing RA than people who don’t smoke.

Medications help many people with RA improve their quality of life. Some medications relieve inflammation and other symptoms, while others stop or slow the condition from progressing. You will likely take more than one type of medication.

• Corticosteroid injections: Your doctor may recommend these injections to address joint pain in the short term.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs can help control pain and swelling. Many types, including ibuprofen and naproxen, are available over the counter, but your doctor can prescribe stronger NSAIDs if over-the-counter medications don’t bring adequate relief.
• Disease-modifying antirheumatic drugs (DMARDs): These medications help prevent your immune system from attacking your joints, preventing RA from worsening. There are many types of DMARDs, some given in pill form and some delivered by injection or intravenous (IV) infusion.
• Janus kinase (JAK) inhibitors: JAK inhibitors are a type of DMARD your doctor may recommend if your first treatment isn’t effective. These medications help prevent immune cells from causing the inflammation that causes pain and joint deterioration.

Physical therapy can help improve your fitness, strength and joint flexibility. For hands or wrists, a customized exercise program may be provided, with both in-person and home exercises. Physical therapists can also use treatments like heat, ice or TENS (a small electrical pulse to numb pain) for relief.

If rheumatoid arthritis affects daily tasks, an occupational therapist can guide joint protection at home and work. They may recommend splints or assistive devices to make tasks easier, like tools to open jars or turn faucets.

Complementary treatments can be helpful in managing rheumatoid arthritis symptoms when used alongside your prescribed medications. However, they should never replace the treatments your doctor has prescribed. It's important to always consult with your healthcare team, particularly your rheumatology team, before trying any integrative medicine.

Some common complementary treatments that may support your RA management include:

• Acupuncture
• Chiropractic care
• Massage therapy
• Osteopathy

Always discuss these treatments with your doctor to ensure they are safe and appropriate for your specific condition.

If medications aren't enough to prevent or slow joint damage, surgery may be an option to repair the affected joints. Surgery can help relieve pain, improve movement and restore joint function.

There are several types of surgery that may be considered for rheumatoid arthritis, including:

• Joint fusion: The most common procedure to treat RA is joint fusion, surgery to permanently connect bones. Two bones are fused into a single bone, eliminating painful movement and allowing for a more stable joint.
• Joint replacement surgery: During joint replacement, an orthopedic surgeon replaces a damaged joint with an artificial joint made of ceramic, metal or plastic. You can have a joint replacement in any joint, and the procedure helps reduce pain associated with significant damage.
• Synovectomy: This procedure involves removing the synovium. It’s typically reserved for people with early-stage rheumatoid arthritis that has damaged only the joint lining.
• Tendon surgery: RA can also affect a type of tissue called tenosynovium, a tissue that lines tunnels in the fingers, wrists, toes and ankles through which tendons travel. Damaged tenosynovium can cause tendons to fray or tear, which may require surgery.