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Rheumatoid arthritis
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Rheumatoid arthritis affects the joints and particularly hands, feet and knees. Other parts of the body can also be affected. Inflammation causes the joints to become painful and swollen and movement is restricted. Stiffness in the joints is common, especially in the morning. The inflammation caused by rheumatoid arthritis can result in damage to the joints.
Rheumatoid arthritis usually starts in middle life, with onset generally occurring between the ages of 25 to 50. However, elderly people can develop it.
Three times more women than men are affected by rheumatoid arthritis and there are varying degrees of severity. A similar form of arthritis, called juvenile arthritis, can also affect children.
Symptoms
The most common symptoms of rheumatoid arthritis include:
- Swelling, pain and heat in the joints
- Stiffness in the joints, especially in the morning
- Persistent fatigue
- Sleeping difficulties because of the pain
- Weak muscles
- Joints on both sides of the body are usually affected.
Seek advice early
It is important to seek medical advice early in the course of the condition. Early treatment will help you manage pain more effectively and minimise long-term joint damage.
Anyone who experiences pain and swelling in one or more joints should discuss this with their doctor. If you are diagnosed with rheumatoid arthritis or suspected of having the condition, you may be referred to a medical specialist known as a rheumatologist.
An immune system attack
The cause or causes of rheumatoid arthritis are not yet fully understood. It seems that the body’s immune system might be attacking the joints. This attack causes inflammation (pain, heat and swelling). The characteristic swelling happens when the joint produces too much lubricating (synovial) fluid in response to the inflammation.
Some people may be more at risk of developing rheumatoid arthritis due to heredity factors. Exactly what triggers the body’s immune system to attack the joints is unknown. Researchers are still investigating bacteria, viruses and other forms of infectious disease to try to find the trigger.
There is no cure for rheumatoid arthritis. However, there are many strategies you can use to manage the condition and its symptoms.
Managing rheumatoid arthritis
To manage rheumatoid arthritis it is helpful to understand the nature of the disease. Self-management education courses can help people with rheumatoid arthritis and other chronic (ongoing) conditions to build their skills and confidence to live with the condition. Arthritis Victoria can provide more information on these courses.
Other important strategies that can help you manage rheumatoid arthritis include:
- Medication – a rheumatologist may prescribe a number of different medications. The disease-modifying anti-rheumatic drugs (DMARDs) are a special group of medications used to treat inflammatory arthritis. Other medication such as anti-inflammatory drugs may be prescribed.
- Aids and equipment – supports such as walking aids and specialised cooking utensils reduce joint strain and can help you to manage pain and fatigue. An occupational therapist can give you advice on aids.
- Relaxation techniques – muscle relaxation, distraction, guided imagery and other techniques can help you manage pain and difficult emotions such as anxiety.
- Exercise – some physical activity will help you maintain muscle strength and joint flexibility and assist in pain management. Appropriate activities include exercising in warm water and doing tai chi.
- Physiotherapy – a physiotherapist can provide advice on pain management and physical activity.
- Rest – rest can help you to manage fatigue and is particularly important when your joints are swollen.
- Nutrition – a healthy diet will help you manage fatigue. Include adequate amounts of dietary calcium and aim to eat oily fish (such as tuna, salmon, herring, sardines and mackerel) at least two to three times a week. These fish contain omega-3 fatty acids, which may have an anti-inflammatory benefit.
- Support – a self-help group can provide support from others. Contact Arthritis Victoria for more information.
- Complementary therapies – such as massage or acupuncture may be helpful. Consult your doctor or rheumatologist before commencing any treatment.
- Joint surgery – may be necessary in some cases.
Any medication or treatment for arthritis must be discussed with, and monitored by, your doctor or rheumatologist. They will take into account the illness being treated, any other health issues and identifiable risk factors.
A note about Cox-2 Inhibitors (coxibs)
Drugs described as Cox-2 inhibitors, also known as coxibs, are a newer group of NSAIDs. In 2005 the Therapeutic Goods Administration (TGA) in Australia advised doctors to take care when prescribing Cox-2 inhibitor drugs.
The medications in this group that may have been, or currently are, prescribed for people with arthritis are known by these brand names:
- Celebrex (celecoxib) – one study of Celebrex has suggested patients taking high doses of the drug (800mg per day) may have a higher risk of heart disease. However, two other studies have found no increased risk of heart disease. In Australia the recommended and most commonly prescribed dosage of Celebrex is 200mg per day.
- Mobic (meloxicam) – the TGA recommends patients avoid taking more than 15mg of Mobic daily.
- Prexige (lumiracoxib) – in August 2007 the TGA withdrew registration for Prexige, after reports of serious liver damage in some people taking this medication. All people taking Prexige were advised to stop taking this medication and see their doctors for an assessment of their liver function.
- Vioxx (rofecoxib) – this was withdrawn from sale in Australia in 2004, after research demonstrated a higher risk of heart attacks and strokes.
Where to get help
- Your doctor – for referral to a rheumatologist (a specialist in arthritis)
- Rheumatologist
- Arthritis Victoria Tel. (03) 8531 8000 or 1800 011 041
- Physiotherapist
- Australian Physiotherapy Association Tel. (03) 9534 9400 or for help to ‘find a physio’ at
- National Prescribing Service Consumer Medicines Line Tel. 1300 888 763 – for expert medicines information for the cost of a local call
Things to remember
- Rheumatoid arthritis commonly affects the hands, knees and feet. Generally both sides of the body are affected.
- The immune system attacks the joints, but the trigger for this isn’t known.
- There is no cure, but the disease can be managed.
You might also be interested in:
Arthritis.
Arthritis - juvenile.
Arthritis and diet.
Arthritis and exercise.
Arthritis and water exercise.
Bursitis.
Gout.
Hip disorders.
Immune system.
Knee replacement surgery.
Want to know more?
Go to More information for support groups, related links and references.
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This page has been produced in consultation with, and approved by:
Arthritis Victoria incorporating Osteoporosis Victoria
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Copyight © 1999/2009 State of Victoria. Reproduced from the Better Health Channel (www.betterhealth.vic.gov.au) at no cost with permission of the Victorian Minister for Health. Unauthorised reproduction and other uses comprised in the copyright are prohibited without permission.
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This Better Health Channel fact sheet has passed through a rigorous approval process. For the latest updates and more information visit www.betterhealth.vic.gov.au.
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Last updated: February 2009
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Rheumatoid arthritis - Better Health Channel
Rheumatoid arthritis is a disease in which inflammation (pain, heat and swelling) affects the joints and other organs of the body. The hands, feet and knees are commonly affected. Stiffness in the joints is common, especially in the morning. A similar form of arthritis, called juvenile arthritis, can also affect children. There is no cure for rheumatoid arthritis but there are ways to manage it...
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Rheumatoid arthritis - Better Health ChannelRheumatoid arthritis is a disease in which inflammation (pain, heat and swelling) affects the joints and other organs of the body. The hands, feet and knees are commonly affected. Stiffness in the joints is common, especially in the morning. A similar form of arthritis, called juvenile arthritis, can also affect children. There is no cure for rheumatoid arthritis but there are ways to manage it...
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The information published here was accurate at the time of publication and is not intended to take the place of medical advice. Please seek advice from a qualified health care professional.
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