Rheumatoid arthritis is an autoimmune disease that causes pain and inflammation of the joints. Other parts of the body can also be affected. Inflammation causes the joints to become painful, hot and swollen and movement to be restricted. Stiffness in the joints is common, especially in the morning. The inflammation caused by rheumatoid arthritis can result in damage to the joints particularly if left untreated.
Rheumatoid arthritis can occur at any age, but usually appears between the ages of 35 to 64. It is the second most common form of arthritis affecting nearly half a million Australians. An estimated 57 per cent of people with rheumatoid arthritis are women.
Symptoms of rheumatoid arthritis
The most common symptoms of RA include:
- swelling, pain and heat in the joints, usually the smaller joints affecting the hands or feet
- stiffness in the joints, especially in the morning
- persistent fatigue
- sleeping difficulties because of the pain
- weak muscles
- the same joints on both sides of the body are usually affected.
The course and severity of rheumatoid arthritis varies from person to person and no two cases are the same. Symptoms may change from day to day and there may be times when your disease is active and ‘flared’ up and at other times when it is inactive.
Cause of rheumatoid arthritis
The causes of rheumatoid arthritis are not yet fully understood but research continues in this area. We do know that rheumatoid arthritis is an autoimmune disease. The normal role of the body’s immune system is to fight off and protect us from infections. However, when a person has an autoimmune disease, the immune system starts attacking the body’s healthy tissues instead of foreign matter like an infection.
In the case of rheumatoid arthritis, the immune system targets the lining of the joints, called the synovial membrane, causing inflammation and joint damage. The characteristic swelling happens when the joint produces too much lubricating (synovial) fluid in response to the inflammation. Sometimes other parts of the body such as the lungs and eyes may also be affected.
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.
Seek advice early for rheumatoid arthritis
It is important to seek medical advice as early as possible in the course of the condition. Early treatment will help you to control the inflammation, manage pain more effectively and minimise the risk of long-term joint damage and disability.
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 for further investigations and medical treatment.
Management of rheumatoid arthritis
While there is no cure for rheumatoid arthritis, there are many strategies to help manage the condition and its symptoms so you can continue to lead a healthy and active life. It is helpful to understand the nature of the disease and build good relationships with your doctor, rheumatologist and healthcare professionals.
Medication for rheumatoid arthritis
A rheumatologist may prescribe a number of different medications depending on your symptoms and the severity of your condition to help reduce the inflammation and prevent structural damage to your joints.
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to reduce pain and inflammation. The disease-modifying anti-rheumatic drugs (DMARDs) are a special group of medications used to treat inflammatory arthritis and work to decrease the abnormal function of the immune system that drives rheumatoid arthritis.
Biological DMARDs are the newest class of arthritis medication and work to stop the disease progressing by targeting specific molecules in the immune system. Often you may be on a combination of medications.
Other strategies to manage rheumatoid arthritis
Other important strategies that can help you manage rheumatoid arthritis include:
- Self-management courses – can help people with rheumatoid arthritis and other chronic (ongoing) conditions to build skills and confidence in becoming more actively involved in your healthcare and in managing rheumatoid arthritis day to day.
- 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. You can also phone the Independent Living Centre for advice.
- Relaxation techniques – muscle relaxation, distraction, guided imagery and other techniques can help you manage pain and difficult emotions such as anxiety.
- Exercise – will help you maintain muscle strength and joint flexibility, build up stamina and help you in managing pain. Appropriate low-impact aerobic activities include exercising in warm water, cycling and walking. Activities like strength training and tai chi are also beneficial. Seek advice from a physiotherapist or an accredited exercise physiologist before you begin an exercise program to make sure it is safe and suits your abilities.
- Physiotherapy – a physiotherapist can provide advice on activity modification, managing pain and prescribing an exercise program to help keep your joints mobile and strong.
- Rest – can help you to manage fatigue and is particularly important when your joints are swollen.
- Occupational therapy – an occupational therapist can give advice on pacing yourself and managing fatigue, as well as how to modify daily activities at both home and work to reduce strain and pain on affected joints.
- Nutrition – while there is no specific ‘diet’ for people with rheumatoid arthritis, it is important to have a healthy, balanced diet to maintain general health and, prevent weight gain and other medical problems, such as diabetes and heart disease.
- Support – a peer support group can provide understanding, advice, support and information from others in a similar situation. 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. Fish oil supplements may also be helpful as they contain a certain type of fat called omega-3. Current research suggests omega-3 fats can help reduce inflammation in rheumatoid arthritis.
- Joint surgery – may be necessary in some cases if the joint is very painful or there is a risk of losing overall function.
Any medication or treatment for arthritis must be discussed with and monitored by your doctor or rheumatologist. They will take into account the condition being treated, any other health issues and identifiable risk factors.
Where to get help
- Your doctor
- Arthritis and Osteoporosis Victoria Tel. (03) 8531 8000 or 1800 263 265
- The MSK Help Line at Arthritis and Osteoporosis Victoria Tel. (03) 1800 263 265
- Australian Physiotherapy Association Tel. (03) 9092 0888 or 1300 306 622
- Accredited exercise physiologist
- Occupational therapist
- Independent Living Centre for advice Tel. (03) 9362 6111
- Medicines Line (Australia) Tel. 1300 MEDICINE (1300 633 424) – for information on prescription, over-the-counter and complementary medicines.
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 and damage to joints can be reduced with early and ongoing treatment.
This page has been produced in consultation with and approved by:
Arthritis Victoria incorporating Osteoporosis Victoria
Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.