What is RA?

If you are newly diagnosed with rheumatoid arthritis (RA), you likely have many questions. Here are the most common questions about RA and their answers.

What is RA?
RA is a chronic autoimmune disorder that affects 1.5 million Americans. Autoimmune disorders occur when the immune system mistakenly attacks your own body’s tissues. In the case of RA, the immune system causes joint pain and inflammation. Over time, joints can bone erode and deform. About 40 percent of RA patients also experience symptoms related to their skin, eyes, lungs, heart, kidneys, salivary glands, nerve tissue, bone marrow, or blood vessels.

What are the symptoms?
People experiencing RA often have tender, warm, swollen joints and joint stiffness in the morning or after inactivity. The pain often begins in the joints that attach the hands to the fingers and the feet to the toes. The condition spreads to wrists, knees, ankles, elbows, hips, and shoulders. Symptoms occur in the same joints on both sides of the body. Some people also experience fatigue, fever, weight loss and loss of appetite with RA. Periods of increased disease activity, called flares, can alternate with periods of remission.

What causes RA?
Genetic predisposition may make it more likely for an infection to result in RA. In addition, there may be associated environmental factors such as having been exposed to a virus or bacteria.

Are their risk factors?
Having a family history, smoking, and being overweight are all risk factors. Smoking seems to affect both the likelihood of getting RA and its severity. The disease is three to four times more likely to affect women, and it commonly begins between the ages of 30 and 60.

How is it diagnosed?
Primary care providers can use a medical history, physical exam, and lab tests to make a referral to a specialist in rheumatology called a rheumatologist. The rheumatologist uses history and physical exam as well as laboratory and imaging tests to confirm the diagnosis.

How is it treated?
There are many ways to treat RA. Your doctor will be interested in goals for treatment including reduction in inflammation, symptom relief, prevention of joint and organ damage and improving function.

What can I do on my own?
There is a lot you can do to help manage RA.

• Eat a healthy diet and move daily. Low-impact exercises, like walking and swimming, are especially helpful. Choosing exercise you enjoy will make you more likely to move regularly.
• During a flare, rest and stretching, rather than vigorous exercise, are recommended.
• Keeping a positive attitude, building a solid support system, and practicing stress-reducing activities all improve symptoms.
• For joint pain, you can use hot and cold treatments (whichever makes the pain feel better) and topical medicines.
• Supplements like curcumin/turmeric and omega-3 fish oil may also help improve symptoms.
• Finally, you can also take a self-management education workshop in person or online.

Even as you take steps to manage the disease on your own, it’s important to work closely with your rheumatologist. RA increases chances of osteoporosis, rheumatoid nodules, dry eyes and mouth, carpal tunnel syndrome, heart problems, lung disease, and lymphoma. Some treatments curtail the immune system, which can relate to increased infection risk. Following your doctor’s recommendations can help you reduce your risk.

The diagnosis of RA can be scary and life altering. Take comfort in knowing that it is among the many chronic conditions being managed successfully by millions every day. With positive lifestyle choices, a good attitude, and a working relationship with your rheumatologist, you can go on to have a long and healthy life, even with RA.


Matthew J. Stanishewski, DO, is a rheumatologist at SVMC Rheumatology, part of Southwestern Vermont Medical Center and Southwestern Vermont Health Care in Bennington.