- Rheumatoid arthritis
- Joints
- Autoimmune
Rheumatoid arthritis: early symptoms and why early treatment matters
Rheumatoid arthritis is an autoimmune disease that attacks the joints. We explain how to tell it apart, who is most at risk, and why an early diagnosis helps prevent damage.
PainManagement ER Published 2 min read
It isn’t wear and tear from aging. Rheumatoid arthritis (RA) is a chronic autoimmune disease: the immune system attacks the body’s own tissues, mainly the joints.[1][2] According to the CDC, it mostly affects the joints of the hands, wrists and knees.[1]
How to tell it apart
Two features help recognize it, according to NIAMS:[2]
- It’s symmetrical: if it affects one knee or hand, it often affects the one on the other side too.
- Morning stiffness: joint stiffness that lasts longer than 30 minutes, typically after waking up.
Other common symptoms include:[1][2]
- Pain, tenderness, swelling, warmth and redness in more than one joint
- Fatigue, weakness and occasional low-grade fever
- Weight loss or loss of appetite
The disease alternates between flares, when symptoms suddenly appear or worsen, and periods of remission, when they improve or go away.[1]
Who is most at risk
| Factor | What the CDC and NIAMS say |
|---|---|
| Sex | Women are 2 to 3 times more likely than men to have it |
| Age | It can start at any age; risk is highest between ages 50 and 59 |
| Smoking | Smoking raises the risk and can make arthritis worse |
| Others | Family history (certain genes), obesity, gum disease and lung disease |
Sources: CDC (2024)[1]; NIAMS (2022).[2]
It isn’t known what makes the immune system turn against the joints; researchers point to a combination of genes, environmental factors and sex hormones.[2]
Why treating it early matters
Left uncontrolled, RA can cause long-term pain, swelling, balance problems and deformed joints, and it can also affect the lungs, heart and eyes.[1]
The CDC stresses early diagnosis and treatment by a rheumatologist, because it helps prevent joint damage.[1] According to NIAMS, the goal of treatment is to control the disease until it reaches remission or near remission, with few or no signs of disease activity.[2]
How it is treated
Treatment is based on disease-modifying antirheumatic drugs (DMARDs), which slow progression, control joint swelling and prevent deformity. If the first treatment doesn’t work, doctors may prescribe biologic DMARDs.[1]
The American College of Rheumatology’s 2021 guideline includes 44 recommendations on these drugs and stresses that they are not prescriptive: decisions should be made together with the patient, based on their values, goals, preferences and other health conditions.[3]
No medication should be taken without medical advice: each one has contraindications and side effects.
What you can do
RA has no cure, but it can be managed. The CDC recommends:[1]
- Staying physically active.
- Keeping a healthy weight.
- Avoiding joint injuries and repetitive motions.
- Quitting smoking.
If you have pain and swelling in several joints with morning stiffness, an early assessment can make a real difference in protecting your joints.
Sources
- Rheumatoid Arthritis . Centers for Disease Control and Prevention (CDC) , January 25, 2024.
- Rheumatoid Arthritis . National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), NIH , reviewed November 2022.
- 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis . Fraenkel L, et al. Arthritis & Rheumatology 2021 , 2021.
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