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HomeYour HealthConditionsArthritisUnderstanding Rheumatoid ArthritisUnderstanding Rheumatoid Arthritis

Published on October 26, 2023

Authored by Pfizer Medical Affairs

Things to remember

  • Rheumatoid arthritis (RA) causes pain and inflammation in your joints

  • It commonly affects the hands, knees and feet

  • There’s no cure, but it can be managed and damage to your joints can be reduced with early and ongoing treatment

Rheumatoid arthritis is a chronic condition that results from a malfunctioning immune system.


Your immune system is designed to identify foreign bodies (e.g. bacteria and viruses) and attack them to keep you healthy. However in the case of rheumatoid arthritis, your immune system mistakenly attacks healthy tissue in and around your joints causing ongoing inflammation and pain.

Your joints
  • Joints are places where bones meet. Bones, muscles, ligaments and tendons all work together so that you can bend, twist, stretch and move about.
  • The ends of your bones are covered in a thin layer of cartilage. It acts like a slippery cushion absorbing shock and helping your joint move smoothly.
  • The joint is wrapped inside a tough capsule filled with synovial fluid. This fluid lubricates and nourishes the cartilage and other structures in the joint.
  • In RA, the immune system attack on the joints causes a build-up of synovial fluid and inflammation of the tissues that line the joint (synovial membrane). This causes pain, heat and swelling.
  • Cartilage becomes brittle and breaks down. Because the cartilage no longer has a smooth surface, the joint becomes stiff and painful to move.
  • Ligaments, tendons and muscles surrounding the joint can also be affected, causing joints to become unstable.
What are symptoms linked with rheumatoid arthritis?

The most common symptoms of RA include:

  • swelling, pain and heat in the joints, usually the smaller joints of the hands or feet
  • stiffness in the joints, especially in the morning
  • persistent mental and physical tiredness (fatigue)
  • same joints on both sides of the body are usually affected
  • sometimes other parts of the body (e.g. lungs, eyes) may be affected


Less common symptoms may include weight loss, inflammation of other body parts (e.g. lungs, eyes) or rheumatoid nodules (fleshy lumps below the elbows or on hands or feet).

Rheumatoid arthritis can occur at any age, but usually appears between the ages of 30 to 60. It affects women more often than men.

The course and severity of RA varies from person to person. Symptoms may change from day to day.

At times your symptoms (e.g. pain, fatigue, inflammation) can become more intense. This is a flare. Flares are unpredictable and can seem to come out of nowhere.

What are the causes of rheumatoid arthritis?We don’t know what causes the immune system to malfunction and attack the joints, however it appears that your genes may play a role. Other factors such as hormones, infection (by an unknown bacteria or virus), emotional distress or environmental triggers (e.g. cigarette smoke, pollutants) may be involved.Seek advice early for rheumatoid arthritisIf you’re experiencing joint pain and inflammation, it’s important that you discuss your symptoms with your doctor. Getting a diagnosis as soon as possible means that treatment can start promptly. Early treatment will help you to control the inflammation, manage pain more effectively and minimise the risk of long-term joint damage and disability.

If you’re diagnosed with RA you may be referred to a medical specialist known as a rheumatologist for further investigations and medical treatment.
What are some treatment options for rheumatoid arthritis?While there’s no cure for RA, there are many strategies to help manage the condition and its symptoms so you can continue to lead a healthy and active life.What are some medication options for rheumatoid arthritis?

Your doctor or specialist may prescribe a number of different medications depending on your symptoms and the severity of your condition.

Some of the medications you may take include:

  • Pain relievers (or analgesics) – for temporary pain relief.
  • Non-steroidal anti-inflammatories (NSAIDs) – control inflammation and provide pain relief.
  • Corticosteroids – quickly control or reduce inflammation.
  • Disease-modifying anti-rheumatic drugs (DMARDs) – control your overactive immune system.
  • Biologics and biosimilars (bDMARDs) – are biological disease-modifying drugs that work to control your immune system, but in a much more targeted way.
  • Targeted synthetic disease-modifying anti-rheumatic drugs (tsDMARDs) - are a class of treatment that work to control your immune in a targeted way. Unlike bDMARDS, which are administered via injection or infusion, these are oral medications.2

Depending on your particular symptoms, and how much pain and inflammation you have, you may take one medication or a combination of different medications.

Tips to self manage rheumatoid arthritis 

There are other things you can do to manage your RA:

  • learn about RA – knowing as much as possible about your condition means that you can make informed decisions about your healthcare and play an active role in the management of your condition.
  • exercise – will help you maintain muscle strength and joint flexibility, build up stamina and help you manage your pain. 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 exercise physiologist before you begin an exercise program.
  • see a physio – a physiotherapist can provide advice on ways you can modify your activities, show you pain relief techniques and design an individual exercise program for you.
  • talk to an OT – an occupational therapist can give advice on pacing yourself and managing fatigue, as well as how to modify daily activities both at home and work to reduce strain and pain on affected joints.
  • try relaxation techniques – muscle relaxation, distraction, guided imagery and other techniques can help you manage pain and difficult emotions such as anxiety, and can help you get to sleep.
  • grab a gadget – supports such as walking aids, specialised cooking utensils, ergonomic computer equipment and long-handled shoe horns can reduce pain and fatigue. An occupational therapist can give you advice on aids and equipment to suit you.
  • rest – can help you to manage fatigue and is particularly important when your joints are swollen.
  • stay at work – it’s good for your health and wellbeing. Talk to your doctor or allied healthcare professional about ways to help you stay at work or get back to work.
  • eat well – while there’s no specific diet for people with RA, it’s important to have a healthy, balanced diet to maintain general health and prevent other medical problems, such as diabetes and heart disease.
  • complementary therapies – treatments such as massage, meditation or acupuncture may be helpful. Talk with your doctor or rheumatologist before starting any treatment. Fish oil supplements may also be helpful as they contain omega-3 fats. Research suggests omega-3 fats can help reduce inflammation in RA.1
Joint surgerySurgery may be necessary in some cases if the joint is very painful or there’s a risk of losing joint function.

Where to get help

This information is adapted from Musculoskeletal Australia (MSK) with their permission.

MSK is a consumer organisation supporting people with conditions such as rheumatoid arthritis, osteoarthritis, lupus, fibromyalgia, and back pain. To access their free Help Line, webinars and other services, call MSK weekdays on 1800 263 265, email [email protected] or visit msk.org.au

References

  1. The Consumer’s Guide to JAK Inhibitors for Ankylosing Spondylitis, Everyday Health. Available from: https://www.everydayhealth.com/ankylosing-spondylitis/consumers-guide-to-jak-inhibitors-for-ankylosing-spondylitis/. Accessed Oct 2023
  2. Omega-3 Fatty Acids, National Institutes of Health. Available from: https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/. Accessed Oct 2023

External Resources

  1. https://msk.org.au/rheumatoid-arthritis/ - Accessed Oct 2023
  2. https://arthritisaustralia.com.au/ - Accessed Oct 2023
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