Rheumatoid Arthritis

Rheumatoid arthritis or osteoarthritis?

People often wonder what the difference is between rheumatoid arthritis and osteoarthritis. Put simply, osteoarthritis is when the cartilage in a joint wears down over time. Rheumatoid arthritis (RA) is an autoimmune disease: the immune system attacks the lining of the joints, causing pain, swelling and, if untreated, damage to cartilage and bone.

RA can start at any age but most often begins in middle age, and it is more common in women than in men. Genes, hormones and environmental factors, smoking in particular, all play a part.

Common symptoms

• pain, swelling and warmth in several joints, often the small joints of the hands and feet
• symptoms on both sides of the body
• stiffness in the morning that lasts more than half an hour
• tiredness, a general feeling of being unwell and sometimes a mild fever

Symptoms often come and go in flares. If you have swollen joints for more than a few weeks, see a doctor. Early treatment makes a big difference to how the disease develops.

How it is diagnosed

There is no single test for rheumatoid arthritis. A doctor, usually a rheumatologist, puts together the picture from an examination of the joints, blood tests and sometimes imaging. Blood tests often include rheumatoid factor and anti-CCP antibodies, as well as inflammation markers such as CRP and ESR. X-ray or ultrasound can show inflammation and joint damage.

Treatment

Modern treatment aims to calm the disease as early as possible. The mainstay is disease-modifying drugs such as methotrexate, often combined with short courses of steroids. If they are not enough, biological drugs and other targeted treatments can be added. Pain relief, physiotherapy and occupational therapy help people stay active and protect their joints.

Lifestyle also matters. Regular exercise keeps joints mobile and muscles strong, and stopping smoking improves both the disease and the response to treatment. A balanced, anti-inflammatory diet supports general health, although it does not replace medication.

Rheumatoid arthritis and the heart

People with RA have a higher risk of heart attack and stroke than the general population. Chronic inflammation affects the blood vessels in much the same way as it does the joints, and speeds up the build-up of plaque in the arteries. This is one reason why controlling the inflammation matters, and why it is worth checking blood pressure, cholesterol and blood sugar regularly. Read more about the link in our overview of the research background.

Mental wellbeing

Living with a long-term condition can be tough. Pain and tiredness affect work, family life and mood. Many people benefit from support from a counsellor or patient organisation, and it is worth raising these concerns with your care team.

This article is general information and not medical advice. If you have symptoms or questions about your own health, talk to a doctor. In an emergency, call your local emergency number.