Rheumatoid arthritis (RA) is a chronic (long-lasting) autoimmune disease that mostly affects joints. RA occurs when the immune system, which normally helps protect the body from infection and disease, attacks its own tissues. The disease causes pain, swelling, stiffness, and loss of function in joints.

Additional features of rheumatoid arthritis can include the following:

1. It affects the lining of the joints, which damages the tissue that covers the ends of the bones in a joint.

2. RA often occurs in a symmetrical pattern, meaning that if one knee or hand has the condition, the other hand or knee is often also affected.

3. It can affect the joints in the wrists, hands, elbows, shoulders, feet, spine, knees, and jaw.

4. RA may cause fatigue, occasional fevers, and a loss of appetite.

5. RA may cause medical problems outside of the joints, in areas such as the heart, lungs, blood, nerves, eyes, and skin.

Fortunately, current treatments can help people with the disease to lead productive lives.

What happens in rheumatoid arthritis?

Doctors do not know why the immune system attacks joint tissues.

However, they do know that when a series of events occurs, rheumatoid arthritis can develop.

This series of events includes:

1. A combination of genes and exposure to environmental factors starts the development of RA.

2. The immune system may be activated years before symptoms appear.

3. The start of the autoimmune process may happen in other areas of the body, but the impact of the immune malfunction typically settles in the joints.

4. Immune cells cause inflammation in the inner lining of the joint, called the synovium.

5. This inflammation becomes chronic, and the synovium thickens due to an increase of cells, production of proteins, and other factors in the joint, which can lead to pain, redness, and warmth.

6. As RA progresses, the thickened and inflamed synovium pushes further into the joint and destroys the cartilage and bone within the joint.

7. As the joint capsule stretches, the forces cause changes within the joint structure.

8. The surrounding muscles, ligaments, and tendons that support and stabilize the joint become weak over time and do not work as well. This can lead to more pain and joint damage, and problems using the affected joint.

Who Gets Rheumatoid Arthritis?

You are more likely to get rheumatoid arthritis if you have certain risk factors. These include:

1. Age The disease can happen at any age; however, the risk for developing rheumatoid arthritis increases with older age. Children and younger teenagers may be diagnosed with juvenile idiopathic arthritis, a condition related to rheumatoid arthritis.

2. Sex Rheumatoid arthritis is more common among women than men. About two to three times as many women as men have the disease. Researchers think that reproductive and hormonal factors may play a role in the development of the disease for some women.

Mental health management Living with RA can be hard and isolating. If you feel alone, anxious, or depressed about having the disease, talk to your doctor, an RA support social worker, or mental health professional. Keep the lines of communication open. Talk to family and friends about your RA to help them understand the disease. You may find it helpful to join an online or community support group.

Healthy diet A healthy and nutritious diet that includes a balance of calories, protein, and calcium is important for maintaining overall health. Talk to your doctor about drinking alcoholic beverages because they may interact with the medications you take for rheumatoid arthritis.

Before making any changes to your diet or activity, talk to your doctor.