Rheumatoid Arthritis Symptoms and Treatment

Learn more about rheumatoid arthritis and how INTEGRIS Health can partner with you to help treat and manage this condition.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects more than just your joints. As an autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues.

Signs and Symptoms of Rheumatoid Arthritis | Causes of Rheumatoid Arthritis | Complications from Rheumatoid Arthritis | Diagnosing Rheumatoid Arthritis | Rheumatoid Arthritis Treatments

Uncontrolled inflammation can damage cartilage which is needed to absorb shock and stress on your joints. Once the cartilage is gone, your bones will begin to erode and lead to fusing together as a way to prevent constant irritation.

In some cases, people can experience damage to other parts of their body.

Rheumatoid arthritis can also affect the following:

  • Skin
  • Eyes
  • Mouth
  • Lungs
  • Heart

Signs and Symptoms of Rheumatoid Arthritis

The most common symptoms of rheumatoid arthritis are joint pain and stiffness. Patients often experience the worst of these symptoms in the morning and after sitting for a long period of time. Stiffness tends to go away after movement.

Symptoms typically fluctuate as they come and go and range in severity.

Other symptoms include:

  • Tender, warm and swollen joints
  • Joint stiffness that is generally worse in the mornings and after inactivity
  • Fatigue, fever and loss of appetite
  • Weakness
  • Fever

Early signs and symptoms of rheumatoid arthritis often affect smaller joints first, such as the joints that attach your fingers to your hands and toes to your feet.

As the disease continues, symptoms will often spread to other parts of the body, including:

  • Wrists
  • Knees
  • Ankles
  • Elbows
  • Hips
  • Shoulders

Often, you'll experience symptoms in the same joint on both sides of the body.

Roughly 40% of people who have rheumatoid arthritis will experience additional symptoms in non-joint areas.

These areas include the following:

  • Skin
  • Eyes
  • Lungs
  • Heart
  • Kidneys
  • Salivary glands
  • Nerve tissue
  • Bone marrow
  • Blood vessels

People with rheumatoid arthritis will experience symptoms that range in severity and usually come and go. Periods of increased disease activity are called flares and alternate with periods of relative remission which is when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place.

Causes of Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease. In a healthy body, your immune system helps protect your body against infections and diseases. In rheumatoid arthritis, your own immune system attacks the healthy tissue in your joints. The disease can also spread from your joints and affect your heart, lungs, nerves, eyes and skin.

Doctors don't know what starts this disease from happening, but they believe a genetic component is involved. Genes don't cause rheumatoid arthritis; however, they can make them more likely to react to environmental factors. It's possible to contract an infection with certain viruses and bacteria which can trigger the disease.

Risk Factors

There are several factors that can heighten your risk of rheumatoid arthritis.

They include the following:

  • Sex: women are more likely to develop the condition compared to men
  • Age: Rheumatoid arthritis can develop at any age, but it's most common in middle-aged adults
  • Family history: if a family member has rheumatoid arthritis, you may have a greater risk of developing it
  • Smoking: cigarette smoking increases your risk of developing the condition. Smoking also appears to be linked to greater disease severity
  • Excess weight: people who are overweight appear to be at a higher risk of developing the disease

Complications from Rheumatoid Arthritis

Rheumatoid arthritis can also increase your risk of developing the following:

  • Osteoporosis: both the disease and the medication can increase your risk of osteoporosis, a condition that weakens your bones and makes them more prone to fracture
  • Rheumatoid nodules: firm bumps of tissue can form around pressure points like the elbows. These nodules can also form anywhere in the body, including the heart and lungs
  • Dry eyes and mouth: more likely to develop Sjogren's syndrome. A disorder that decreases the amount of moisture in the eyes and mouth
  • Infections: an impaired immune system means a heightened risk of developing infections like influenza, pneumonia and shingles
  • Abnormal body composition: the proportion of fat to lean mass is often higher in people with rheumatoid arthritis, even people who have a normal body mass index (BMI)
  • Carpal Tunnel Syndrome: if the disease affects your wrists; the inflammation can compress the nerve that serves most of your hand and fingers
  • Heart problems: a higher risk of hardened and blocked arteries also the inflammation of the sac that encloses the heart muscle
  • Lung disease: increased risk of inflammation and scarring of the lung tissues and lead to shortness of breath
  • Lymphoma: increased risk of developing lymphoma, a group of blood cancers that can develop in the lymph system

Diagnosing Rheumatoid Arthritis

Rheumatoid arthritis is difficult to diagnose in its early stages because the signs and symptoms often replicate those of similar diseases. There isn't a singular blood test or physical finding that can confirm the diagnosis.

During a physical exam, your doctor will check your joints for swelling, redness and warmth. They may also check your reflexes and muscle strength to determine joint mobility.

Blood Test

People with rheumatoid arthritis often have an elevated erythrocyte sedimentation rate or C-reactive protein level. These may indicate to your doctor the presence of an inflammatory process in the body. Other common blood tests look for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies.

Imaging Tests

Your doctor may also recommend X-rays to help track the development of rheumatoid arthritis in your joints over time. An MRI and ultrasound tests can help your doctor judge the severity of the disease in your body.

Rheumatoid Arthritis Treatments

At the moment, there is no cure for rheumatoid arthritis. However, your symptoms are more likely to enter remission when treatment begins early with the help of medications such as disease-modifying antirheumatic drugs (DMARDs).


Depending on the severity of your symptoms and condition history, your doctor may recommend the following medications.

  • NSAIDs: nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and inflammation in patients. Over-the-counter NSAIDs can include Ibuprofen (Advil, Motrin IB, etc.) and naproxen sodium (Aleve). There are stronger NSAIDs, but those will need a prescription. Be aware that possible side effects can include stomach irritation, heart problems and kidney damage.
  • Steroids: corticosteroid medications such as prednisone can reduce inflammation and pain while also slowing down joint damage. However, side effects can include thinning of bones, weight gain and diabetes. Doctors may recommend corticosteroids to relieve symptoms quickly and then taper off the medication as symptoms improve.
  • Conventional DMARDs: these drugs recommended by your doctor can help slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. Common DMARDs include methotrexate (Trexall, Otrexup), leflunomide (Arava), hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine). Side effects may vary but can include liver damage and severe lung infections.
  • Biologic agents: Also known as biologic response modifiers, this is a newer class of DMARDs. Biologic DMARDs are often paired with conventional DMARDs such as methotrexate for most effectiveness. Biologic agents can include abatacept (Orecncia), adalimumab (Humira), anakinra (Kineret), certolizumab (Cimzia), etanercept (Enbrel), golimumab (Simponi), infliximab (Remicade), rituximab (Rituxan), sarilumab (Kevzara) and tocilizumab (Actemra). Possible side effects for these are an increased risk of infections.
  • Targeted synthetic DMARDs: medications such as baricitinib (Olumiant), tofacitinib (Xeljanz) and upadacitinib (Rinvoq) can be used if conventional DMARDs and biologic agents haven't been as effective. However, higher doses of tofacitinib can increase the risk of blood clots in the lungs, cancer and serious heart-related complications.


Your doctor may also refer you to a physical or occupational therapist. There, they'll be able to teach you exercises to help your joints be flexible and maintain mobility. Therapists can also provide new ways of handling daily tasks to reduce the stress on your joints.


Your doctor may recommend a surgical procedure if your medications fail to prevent or slow joint damage. Surgery may help improve joint mobility and help reduce pain.

Rheumatoid arthritis surgery may include one or more of the following procedures:

  • Synovectomy: surgical procedure to remove the inflamed lining of the joint (synovium). This can help reduce pain and improve the joint's flexibility.
  • Tendon repair: Inflammation and joint damage can cause the tendons around your joint to loosen or rupture. Your doctor may be able to repair the tendons around your joint.
  • Joint fusion: your doctor may be able to surgically fuse a joint to stabilize or realign for pain relief. This procedure can be done when a joint replacement isn't an option.
  • Total joint replacement: your doctor may recommend a total joint replacement, a procedure that removes damaged parts of the joint and inserts a prosthesis typically made of metal and plastic.

Our physicians use a multidisciplinary approach to treat the complex symptoms of individuals living with lupus and rheumatic diseases such as rheumatoid arthritis, Sjogren's syndrome and scleroderma. We strive to provide complete care, including management of related secondary conditions frequently associated with autoimmune diseases, such as heart disease and diabetes.

Available Near You