Rheumatoid arthritis (RA) isn’t the same as grandma’s stiff joints (aka osteoarthritis). It’s an autoimmune disease that causes a person’s immune system to attack their joints by mistake, causing pain and swelling—and it most often shows up between the ages of 30 and 50, per the American College of Rheumatology.
RA isn’t super common among all cases of arthritis—about 1.3 million people are affected by it, according to the American College of Rheumatology. But for those who do have it, it can be debilitating. Here’s what you need to know.
No one knows exactly what causes rheumatoid arthritis.
“We don’t really know the cause, even to date,” Orrin Troum, M.D., a rheumatologist at Providence Saint John’s Health Center in Santa Monica, California, tells SELF. What we do know is that it’s an autoimmune disease and that there is evidence that it runs in families. According to Dr. Troum, there are some factors that have been linked to RA, including smoking cigarettes, poor dental hygiene, and genetics.
Your genes don’t actually cause you to develop rheumatoid arthritis, but they can make you more susceptible to environmental factors, like bacterial or viral infections, that could potentially trigger the disease, according to the Mayo Clinic. In other words, having a genetic predisposition doesn’t mean that you’ll get RA; rather, it means you inherited genetic variations from your parents that could make it harder for your body to fend off infection (which can then contribute to the development of a disease).
It’s not the same as osteoarthritis, the most common form of arthritis.
People tend to associate the word “arthritis” with osteoarthritis, which causes joint inflammation that typically comes from the wear and tear of age. But rheumatoid arthritis is an immune condition that impacts the lining of a person’s joints. In some patients, RA can impact the skin (via nodules—lumps that form beneath the skin—and rashes), cause inflammation in the lungs and whites of the eyes, lead to plaque buildup in the heart and an increased risk of heart attack and stroke, and damage the blood vessels, according to the Arthritis Foundation.
The symptoms can be incredibly painful.
Rheumatoid arthritis starts in a person’s joints, but it can be felt all over. Symptoms typically include joint pain, tenderness, swelling, or stiffness (especially in the morning), according to the Arthritis Foundation. People can also experience fatigue, loss of appetite, and a low-grade fever, the organization says.
“While you have pain in your joints, your whole body [feels] sick,” Marcy O’Koon, senior director of consumer health at the Arthritis Foundation, tells SELF. “People just feel ill. They have fatigue because they don’t sleep well due to the pain.” The first symptoms tend to happen in the joints of the hands and feet and then spread to other areas of the body, Reddog Sina, D.O., assistant professor in the department of family and community medicine at Michigan State University, tells SELF.
People suffer from flare-ups with RA.
Depending on how severe their condition is, people with RA can feel fine one day and terrible the next. These flare-ups can be unpredictable and debilitating, the Arthritis Foundation says. Some flare-ups have known triggers, like overexerting yourself and having swollen joints the next day, but others have no known cause.
It disproportionally impacts women.
About 75 percent of patients in the U.S. with RA are women, according to the American College of Rheumatology, and 1 to 3 percent of women may get RA in their lifetime. This is true for several other autoimmune conditions like lupus and thyroid disease, Dr. Troum says, and experts aren’t sure why it happens. Women with RA tend to feel better during pregnancy, only to have a flare-up afterward, O’Koon says. “It may have something to do with hormonal differences, but we just don’t know,” Dr. Troum says.
You can’t be cured of rheumatoid arthritis, but it is treatable.
Since rheumatoid arthritis can get worse with time, early diagnosis is key, Dr. Troum says. But diagnosis can be difficult. “Often, patients aren’t recognized as having rheumatoid arthritis at first and are treated with over-the-counter medications,” he says. It’s not uncommon for RA patients to originally be misdiagnosed with osteoarthritis, Dr. Troum says.
Once a person receives a diagnosis, verified through a blood test and sometimes an X-ray, they’re often put on disease-modifying antirheumatic drugs (DMARDS) which can stop the progression of the disease and prevent disability, Dr. Troum says. Typically patients stay on the drugs for life, but they don’t have a positive effect on everyone. “It’s very individually dependent. Some people function incredibly well with medication their entire lives, and others don’t,” Dr. Sina says. Getting good sleep, eating a healthy diet, and trying to decrease stress may also help people manage their RA, Dr. Troum says.
If you’re diagnosed with RA, know this: You can still have a good, active life with proper care. “Most of my patients lead normal, healthy, productive lives,” Dr. Troum says.