Rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels.

An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues.

Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.

The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities.

Signs and symptoms of rheumatoid arthritis may include:

Tender, warm, swollen joints

Joint stiffness that is usually worse in the mornings and after inactivity

Fatigue, fever and loss of appetite

Early rheumatoid arthritis tends to affect your smaller joints first — particularly the joints that attach your fingers to your hands and your toes to your feet.

As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body.

About 40% of people who have rheumatoid arthritis also experience signs and symptoms that don't involve the joints. Areas that may be affected include:

Skin

Eyes

Lungs

Heart

Kidneys

Salivary glands

Nerve tissue

Bone marrow

Blood vessels

Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission — when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place.

RA is an autoimmune disorder and is the result of your body’s immune system attacking healthy body tissues. However, the specific causes or triggers of RA are not yet known.

If you have RA, your immune system sends antibodies to the lining of your joints as part of the disease process. These antibodies attack the tissues lining your joints, causing the lining cells (synovial cells) to divide and contribute to inflammation. During this process, chemicals are released that can damage nearby bones, cartilage, tendons, and ligaments.

If RA is not treated, the joint will become damaged and lose its shape and alignment, eventually becoming destroyed.

Age. The onset of RA is highestTrusted Source among adults in their 50s. Risk continues to increase with age for people assigned male at birth. RA often occurs in people assigned female at birth during their child-bearing years.

Sex. People assigned female at birth are two to three times more likely to develop RA than people assigned male at birth.

Genetics. People born with certain genes, called HLA class II genotypes, are more likely to develop RA. The risk of RA may be highest when people with these genes have obesity or are exposed to environmental factors like smoking.

History of live births. People with ovaries who have never given birthTrusted Source may be at a greater risk of developing RA than those who have given birth.

Early life exposure. According to the Centers for Disease Control and PreventionTrusted Source, children whose mothers smoked have double the risk of developing RA as adults.

Smoking. Studies show that people who smoke cigarettes are at an increased risk of developing RA.

Obesity. Having obesity can increase the risk of developing RA.

Diet. High consumption of sodium, sugar (especially fructose), red meat, and iron is associated with an increased risk of developing RA.

Rheumatoid arthritis increases your risk of developing:

Osteoporosis. Rheumatoid arthritis itself, along with some medications used for treating rheumatoid arthritis, can increase your risk of osteoporosis — a condition that weakens your bones and makes them more prone to fracture.

Rheumatoid nodules. These firm bumps of tissue most commonly form around pressure points, such as the elbows. However, these nodules can form anywhere in the body, including the heart and lungs.

Dry eyes and mouth. People who have rheumatoid arthritis are much more likely to develop Sjogren's syndrome, a disorder that decreases the amount of moisture in the eyes and mouth.

Infections. Rheumatoid arthritis itself and many of the medications used to combat it can impair the immune system, leading to increased infections. Protect yourself with vaccinations to prevent diseases such as influenza, pneumonia, shingles and COVID-19.

Abnormal body composition. The proportion of fat to lean mass is often higher in people who have rheumatoid arthritis, even in those who have a normal body mass index (BMI).

Carpal tunnel syndrome. If rheumatoid arthritis affects your wrists, the inflammation can compress the nerve that serves most of your hand and fingers.

Heart problems. Rheumatoid arthritis can increase your risk of hardened and blocked arteries, as well as inflammation of the sac that encloses your heart.

Lung disease. People with rheumatoid arthritis have an increased risk of inflammation and scarring of the lung tissues, which can lead to progressive shortness of breath.

Lymphoma. Rheumatoid arthritis increases the risk of lymphoma, a group of blood cancers that develop in the lymph system.

There's no way to prevent RA, but you can lower your chances if you: Quit smoking. It's the one sure thing besides your genes that boosts your odds of getting RA. Some studies show it also can make the disease get worse faster and lead to more joint damage, especially if you're ages 55 or younger.