What Exactly Is Rheumatoid Arthritis? A Rheumatologist Explains

RA isn’t what you normally think of when you hear “arthritis.”

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What most people think of as arthritis—painful joints from “wear and tear” as you age—is actually just one type of arthritis known as osteoarthritis. Here’s the thing: Arthritis is an umbrella term for a variety of pain-causing conditions. One common type of arthritis that actually has very little to do with aging is rheumatoid arthritis, or RA.

“Rheumatoid arthritis is an autoimmune disease, which means the immune system—which is supposed to be your protection against viruses or bacteria—becomes active against your own tissues,” says Ashira Blazer, MD, a rheumatologist at NYU Langone Medical Center.

In RA, the immune system attacks joint tissues, causing chronic inflammation, swelling, and pain in the joints. The most commonly affected joints are knuckles, wrists, elbows, shoulders, hips, and ankles, according to Dr. Blazer.

“Along with the joint pain caused by RA, patients tend to have systemic symptoms,” says Dr. Blazer. “This is because the immune system is active.” Any time the immune system is actively responding to a perceived threat—whether it’s a flu virus, an allergen, or something more serious—you can have some under-the-weather symptoms, such as fatigue, low-grade fever, and loss of appetite. (It’s that immune response that causes symptoms, and not the illness itself.)

When it comes to pain, RA joint pain tends to have some unique characteristics compared with other kinds of joint pain. “RA joint pain tends to be symmetrical,” says Dr. Blazer.  “If it affects one or two joints on one side of the body, it tends to affect the same joints on the other side of the body.” If someone only has a couple affected joints and they’re only on one side, doctors usually rule out an RA diagnosis.

People with RA tend to be a bit younger than “typical” arthritis patients. Most people with RA are diagnosed in their 30s to 50s; women are three times more likely than men to have RA, according to the Arthritis Foundation. However, RA can strike at any age, and juvenile rheumatoid arthritis has been seen in kids as young as two.

RA symptoms can come on slowly, over a period of weeks to months. “A lot of times busy adults, who are otherwise in control of their lives, like to just push through the pain and soldier through,” says Dr. Blazer. “With rheumatoid arthritis, that could delay diagnosis and could lead to more trouble in the future.”

The longer RA goes untreated, the more damage occurs to the joints. The first stage of treatment works to aggressively halt inflammation to prevent further damage and long-term complications, according to the Arthritis Foundation.  Recent treatment options have allowed doctors and patients to control RA better and significantly slow the progression of the disease.

“[RA] is a chronic condition, but it can be managed quite well,” says Dr. Blazer. “Most patients can achieve a remission or partial remission.”

Diagnosed with RA? Here are tips for living with rheumatoid arthritis, according to fashion designer and RA patient Michael Kuluva.