Rheumatoid Arthritis

Inflammation of one or more joints, causing pain and stiffness that can worsen with age.

1.5M

Americans and 1% of the global population are living with rheumatoid arthritis.

3X

Women are three times more likely than men to develop RA

80%

of people with RA eventually test positive for the Rheumatoid factor (RF) antibody 

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is an autoimmune condition. Autoimmune conditions occur when the body’s immune system mistakes its own tissues for foreign invaders, such as bacteria or viruses. The confused immune system springs into action, seeking out to destroy the “invaders” in the tissues. 

In the case of rheumatoid arthritis, this results in chronic, sometimes severe, joint pain and inflammation. [1]

Who is affected?

Anyone can be diagnosed with rheumatoid arthritis. But women are about two to three times more likely to get rheumatoid arthritis than men [2]. The condition generally starts between the ages of 30 and 60 in women and somewhat later in life in men [3]. 

What happens in your body?

Common symptoms of rheumatoid arthritis include: [1] [4]

  • Joint pain, stiffness, and/or swelling (commonly in fingers, wrists, and feet, but also in elbow, hip, shoulder, knee, back) lasting longer than 30 minutes in the morning or after sitting
  • Fatigue
  • Eye redness and pain, and sensitivity to light
  • Firm lumps beneath the skin, primarily in the hands (on knuckles), elbows, or ankles (also called rheumatoid nodules)
  • Low-grade fever
  • Weight loss
  • Muscle ache
  • Chest pain or discomfort and difficulty breathing

Inflammation resulting from rheumatoid arthritis can extend beyond joints, and attack organs, such as the heart, the lungs, or other tissues like muscles, cartilage, and ligaments. This is because rheumatoid arthritis symptoms can worsen over time if not managed through appropriate treatments. [4]

Rheumatoid arthritis-related inflammation usually occurs in symmetry. This means that, if joints on one side of your body are impacted, joints on the other side of your body will be impacted as well [4]. But this may not be the case initially. Many people with rheumatoid arthritis report only experiencing symptoms on one side of the body in early stages. [5]

How do I know if I have Rheumatoid Arthritis?

In its early stages, rheumatoid arthritis symptoms are very similar to the symptoms of other conditions. It is important to get an accurate diagnosis as quickly as possible to make sure that the condition does not worsen. The best way to do this is by visiting your doctor and, if possible, getting a referral to visit a rheumatologist, a doctor with specialized training in treating arthritis.[4] 

Some ways that your doctor can assess whether you have the condition is through reviewing your medical history, and conducting a physical examination and lab tests (such as blood tests and imaging tests). [4]

How is it treated?

There is no cure for rheumatoid arthritis, but integrative interventions have shown to reduce pain and discomfort and improve quality of life by slowing the condition’s progression and easing the severity of symptoms. 

Integrative interventions offer a holistic approach to treatment. Instead of just conventional medicine, integrative treatments combine conventional medicine with nutritional tools, mind-body medicine, and manual medicine for a holistic approach to treating rheumatoid arthritis.

For those new to integrative medicine, learn more here

Conventional Medicine

Many people with RA find that certain medications work for them and others do not. So, in order to find an effective conventional treatment, people with rheumatoid arthritis often work with their doctors to determine which medication works best with their body and needs. 

With the right medication, it is possible to manage symptoms like pain and inflammation and prevent the rapid worsening of the condition. Before starting to take any medication, be sure to ask your doctor about possible side effects. And if you notice any of the side effects once you start your treatment, let your doctor know as soon as possible.

Examples of conventional treatments:

  • Non-steroidal anti-inflammatory drugs (common name: ibuprofen), or NSAIDs, are the most commonly used treatments for inflammation and pain. [4]

  • Analgesics (common name: aspirin) are intended to relieve pain, and are normally used while RA patients wait for other medications to begin working. Analgesics are often recommended for patients who have previously experienced negative side effects when taking NSAIDs.  [4]

  • Glucocorticoids (also known as corticosteroids) are steroid drugs that can be taken by mouth or injection, and are meant to start working immediately to reduce pain and inflammation.  [4]

  • DMARDs (such as methotrexate) are the most widely used drug for RA. They intend to reduce swelling, pain, and long-term damage to joints.  [4]

  • Janus Kinase (JAK) Inhibitors are newer DMARDs that are shown to be promising for RA patients who do not respond to older DMARDs such as methotrexate.  [4]

  • Biologics (also known as biologic response modifiers) are a class of drugs used to treat rheumatoid arthritis. They are proven to have fewer side effects than older RA medications, and they can dramatically slow the worsening of RA. [4]

Mind-Body Medicine

Research shows that gentle, low-intensity mind-body treatments can help RA patients with mobility, mood, decreased pain, and more. There are a wide variety of mind-body treatments for rheumatoid arthritis, ranging from deep breathing to aqua-therapy.

When living with chronic pain, engaging in regular movement and exercise may feel difficult and unnecessary. But doing so can actually improve your symptoms. 

Before starting a physical exercise regimen, consult with your doctor about what might be the best activities for you and your body.

Examples of mind-body medicine:

  • Tai chi is a Chinese practice of slow, low-intensity movements that researchers have found can improve mobility, functionality, and psychological health in patients with RA.

  • Yoga comes in many different styles, often engaging both the body and the mind through controlled breathing and stretching. Studies suggest that yoga improves physical functionality (including balance and flexibility) and decreases pain and depression in rheumatoid arthritis patients.

  • Aqua-therapy and warm water exercise can help you stay active without aggravating your joints, and is particularly useful for individuals who have difficulty with other forms of physical exercise. Research shows aquatic exercises can relieve pain and improve physical functionality in RA patients.

  • Gentle exercise programs guided by instructors who understand your condition can help you both lose weight and manage your RA symptoms. Weight loss has shown to relieve pressure on your knees and curb pain-causing inflammation.

  • Relaxation therapies like deep breathing techniques, meditation, and biofeedback can help RA patients ease anxiety and better manage chronic pain. Stanford researchers suggest that mind-body treatments like these can reduce RA symptoms more effectively than anti-inflammatory medicines (such as ibuprofen) alone.

Manual Medicine

Manual treatments are administered by certified therapists, using physical pressure and stimulation on the body to reduce rheumatoid arthritis symptoms. Treatments can vary in intensity and incorporate other elements such as heat and aromatherapy to enhance relief. 

Examples of manual medicine:

  • A widely-adopted Chinese treatment administered by certified acupuncturists who insert very thin needles at strategic points on the body to support overall wellness. Research shows that acupuncture is effective in treating chronic pain.

  • Licensed massage therapists use different techniques, like shiatsu, hot stone, and Swedish massage, to provide temporary pain relief. Studies suggest that massage therapy is particularly helpful for muscle pain, and that it can also help reduce anxiety.              

  • Physical therapy can help with physical strengthening, mobility, and overall functionality. Licensed therapists provide one-on-one treatment and teach patients self-management techniques so that they can improve their condition on their own too. Recent research shows that physical therapy counseling is a promising treatment in improving functionality for people with inflammatory arthritis. 

  • Osteopathic manipulative treatment, or OMT, is a form of manual therapy used by osteopathic physicians (DOs). A study published in The New England Journal of Medicine demonstrated that osteopathic manual care had similar clinical results to standard medical care, but required fewer medications.

Nutritional Tools

Nutrition plays a crucial role in your overall health, and is a tool you can use to combat joint damage, reduce inflammation, and manage other rheumatoid arthritis symptoms. 

 

Just like with conventional, mind-body, and manual medicines, there is not one ideal treatment for every RA patient. When selecting nutritional tools to treat your condition, it is best to consult with your doctor or work with a dietitian, naturopath, or nutritionist to find out the best diet for you. 

Examples of nutritional tools:

  • Anti-inflammatory diets

    • Anti-inflammatory diets include nutrient-dense foods that contain antioxidants and intend to reduce inflammation in the body. A popular anti-inflammatory diet is the Mediterranean diet which has been shown to reduce signs of inflammation.

  • Plant-based diets

     

    • Vegetarian and vegan diets have shown to promote gut health, which may have an anti-inflammatory impact in rheumatoid arthritis patients.

  • Elimination diet

    • While some foods can help reduce RA symptoms, other foods may trigger them. An elimination diet, which is an eating plan that eliminates certain foods or food groups believed to be causing negative bodily reactions, can help you figure out which foods are triggering those symptoms and bring you closer to your ideal diet.

  • Fish

    • Research suggests that eating fish may reduce joint inflammation for those with rheumatoid arthritis. 

    • Recommendation: Eat three to four ounces of fish (salmon, tuna, sardines, anchovies, or other cold-water fish) twice a week.

  • Fruits and vegetables

    • Fruits and vegetables have antioxidants, which support your immune system and may fight inflammation.

    • Recommendation: Eat one and a half to two cups of fruit (like blueberries, blackberries, cherries, and strawberries) and two to three cups of vegetables (like spinach, kale, and broccoli) per meal.

  • Nuts

    • Nuts are rich in healthy fat, protein, and fiber, and help fight inflammation.

    • Recommendation: Eat one and a half ounces–about a handful–of nuts (like walnuts, pine nuts, pistachios, and almonds) per day. 

  • Beans

  • Olive oil

    • This heart-healthy ingredient contains healthy fat, antioxidants, and oleocanthal, an anti-inflammatory compound.        

    • Recommendation: Consume two to three tablespoons of extra virgin olive oil per day by using it in your cooking or salad dressings. 

  • Onions

    • These simple, flavor-rich vegetables are packed with antioxidants and may help reduce inflammation, improve heart health, and help control cholesterol levels.

  • Fiber

    • Fiber is found in foods like beans, whole grain breads, and fresh vegetables. It makes you feel fuller for longer and boosts digestive health. Research suggests that is may also help reduce inflammation.

    • Recommendation: Incorporate a good mix of insoluble fiber (from vegetables, wheat, and seeds) and soluble fiber (from fruits and oats) in your diet or try fiber supplements. 

  • Turmeric

    • Turmeric is a spice from the turmeric plant that has anti-inflammatory properties. Research shows that a key chemical compound (curcumin) in turmeric can relieve rheumatoid arthritis and its symptoms.      

    • Recommendation: Turmeric is a popular spice which you can add to any food or drink (like vegetables, rice, tea, or smoothies). Add it to your meals or take it in supplement form. Some supplements combine turmeric curcumin with black pepper for enhanced health benefits.

  • Folic acid

    • Folic and folinic acid supplements have been shown to improve liver function and ease gastrointestinal intolerance (the digestive system’s difficulty processing certain foods, which can lead stomach pain and bloating). 

  • Vitamin D

     

    • Vitamin D supplements are good for bone health, and they can also help keep the immune system functioning properly. Research shows that individuals who respond poorly to rheumatoid arthritis treatment tend to have lower levels of vitamin D. This suggests that it may help the treatment process if RA patients take vitamin D supplements alongside other therapies.

  • Antioxidants

     

    • Selenium supplements can help keep your immune system functioning properly and prevent cell damage (also known as oxidative stress) caused by rheumatoid arthritis.

    • Research shows other antioxidants that can help prevent cell damage and keep the body in a balanced state are vitamin A and vitamin C.

  • Probiotics

     

    • Rheumatoid arthritis can have a negative impact on gut health. Research shows probiotic supplements may help improve gut health and even lead to lower levels of inflammation. 

  • Pomegranate

    • Research shows the antioxidant quality of pomegranates may ease symptoms of rheumatoid arthritis, such as tender joints.   

  • Green tea extract 

    • Research shows green tea extract (GTE) may help reduce rheumatoid arthritis symptoms such as overall inflammation and joint damage.

  • [1] Centers for Disease Control and Prevention. (2020, July 27). Rheumatoid Arthritis (RA). Centers for Disease Control and Prevention. https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html.  
  • [2] Vollenhoven, R. F. V. (2009). Sex differences in rheumatoid arthritis: more than meets the eye... BMC Medicine, 7(1). https://doi.org/10.1186/1741-7015-7-12  
  • [3] Jennifer Freeman, M. D. RA Facts: What are the Latest Statistics on Rheumatoid Arthritis? RheumatoidArthritis.org. https://www.rheumatoidarthritis.org/ra/facts-and-statistics/.  
  • [4] Mayo Foundation for Medical Education and Research. (2019, March 1). Rheumatoid arthritis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/symptoms-causes/syc-20353648.  
  • [5] O'Neill, K. (2019, October 5). Rheumatoid Arthritis Signs and Symptoms. Rheumatoid Arthritis Warrior. https://rawarrior.com/rheumatoid-arthritis-sign-symptoms/.  
  • [6] Arthritis Foundation. Arthritis By the Numbers. 2019; v3; 4100.17.10445 
  • [7] van Vollenhoven R. F. (2009). Sex differences in rheumatoid arthritis: more than meets the eye... BMC medicine, 7, 12. https://doi.org/10.1186/1741-7015-7-12 
  • [8] Matthew Ezerioha, M. (n.d.). RF Test: What is the Normal Range for a Rheumatoid Factor Test? Retrieved July 12, 2020, from https://www.rheumatoidarthritis.org/ra/diagnosis/rheumatoid-factor/ 
The information on this page is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek medical advice from your physician or health provider for your specific needs.