Rheumatoid Arthritis

What Is Rheumatoid Arthritis? Symptoms, Causes, Diagnosis, Treatment, and Prevention

约瑟夫·本宁顿·卡斯特罗（Joseph Bennington-Castro）
By Medically Reviewed by
Reviewed:
Medically Reviewed
illustration of joint pain related to rheumatoid arthritis
Rheumatoid arthritis causes pain and swelling in the joints; if untreated, the inflammatory disease may damage cartilage and bone. iStock

Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joints. Within the body, joints are the points where bones come together and allow for movement. Most of these joints — those called synovial joints — also provide shock absorption.

RA is anautoimmune condition, in which your immune system mistakes the linings of your joints as "foreign" and attacks and damages them, resulting in inflammation and pain.

This disease most often affects the joints of the hands, wrists, and knees symmetrically. There is no cure, but RA can be managed with good treatment, according to the Centers for Disease Control and Prevention (CDC).

Common Questions & Answers

What is rheumatoid arthritis?
Rheumatoid arthritis (RA) is a chronic autoimmune condition in which your immune system mistakes the linings of your joints as foreign and attacks them. The damage results in inflammation and pain.
What is the difference between rheumatoid arthritis and osteoarthritis?
类风湿关节炎使关节衬里炎症，最终侵蚀了关节。对于骨关节炎，多种原因可能会损害覆盖关节骨头末端的软骨。骨关节炎是最常见的关节炎类型，被认为是一种机械性（磨损）疾病。
How is RA diagnosed?
没有一个测试可以诊断类风湿性关节炎。Doctors consider symptoms such as joint swelling and morning stiffness. Blood tests detect rheumatoid factor and anti-citrullinated protein antibodies (ACPAs), which are markers for systemic inflammation. X-ray, ultrasound, and magnetic resonance imaging (MRI) scans can help determine joint health.
Can RA be fatal?
RA is not generally considered a lethal disease. The disease can usually be managed with medication.
Are there home remedies for rheumatoid arthritis?
Exercise is an essential aspect of RA treatment, consisting of stretching, aerobics, and strength training. For pain and inflammation, try heat treatment to soothe stiff joints, or cold treatments for acute pain, as well as over-the-counter topical ointments and specialized braces or splints that support the joints.

Signs and Symptoms of Rheumatoid Arthritis

Rheumatoid arthritis is a complex disease that is not well understood by medical practitioners or researchers.

Early signs of disease, such as joint swelling, joint pain, and joint stiffness, typically begin in a gradual and subtle way, with symptoms slowly developing over a period of weeks to months and getting worse over time. RA usually begins in the small bones of the hands (particularly those at the base and middle of the fingers), base of the toes, and wrists. Morning stiffness that lasts for 30 minutes or more is another hallmark symptom of RA, per the Arthritis Foundation.

RA is a progressive disease. When left untreated, inflammation can start to develop in other parts of the body, causing various potentially serious complications that can affect other organs, such as the heart, lungs, and nerves, and could cause significant long-term disability.

If you're experiencingRA症状, it's crucial to get diagnosed as soon as possible so that you can receive prompt treatment.

Learn More About Rheumatoid Arthritis Signs and Symptoms

Causes and Risk Factors of Rheumatoid Arthritis

RA发展当白细胞正常protect the body from foreign invaders such as bacteria and viruses, enter the synovium (the thin tissue that lines the synovial joints). Inflammation ensues — the synovium thickens, causing swelling, redness, warmth, and pain in the synovial joint.

Over time, the inflamed synovium can damage the cartilage and bone within the joint, as well as weaken supportive muscles, ligaments, and tendons.

Researchers don't know exactly what causes the immune system to invade the synovium, but it's believed that genes and environmental factors play a role in the development of RA.

Research suggests that people with certain genetics, namely the human leukocyte antigen (HLA) genes, have a significantly increased risk of developing RA.

The HLA gene complex controls immune responses by producing proteins that help the immune system recognize proteins from foreign invaders.
A number of other genes also appear to be associated with RA susceptibility, including STAT4, PTPN22, TRAF1-C5, PADI4, CTLA4, among others, according to a report in the journalRheumatology。

But not everyone with these identified gene variants develops RA, and people without them can still develop it. So, it's likely that environmental factors often trigger the disease, particularly in people with a genetic makeup that makes them more susceptible to it. These factors include:

  • Viruses and bacteria (though certain infections may reduce RA risk, at least temporarily)
  • Female hormones
  • Exposure to certain kinds of dust and fibers
  • 暴露于二手烟

  • Obesity, whichalso increases progression of disabilityfor people with RA.

    Obese patients are less likely to achieve RA remission regardless of the treatment they receive.

  • Severely stressful events
  • Foods
Equally important are smoking and a family history of RA in increasing a person's risk of developing the condition.


Children up to age 16 who experience prolonged swollen or painful joints anywhere in the body are typically diagnosed with juvenile idiopathic arthritis (JIA).

Learn More About Juvenile Idiopathic Arthritis: Symptoms, Causes, Diagnosis, and Treatment

How Is Rheumatoid Arthritis Diagnosed?

While no single test can definitively diagnose RA, doctors consider several factors when evaluating a person for rheumatoid arthritis.

诊断过程通常是在医生获得您的病史并进行身体检查时开始的。他们会询问您的症状signs of RA, in particular things like prolonged joint swelling and morning stiffness that lasts at least half an hour after you wake up.

Next, your doctor will orderblood teststo detectrheumatoid factor (RF)and anti-citrullinated protein antibodies (ACPAs), which can be specific markers for RA and could indicate RA. You can still have symmetrical inflammatory arthritis with or without systemic markers of inflammation.

Imaging tests such asX-ray,ultrasound, andmagnetic resonance imageryscans may be used to help a doctor determine if your joints have been damaged or to detect joint inflammation, erosion, and fluid buildup.

In the future, doctors may be able todiagnose RA using (noninvasive) infrared light。

不同类型的类风湿关节炎

Rheumatoid arthritis is classified as either seropositive orseronegative。

具有血清阳性RA的人有ACPA，也称为抗循环柠檬硫化肽blood test。These antibodies attack the synovial joints and producesymptoms of RA。

About 60 to 80 percent of peoplediagnosed with RAhave ACPAs, and for many people, the antibodies precede the symptoms of RA by 5 to 10 years, notes the Arthritis Foundation.

People with seronegative RA have the disease without the presence of the antibodies or RF in their blood.

Learn More About Diagnosing Rheumatoid Arthritis: Tests and Screenings, Early Diagnosis, and Your Doctors

Duration of Rheumatoid Arthritis

RA is aprogressiveand chronic disease. Damage to the joint bones occurs very early in the progression of the disease, typically within the first two years, according to the Johns Hopkins Arthritis Center.

这就是为什么early treatmentis so important.
With effective, early treatment, most people with RA can live as they normally would, and many people can achieve缓解of symptoms. This doesn't mean that you're cured but rather that your symptoms are alleviated to the point where you can function at your fullest and your joints are not being further damaged by RA. It's also possible to achieve remission and then relapse, or have your symptoms return.

But remission doesn't happen for everyone, and because the pain and other symptoms of RA may change over time,pain managementcan be an ongoing concern. In addition to pain medications like nonsteroidal anti-inflammatory drugs andcorticosteroids, there are many options for pain relief for people living with RA. These include, among others:

了解有关类风湿关节炎如何进展的更多信息

Treatment and Medication Options for Rheumatoid Arthritis

Totreat RA, doctors aim to stop the progression of the disease by reducing symptoms, controlling inflammation, minimizing joint and organ damage, and improving physical function.

Proven treatments include medication and physical therapy. Early, aggressive measures can help control symptoms and complications before the disease significantly worsens, by reducing or altogether stopping inflammation as quickly as possible.

This strategy is essential to preventing disability, and it usually amounts to treatment with anti-inflammatory drugs, and sometimes more than one medication at a time.

药物选择

In recent years, there have been significant advancements in medicines fortreating RA, but there is still no cure. Medications known asdisease-modifying antirheumatic drugs (DMARDs)are considered the gold standard forRA treatment。

DMARDscan change or slow the progression of the disease, helping prevent severe joint damage and other complications.

In general, these drugs work by slowing the inflammation and protecting the joints from further damage, and are generally prescribed shortly after diagnosis. The type of DMARD a doctor prescribes depends on several factors, including disease severity and the balance between the medication's benefits and potential side effects.

Biologics and JAK inhibitors are newer options alongside traditionalDMARDs。传统的DMARD针对整个免疫系统，而生物制剂通过针对炎症过程中的特定步骤来起作用，而JAK抑制剂阻止了您体内的动作，以帮助防止炎症开始。传统的dmard通常以药丸形式服用，JAK抑制剂也是如此。通常通过静脉输注对生物制剂进行注射或输送。

Nonsteroidal anti-inflammatory drugs (NSAIDS) andcorticosteroidsare used to treat pain and inflammation.

But the latest treatment guidelines issued by the American College of Rheumatology recommend that steroid use be minimized.

RELATED:New Medication Guidelines for Treating Rheumatoid Arthritis Released

Learn More About Rheumatoid Arthritis Medications

Alternative and Complementary Therapies for Rheumatoid Arthritis

Certainlifestyle changes and home remediesmay be beneficial — in addition to the conventional treatment of medication, physical therapy, and surgery — if needed.

Some people have found relief from RA symptoms throughacupuncture, tai chi, and瑜伽, though the scientific evidence supporting this isn't particularly conclusive.Complementary or alternative therapies, such as homeopathy, hydrotherapy, orcryotherapy，也可能值得考虑缓解RA疼痛和僵硬。

Relaxation techniques, visualization exercises, group counseling, and psychotherapy can help reduce the stress of living with RA.Sleeping wellis also an important part of managing symptoms.

You should always check with your medical provider before trying any complementary or alternative therapies.

Learn More About Alternative Therapies for Rheumatoid Arthritis

Many people can manage RA with medication and physical therapy, but joint surgery may be an option if your joint damage is severe and limiting your quality of life.

Learn More About Treatment for Rheumatoid Arthritis: Medications, Alternative and Complementary Therapies, Surgery Options, and More

Complications of Rheumatoid Arthritis

It's well established that风湿性diseasessuch as RA increase the risks for developing a variety of health conditions.

最常见的RA合并症是心血管疾病，但这种病也与几个特定的​​心血管问题有关，包括心脏病发作，中风，congestive heart failure, peripheral vascular disease, andatherosclerosis。

It's important for people with RA to work with their doctors to assess theirheart disease risk factors, such as high blood pressure, diabetes, and smoking, and to reduce them.

RA can also lead to inflammation in other areas of the body, including blood vessels, where it's known as rheumatoidvasculitis; thelungs, resulting in rheumatoidlung disease or other conditions; theeyes; and the wrists, causingcarpal tunnel syndrome。

Another possible complication is kidney impairment as a result ofRA medication。And pregnant women need to be aware that RA is linked topregnancy complications, such ashypertension（高血压）在怀孕后期，并增加了过早分娩的风险。

Learn More About the Complications of Rheumatoid Arthritis: How It Affects Your Body in the Short and Long Term

Dietary Modifications to Consider for Rheumatoid Arthritis

While there is a lot of interest in the role of diet and nutrition in symptom management for rheumatoid arthritis, there is no comprehensive research on the topic nor is there a dietary magic formula to fight RA symptoms.

But some evidence suggests that eating certain foods may help reduce inflammation and improve symptoms for some people, while other foods have been shown to worsen inflammation and related symptoms.

For instance, theketogenic diet- 在某些健康的谷物，水果和有助于抵抗炎症的脂肪中，脂肪含量很高 - 通常认为是bad for RA symptoms and pain。

On the other hand,the Mediterranean dietis high in seafood (omega-3 fatty acids) and fiber, which can help fight inflammation. It's sometimes called theanti-inflammatory dietor arthritis diet.

Some research, including a recent review inFrontiers in Nutrition,suggests that diets that exclude animal products completely and focus on vegetables, fruits, and fiber may also be beneficial for RA.

Learn More About Rheumatoid Arthritis and Diet

Research and Statistics: Who Has Rheumatoid Arthritis?

约有1％的美国人患有类风湿关节炎。根据日报2017年的报告风湿病国际，美国RA的患病率在2004年至2014年之间似乎有所增加，2014年影响约130万成年人。

Similar to previous decades, the annual incidence of RA in 2005–2014 was 41 per 100,000 people, and the incidence for women and men was 53 in 100,000 and 29 in 100,000, respectively, according to a study published in theAnnals of the Rheumatic Diseasesin 2020.

Women are more likely than men to develop RA at an early age, and two to three times as many women as men develop RA, according to the Centers for Disease Control and Prevention (CDC).

Inflammatory arthritis can affect children. It's known asjuvenile idiopathic arthritis (JIA)根据美国国家医学图书馆，它影响了美国近30万儿童。

JIA can't be diagnosed with ablood test，因此医生认为症状和病史以排除可能类似于JIA的疾病，例如感染，癌症，Lyme disease, bone disorders, andlupus。

相关条件Rheumatoid Arthritis

有几种关节炎（“ Arth”是拉丁语的“关节”和“ ITIS”是拉丁语的“疾病”或“炎症”），包括RA，包括RA，骨关节炎,gout, andlupus。

骨关节炎is the most common type of arthritis, affecting more than 32.5 million Americans, according to the CDC.

Rheumatoid arthritis and osteoarthritisaffect the body differently. In RA, the joint lining becomes inflamed and eventually erodes the joint. But in osteoarthritis, the cartilage that covers the ends of the bones in a joint is damaged by multiple different causes, and it is considered more of a mechanical (wear and tear) disease.

There are other health conditions related to rheumatoid arthritis, too.Osteoporosis, or low bone density,

as well as mental health conditions likeanxietyanddepressionare also common in people with RA.

Pulmonary conditions are linked to RA as well. An estimated 10 percent of people with RA will develop interstitial lung disease, according to the Arthritis Foundation.

Additionally, people with RA have anincreased risk of lymphomas，可能是由于慢性炎症。

Resources We Love

Favorite Orgs for Essential Rheumatoid Arthritis Information

TheAmerican College of Rheumatologyis an organization for physicians, health professionals, and scientists that advances rheumatology through education, research, advocacy, and practice support relating to the care of people with arthritis and风湿性和肌肉骨骼疾病。这页ublishes two medical journals (Arthritis & RheumatologyandArthritis Care & Research) and promotes research into rheumatological conditions.

TheArthritis Foundationis a nonprofit organization dedicated to the prevention, control, and cure of arthritis. The foundation provides information and resources, access to optimal care, advancements in science, and community networking.

吱吱作响is a leading support, education, advocacy, and research organization for people living with arthritis and风湿性disease. It is dedicated to raising awareness of all forms of arthritis, which includes educating people about the available varieties of treatment and management strategies.

Favorite Online Support Network for RA

The活着！关节炎网络, from the Arthritis Foundation, provides a network of support with the aim of helping people live their best lives. By exchanging ideas, tips, and experiences with others in provided online forums covering a variety of topics, the network empowers people with RA to gain confidence in dealing with their disease proactively.

Favorite Apps, Products, and Gadgets

Arthritis Power App

Creakychoints与阿拉巴马大学伯明翰大学的风湿病学研究人员合作，创建了这个有用的应用程序，可帮助您跟踪症状和药物，并分享与RA的生活经验。除RA外，该应用还包括针对诸如ankylosing spondylitis;psoriatic arthritis;psoriasis;osteoporosis,osteopenia和低骨矿物质密度；骨关节炎；纤维肌痛;gout; juvenile idiopathic arthritis; inflammatory bowel diseases, like Crohn’s andulcerative colitis; lupus; scleroderma (systemic sclerosis); polymyositis; and dermatomyositis.

Dycem Super Grip Tape, $13.95

Dycem的自我粘附的超级抓地带提供了一个缓冲的握力，手上感觉更舒适。胶带粘附在各种表面上，包括扫帚，轮椅臂，移动设备，甚至笔和餐具。不发光的握把将有助于增加您抓住的任何表面的摩擦。

Besmon Electric Jar Opener, $22.99

这个罐子开瓶器可以处理任何直径为1至3.5英寸的盖子。建议患有关节炎的人来节省关节的扭曲顽固盖的压力。

Hamilton Beach Smooth Touch Electric Can Opener$31.85

光滑的触摸可以打开弹出式和普通罐。它的设计使其沿着罐子的侧面而不是顶部切割，从而最大程度地减少了刀片与食物的接触，防止溅出并创建光滑，可触摸的盖子。

IMAK Compression Arthritis Gloves,$20.99

许多患有类风湿关节炎的人认为压缩手套是必不可少的配件。根据发表在Therapeutic Advances in Musculoskeletal Disease, hand symptoms including pain, stiffness, and swelling improve greatly with the use of compression gloves. IMAK remains one of the easiest brands of gloves to find, both online and in stores.

阳光变暖的毯子

Sunbeam's electric blanket can help those with arthritis get off to a better start in the morning by providing the heat necessary to loosen stiff joints. An easy-to-use controller can adjust the blanket through 10 heating levels to help you warm up your joints before getting out of bed. The blanket comes in twin, full, queen, and king sizes to fit all standard-size beds.

Favorite Patient Blogs

慢性艾琳

Over a period of two and a half years, Eileen Davidson was诊断出患有rheumatoid arthritis, osteoarthritis, and纤维肌痛。She began writing Chronic Eileen in June 2017 as a way to battle her struggles with progressinganxiety and depression并帮助她处理慢性病的母亲的新角色（她的文章parenting techniquesis definitely worth a read). Her posts share many of these ideas, such aswhether arthritis will make tattoos hurtorhow to calm the “bitch within” when living with a chronic illness。

Carla’s Corner

With 25 years of corporate communications experience, Carla Kienast has focused her messaging skill on helping others living with rheumatoid arthritis through her blog. Diagnosed with RA in 2008, Kienast has been through 19 surgeries, including three joint replacements, two spinal fusions, and two rotator cuff operations. She describes her extraordinary experiences dealing withhipand肩膀surgeries, and covers her various, and sometimes ineffective, drug treatments, all with a sense of humor.

From This Point. Forward.

玛丽亚·里奇（Mariah Leach）是诊断出患有rheumatoid arthritisat age 25 while pursuing dual graduate degrees. Since then, she has undoubtedly made the most of living with a chronic illness, including giving birth to her third child. In addition to her blog, Leach writes for various health websites. OnMamas Facing Forward, she pays special attention to mothers living with RA in articles onsex,parenting,treatment, andordinary life with RA。

RELATED:10 Arthritis Blogs to Watch in 2020

Favorite Annual Meetings

American College of Rheumatology Annual Meeting

Every year, nearly 16,000 rheumatologists, rheumatology health professionals, fellows in training, patient advocates, and exhibitors from more than 100 countries gather to discuss the latest scientific advances and clinical issues surrounding rheumatoid arthritis. In 2021, it will be held virtually, due toCOVID-19。The annual convention hosts sessions that provide ample opportunity for professional development, networking, and access to the latest rheumatology research and clinical applications.

Rheumatoid Arthritis and COVID-19

As the novel coronavirus persists, you know you must take extra precautions to protect your health. Find the latest, most accurate information in our guide.

Learn More: A Guide to Living With RA During the COVID-19 Pandemic: Help, Resources, and Making a Personal Checklist

RELATED:8 Things People With Rheumatoid Arthritis Must Know About the COVID-19 Vaccines

Editorial Sources and Fact-Checking

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