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Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune condition where the immune system attacks the lining of the joints, causing chronic inflammation that can destroy cartilage, bone, and surrounding soft tissue. Unlike osteoarthritis, which is driven by wear and age, RA can affect people at any age — including young adults — and typically strikes multiple joints symmetrically. The knees, hands, wrists, and feet are most commonly involved. Left untreated, RA leads to progressive joint deformity and disability.

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Rheumatoid Arthritis - symptoms, treatment options and when to see an orthopaedic specialist

Symptoms

  • Warm, swollen, tender joints — often symmetrical on both sides of the body
  • Morning stiffness lasting more than 30-60 minutes
  • Fatigue, low-grade fever, and general malaise
  • Joint deformity over time if untreated
  • Small bumps under the skin near joints (rheumatoid nodules)
  • Reduced range of motion and grip strength

When to See a Doctor

See a rheumatologist if you have persistent joint swelling and morning stiffness lasting longer than an hour — especially if multiple joints are affected. Early treatment with disease-modifying drugs (DMARDs) can halt or slow joint destruction. If joints have already been severely damaged, an orthopaedic surgeon can evaluate whether joint replacement is appropriate.

Treatment Options

Disease-modifying antirheumatic drugs (DMARDs)

Methotrexate, hydroxychloroquine, and others slow or stop the immune attack on joints. The first-line treatment for most RA patients.

Biologic agents

TNF inhibitors (like adalimumab, etanercept) and other biologics target specific parts of the immune response. Used when conventional DMARDs fail.

Corticosteroids

Short-term prednisone or joint injections for acute flares. Not a long-term solution due to side effects.

Physical and occupational therapy

Maintain joint function, reduce stiffness, and adapt activities to protect joints from further damage.

Joint replacement surgery

When RA has destroyed a joint beyond what medication can manage, total knee or hip replacement restores function. Requires careful timing with a rheumatologist.

Recovery Timeline

RA is a chronic condition managed over a lifetime with medication. With modern biologics, most patients achieve low disease activity or remission. Joint replacement surgery — if needed — takes 3-6 months for full recovery.

Frequently Asked Questions

What is the difference between rheumatoid arthritis and osteoarthritis?

Osteoarthritis is mechanical wear of cartilage — a structural problem that accumulates over time, usually in older patients and in specific heavily used joints. Rheumatoid arthritis is an autoimmune disease — the immune system mistakenly attacks the joint lining. RA can strike at any age, causes systemic symptoms like fatigue and fever, and typically affects multiple joints symmetrically. Treatment strategies are completely different.

Can rheumatoid arthritis be cured?

Not cured, but it can be put into remission. Modern biologics have transformed outcomes — many patients reach a state where the disease is effectively dormant with medication. Stopping medication typically causes the disease to return, so management is ongoing.

Does RA always lead to joint replacement?

No. With early and aggressive treatment, many RA patients never need joint replacement. The key is catching it early and getting on effective medication before significant joint destruction occurs. Patients whose disease is poorly controlled or who present late are at higher risk of eventually needing surgery.

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This information is for educational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.