An official website of the United States government
          Here’s how you know
        Here’s how you know**Official websites use .gov**A
              **.gov** website belongs to an official government
              organization in the United States.
        **Secure .gov websites use HTTPS**A
              **lock** (
              Locked padlock icon) or **https://** means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
 Top Utility Nav
        
        
        Asian-Language Resources
        
        Portal en español


Site search Mega Menu
  

        

        Home
                  Health Topics
                                      
    
  Health Topics

    Arthritis and Rheumatic Diseases
          
    Muscle and Bone Diseases
          
    Skin Diseases
          
    All Diseases and Conditions
          
    Publication Catalog
                  Grants & Funding
                                      
    
  Grants & Funding

    Current Funding Opportunities
          
    Supported Scientific Programs
          
    NIAMS-Supported Programs
          
    Applying for a Grant
          
    NIH Policies and Guidance
          
    Peer Review and Grants Administration Resources
          
    Types of Funding Mechanisms (Activity Codes)
                  Labs @ NIAMS
                                      
    
  Labs @ NIAMS

    NIAMS Labs and Core Facilities
          
    Research Faculty
          
    Research Areas
          
    NIAMS Scientific Advances
          
    Training and Career Development
                  Clinical Trials
                                      
    
  Clinical Trials
      
            For Principal Investigators

    Clinical Trial Policies, Guidelines, and Templates
          
    Conducting Clinical Trials
          
    Register with ClinicalTrials.gov

For Patients

What is a Clinical Trial?
	Clinical Trials at NIAMS
	Clinical Trials in the Spotlight
                  News & Events
                                      
    
  Newsroom

    All NIAMS News
          
    NIAMS Newsletters
          
    Meetings & Events
                  About NIAMS
                                      
    
  About NIAMS

    Director's Page
          
    NIAMS Organization
          
    Strategic Plan Fiscal Years 2020-2024
          
    Staff Directory
          
    NIAMS Budget
          
    Partnerships
          
    Contact NIAMS
                  Community Outreach
                                      
    
  Community Outreach

    Bone Health
          
    Joint Health
          
    Muscle, Tendon, and Ligament Health
          
    Skin Health
          
    Health Information For Kids And Young Adults
          
    Health Information For Older Adults/Seniors
          
    Printable Materials for Community Events
          
    Resources in Other Languages
          
    Annual Health Observances
          
    Social Media Resources Breadcrumb
    Home
          Health Topics
          Rheumatoid Arthritis


EnglishEspañol繁體中文한국어tiếng Việt





Rheumatoid Arthritis Basics
    In-Depth Read
    
  FacebookEmailPrintFacebookEmail
              Download PDF
      
            Woman with rheumatoid arthritis sits outside.

            Overview, Symptoms, & Causes
            Diagnosis, Treatment, & Steps to Take
            More InfoOverview of Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic (long-lasting) autoimmune disease that mostly affects joints. RA occurs when the immune system, which normally helps protect the body from infection and disease, attacks its own tissues. The disease causes pain, swelling, stiffness, and loss of function in joints.

Additional features of rheumatoid arthritis can include the following:

It affects the lining of the joints, which damages the tissue that covers the ends of the bones in a joint.
	RA often occurs in a symmetrical pattern, meaning that if one knee or hand has the condition, the other hand or knee is often also affected.
	It can affect the joints in the wrists, hands, elbows, shoulders, feet, spine, knees, and jaw.
	RA may cause fatigue, occasional fevers, and a loss of appetite.
	RA may cause medical problems outside of the joints, in areas such as the heart, lungs, blood, nerves, eyes, and skin.Fortunately, current treatments can help people with the disease to lead productive lives.

What happens in rheumatoid arthritis?

Doctors do not know why the immune system attacks joint tissues. However, they do know that when a series of events occurs, rheumatoid arthritis can develop. This series of events includes:

A combination of genes and exposure to environmental factors starts the development of RA.
	The immune system may be activated years before symptoms appear.
	The start of the autoimmune process may happen in other areas of the body, but the impact of the immune malfunction typically settles in the joints.
	Immune cells cause inflammation in the inner lining of the joint, called the synovium.
	This inflammation becomes chronic, and the synovium thickens due to an increase of cells, production of proteins, and other factors in the joint, which can lead to pain, redness, and warmth.
	As RA progresses, the thickened and inflamed synovium pushes further into the joint and destroys the cartilage and bone within the joint.
	As the joint capsule stretches, the forces cause changes within the joint structure.
	The surrounding muscles, ligaments, and tendons that support and stabilize the joint become weak over time and do not work as well. This can lead to more pain and joint damage, and problems using the affected joint.

                                    Who Gets Rheumatoid Arthritis?

You are more likely to get rheumatoid arthritis if you have certain risk factors. These include:

**Age.** The disease can happen at any age; however, the risk for developing rheumatoid arthritis increases with older age. Children and younger teenagers may be diagnosed with juvenile idiopathic arthritis, a condition related to rheumatoid arthritis.
	**Sex.** Rheumatoid arthritis is more common among women than men. About two to three times as many women as men have the disease. Researchers think that reproductive and hormonal factors may play a role in the development of the disease for some women.
	**Family history and genetics.** If a family member has RA, you may be more likely to develop the disease. There are several genetic factors that slightly increase the risk of getting RA.
	**Smoking.** Research shows that people who smoke over a long period of time are at an increased risk of getting rheumatoid arthritis. For people who continue to smoke, the disease may be more severe.
	**Obesity.** Some research shows that being obese may increase your risk for the disease as well as limit how much the disease can be improved.
	**Periodontitis.** Gum disease may be associated with developing RA.
	**Lung diseases.**Diseases of the lungs and airways may also be associated with developing RA.
            
                                    
            
                                    Symptoms of Rheumatoid Arthritis

Common symptoms of rheumatoid arthritis include:

RA affects people differently. In some people, RA starts with mild or moderate inflammation affecting just a few joints. However, if it is not treated or the treatments are not working, RA can worsen and affect more joints. This can lead to more damage and disability.

At times, RA symptoms worsen in “flares” due to a trigger such as stress, environmental factors (such as cigarette smoke or viral infections), too much activity, or suddenly stopping medications. In some cases, there may be no clear cause.

The goal of treatment is to control the disease so it is in remission or near remission, with no signs or symptoms of the disease.

Rheumatoid arthritis can cause other medical problems, such as:

Joint pain at rest and when moving, along with tenderness, swelling, and warmth of the joint.
	Joint stiffness that lasts longer than 30 minutes, typically after waking in the morning or after resting for a long period of time.
	Joint swelling that may interfere with daily activities, such as difficulty making a fist, combing hair, buttoning clothes, or bending knees.
	Fatigue – feeling unusually tired or having low energy.
	Occasional low-grade fever.
	Loss of appetite.Rheumatoid arthritis can happen in any joint; however, it is more common in the wrists, hands, and feet. The symptoms often happen on both sides of the body, in a symmetrical pattern. For example, if you have RA in the right hand, you may also have it in the left hand.

RA affects people differently. In some people, RA starts with mild or moderate inflammation affecting just a few joints. However, if it is not treated or the treatments are not working, RA can worsen and affect more joints. This can lead to more damage and disability.

At times, RA symptoms worsen in “flares” due to a trigger such as stress, environmental factors (such as cigarette smoke or viral infections), too much activity, or suddenly stopping medications. In some cases, there may be no clear cause.

The goal of treatment is to control the disease so it is in remission or near remission, with no signs or symptoms of the disease.

Rheumatoid arthritis can cause other medical problems, such as:

Rheumatoid nodules that are firm lumps just below the skin, typically on the hands and elbows.
	Anemia due to low red blood cell counts.
	Neck pain.
	Dry eyes and mouth.
	Inflammation of the blood vessels, the lung tissue, airways, the lining of the lungs, or the sac enclosing the heart.
	Lung disease, characterized by scarring and inflammation of the lungs that can be severe in some people with RA.
            
                                    Causes of Rheumatoid Arthritis

Researchers do not know what causes the immune system to turn against the body’s joints and other tissues. Studies show that a combination of the following factors may lead to the disease:

**Genes.** Certain genes that affect how the immune system works may lead to rheumatoid arthritis. However, some people who have these genes never develop the disease. This suggests that genes are not the only factor in the development of RA. In addition, more than one gene may determine who gets the disease and how severe it will become.
	**Environment.** Researchers continue to study how environmental factors such as cigarette smoke may trigger rheumatoid arthritis in people who have specific genes that also increase their risk. In addition, some factors such as inhalants, bacteria, viruses, gum disease, and lung disease may play a role in the development of RA.
	**Sex hormones.** Researchers think that sex hormones may play a role in the development of rheumatoid arthritis when genetic and environmental factors also are involved. Studies show:
	Women are more likely than men to develop rheumatoid arthritis.
		The disease may improve during pregnancy and flare after pregnancy.

                              Download PDF

      View all Diseases and Conditions

                  Learn About Research
                Find a Clinical Trial
          Read Journal Articles
            
                        Related Information
                Rheumatoid Arthritis, What People With Rheumatoid Arthritis Need to Know About ...
          ¿Qué es la artritis reumatoide?
            
                        View/Download/Order Publications
                Download this topic as a PDF  
            

News Related to This Health Topic
    
      Study Identifies Subtypes of Inflammation in People with Rheumatoid Arthritis
Spotlight on Research | Dec 11, 2023
    Connecting the Dots: Oral Infection to Rheumatoid Arthritis
NIH Director's Blog | Mar 7, 2023
    Newly Discovered Species of Gut Bacteria May Cause Some Cases of Rheumatoid Arthritis
NIAMS-Related Article | Jan 9, 2023
    Workshop Explores Strategies to Tackle Health Disparities in Osteoarthritis
NIH Record stories | Oct 31, 2022
    NIAMS, NIH Seek to Better Understand Arthritis in Native American Communities
Letter from the Director | Jun 7, 2022
    Recharging cartilage after knee damage
NIAMS-Related Article | Jun 6, 2022
    Parents’ smoking during childhood linked to rheumatoid arthritis later in life
NIH Research Matters | Sep 16, 2021
    Advantage, Wozniacki: Tennis star on taking charge of life with RA
NIH MedlinePlus | Apr 14, 2021
    Blocking enzyme inhibits arthritis progression in mice
NIH Research Matters | Apr 28, 2020
    New clues on tissue damage identified in rheumatoid arthritis and lupus
Press Release | Jun 18, 2019


      
      FacebookEmailPrintFacebookEmail
          Last Reviewed: 
            November 2022
 About NIAMS
                    Clinical Trials
                    Grants & Funding
                    Health Topics
                    Labs @ NIAMS
              News Room
                    NIAMS Multimedia Library
                    Disclaimer
                    FOIA
                    Contact us
              Privacy Statement
                    Accessibility
                    HHS Vulnerability Disclosure
                    Social Media Moderation Policy
                    NIAMS Archives
        Subscribe to Our E-Newsletters
            Click the button to see different options to sign up for newsletters.
            Click Here to Subscribe
          Follow us on
  
  About NIH
                  Accessibility Support
            FOIA requests
                  No FEAR Act data
            Office of the Inspector General
                  Performance reports
            Privacy Policy Back to Top