Overview

Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels.

An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues.

Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.

The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities.

Products & Services

Symptoms

Signs and symptoms of rheumatoid arthritis may include:

Tender, warm, swollen joints
Joint stiffness that is usually worse in the mornings and after inactivity
Fatigue, fever and loss of appetite

Early rheumatoid arthritis tends to affect your smaller joints first — particularly the joints that attach your fingers to your hands and your toes to your feet.

As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body.

About 40% of people who have rheumatoid arthritis also experience signs and symptoms that don't involve the joints. Areas that may be affected include:

Skin
Eyes
Lungs
Heart
Kidneys
Salivary glands
Nerve tissue
Bone marrow
Blood vessels

Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission — when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place.

When to see a doctor

Make an appointment with your doctor if you have persistent discomfort and swelling in your joints.

Rheumatoid arthritis

Vivien Williams: Pain, swelling and stiffness in your joints — all are symptoms of rheumatoid arthritis. But because these symptoms come and go, the condition can sometimes be tricky to diagnose. And it's important to get the right diagnosis because starting treatment early can make a difference.

Virginia Wimmer, has rheumatoid arthritis: Give me your best shot!

Ms. Williams: At first, Virginia Wimmer blamed her painful joints on too much volleyball.

Ms. Wimmer: In my knees and in my wrists.

Ms. Williams: For a couple years, she put up with the pain and swelling that would come and go. Then things got much worse.

Ms. Wimmer: I couldn't have a ball touch my arms.

Ms. Williams: She couldn't do much of anything, let alone play outside with her daughter.

Ms. Wimmer: That was really hard. She'd have to beg me to play with her, and teach her, and help her. And I just had to sit and watch.

Ms. Williams: Virginia was diagnosed with rheumatoid arthritis.

Nisha Manek, M.D., Rheumatology, Mayo Clinic: Rheumatoid arthritis is an inflammatory condition. It's also associated with the immune system.

Ms. Williams: Dr. Nisha Manek says it happens when the immune system becomes deregulated. You see, the joint capsule has a lining of tissue called the synovium. The synovium makes fluid that keeps joints lubricated. When you have rheumatoid arthritis, your immune system sends antibodies to the synovium and causes inflammation. This causes pain and joint damage, especially in small joints in the fingers and wrists. But it can affect any joint.

The good news is that treatment for rheumatoid arthritis has improved dramatically over the last years. Medications, such as methotrexate, help bring the immune system back into balance and steroids can help calm flare-ups. So what was once an often crippling disease can now be controlled for many people — people like Virginia whose disease is pretty severe.

Ms. Wimmer: You can get to the point where you are doing the things that you love and that is the goal.

Ms. Williams: Dr. Manek says if you have pain, swelling and stiffness in your joints that comes and goes and is on both sides of your body, see your doctor to see if it is rheumatoid arthritis.

Rheumatoid is different than osteoarthritis which damages joints because of wear and tear.

For Medical Edge, I'm Vivien Williams.

More Information

Rheumatoid arthritis: Does pregnancy affect symptoms?

Request an appointment

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Causes

Rheumatoid arthritis is an autoimmune disease. Normally, your immune system helps protect your body from infection and disease. In rheumatoid arthritis, your immune system attacks healthy tissue in your joints. It can also cause medical problems with your heart, lungs, nerves, eyes and skin.

Doctors don't know what starts this process, although a genetic component appears likely. While your genes don't actually cause rheumatoid arthritis, they can make you more likely to react to environmental factors — such as infection with certain viruses and bacteria — that may trigger the disease.

Risk factors

Factors that may increase your risk of rheumatoid arthritis include:

Your sex. Women are more likely than men to develop rheumatoid arthritis.
Age. Rheumatoid arthritis can occur at any age, but it most commonly begins in middle age.
Family history. If a member of your family has rheumatoid arthritis, you may have an increased risk of the disease.
Smoking. Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease. Smoking also appears to be associated with greater disease severity.
Excess weight. People who are overweight appear to be at a somewhat higher risk of developing rheumatoid arthritis.

Complications

Rheumatoid arthritis increases your risk of developing:

Osteoporosis. Rheumatoid arthritis itself, along with some medications used for treating rheumatoid arthritis, can increase your risk of osteoporosis — a condition that weakens your bones and makes them more prone to fracture.
Rheumatoid nodules. These firm bumps of tissue most commonly form around pressure points, such as the elbows. However, these nodules can form anywhere in the body, including the heart and lungs.
Dry eyes and mouth. People who have rheumatoid arthritis are much more likely to develop Sjogren's syndrome, a disorder that decreases the amount of moisture in the eyes and mouth.
Infections. Rheumatoid arthritis itself and many of the medications used to combat it can impair the immune system, leading to increased infections. Protect yourself with vaccinations to prevent diseases such as influenza, pneumonia, shingles and COVID-19.
Abnormal body composition. The proportion of fat to lean mass is often higher in people who have rheumatoid arthritis, even in those who have a normal body mass index (BMI).
Carpal tunnel syndrome. If rheumatoid arthritis affects your wrists, the inflammation can compress the nerve that serves most of your hand and fingers.
Heart problems. Rheumatoid arthritis can increase your risk of hardened and blocked arteries, as well as inflammation of the sac that encloses your heart.
Lung disease. People with rheumatoid arthritis have an increased risk of inflammation and scarring of the lung tissues, which can lead to progressive shortness of breath.
Lymphoma. Rheumatoid arthritis increases the risk of lymphoma, a group of blood cancers that develop in the lymph system.

More Information

By Mayo Clinic Staff

Request an appointment

Diagnosis & treatment

Jan. 25, 2023

Rheumatoid arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/Health_Info/Rheumatic_Disease/default.asp. Accessed Feb. 9, 2021.
Rheumatoid arthritis. American College of Rheumatology. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Rheumatoid-Arthritis. Accessed Feb. 9, 2021.
Matteson EL, et al. Overview of the systemic and nonarticular manifestations of rheumatoid arthritis. https://www.uptodate.com/contents/search. Accessed Feb. 9, 2021.
Goldman L, et al., eds. Rheumatoid arthritis. In: Goldman-Cecil Medicine. 26th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Feb. 9, 2021.
Ferri FF. Rheumatoid arthritis. In: Ferri's Clinical Advisor 2021. Elsevier; 2021. https://www.clinicalkey.com. Accessed Feb. 9, 2021.
Kellerman RD, et al. Rheumatoid arthritis. In: Conn's Current Therapy 2021. Elsevier; 2021. https://www.clinicalkey.com. Accessed Feb. 9, 2021.
Moreland LW, et al. General principles and overview of management of rheumatoid arthritis in adults. https://www.uptodate.com/contents/search. Accessed Feb. 9, 2021.
Xeljanz, Xeljanz XR (tofacitinib): Drug safety communication — Initial safety trial results find increased risk of serious heart-related problems and cancer with arthritis and ulcerative colitis medicine. https://www.fda.gov/safety/medical-product-safety-information/xeljanz-xeljanz-xr-tofacitinib-drug-safety-communication-initial-safety-trial-results-find-increased. Accessed Feb. 23, 2021.
Office of Patient Education. Arthritis: Caring for your joints. Mayo Clinic. 2017.
Living with arthritis. American Occupational Therapy Association. https://www.aota.org/About-Occupational-Therapy/Patients-Clients/Adults/Arthritis.aspx. Accessed Feb. 23, 2021.
Renaldi RZ. Total joint replacement for severe rheumatoid arthritis. https://www.uptodate.com/contents/search. Accessed Feb. 9, 2021.
Rheumatoid arthritis: In depth. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/rheumatoid-arthritis-in-depth. Accessed Feb. 23, 2021.
Chang-Miller A (expert opinion). Mayo Clinic. Feb. 27, 2021.

Associated Procedures

News from Mayo Clinic

Mayo Clinic researchers identify link between gut bacteria and pre-clinical autoimmunity and aging in rheumatoid arthritis Oct. 07, 2023, 11:00 a.m. CDT

Products & Services