Appointments
+(603) 5515 1966
General Line
+(603) 5515 1888
April 25, 2025
Rheumatoid arthritis is a chronic autoimmune disorder that primarily affects the joints, causing pain, stiffness and swelling. Unlike osteoarthritis, which results from wear and tear, rheumatoid arthritis occurs when the immune system mistakenly attacks the body’s own tissues.
This progressive condition can lead to joint deformity and systemic complications if left untreated. Millions of people worldwide are affected by this condition and living with it.
Rheumatoid arthritis is an autoimmune disease in which the immune system attacks healthy joint tissue, leading to inflammation, pain, and eventual joint damage. It primarily affects the small joints in the hands, wrists, and feet but can also extend to other parts of the body, including the heart, lungs, and eyes.
This is a progressive disease, meaning it worsens over time. Without proper intervention, it can lead to severe disability and reduced quality of life.
The exact cause of rheumatoid arthritis is unknown but several factors contribute to its development.
Since rheumatoid arthritis is characterised by the immune system attacking the lining of joints, dysfunction of the immune system is a primary cause. The production of autoantibodies such as Rheumatoid Factor and Anti-CCP worsens the disease.
A family history of this condition increases the likelihood of developing the condition. Two specific genes, HLA-DR4 and HLA-DR1, are associated with a higher risk of rheumatoid arthritis. While genetic predisposition alone does not cause this, it does make individuals more susceptible when combined with environmental triggers.
Several external factors may trigger this in genetically predisposed individuals, including:
Rheumatoid arthritis is more common in women than men, possibly due to the influence of hormones. Hormonal changes, like during pregnancy or menopause, can affect the immune system. Some women who have rheumatoid arthritis symptoms experience improvement during pregnancy, suggesting hormones play a role in the condition.
Smoking, poor diet, and obesity are all risk factors that can increase the likelihood of developing rheumatoid arthritis. Smoking can increase the risk and severity of this condition, while a diet high in processed foods and sugar, and low in omega-3 fatty acids, can contribute to inflammation. Excess weight can also put stress on joints and worsen the symptoms.
New research indicates that an imbalance of gut bacteria could be a factor causing this condition. Specific bacterial infections in the gut may lead to inflammation and autoimmunity.
Rheumatoid arthritis manifests in various ways, and early detection is key to managing the disease effectively. Let’s take a look at some of the most common symptoms:
Some people develop firm lumps under the skin, particularly around pressure points such as elbows, fingers, or heels.
Rheumatoid arthritis can affect other organs, leading to complications such as:
This condition progresses through four distinct stages, each requiring different treatment approaches.
Inflammation starts in the synovium, leading to mild joint pain and stiffness. X-rays do not show any joint damage. Early intervention can slow down the progression of the disease.
Inflammation in the body can cause cartilage damage, leading to increased swelling and pain in the joints, and possibly limiting mobility. X-rays may also reveal early signs of bone erosion.
Extensive damage to cartilage and bones leads to deformed joints, causing pain and limiting movement. Muscle weakness and nodules may also develop as a result.
The joints are no longer working properly, causing severe pain, stiffness, and disability. Surgery such as joint replacement may be needed for this stage.
Rheumatoid arthritis (RA) can affect multiple organs and if left untreated can lead to severe complications such as:
Rheumatoid arthritis causes chronic joint inflammation, which can lead to cartilage and bone damage, and joint deformities, which in turn, can limit movement. Severe cases may lead to joint fusion and disability, making accomplishing everyday tasks quite difficult.
Firm lumps can develop under the skin on pressure points such as elbows, fingers, and heels. They can also appear in organs like the lungs and heart, leading to further health issues.
Rheumatoid arthritis can double the risk of heart disease and increase the chances of heart attack, stroke, pericarditis, atherosclerosis, and heart failure due to chronic inflammation and damage to the heart muscles over time.
A complication related to the lungs is ILD or interstitial lung disease which causes lung scarring and shortness of breath. Abnormal development of fluid between the layers that line the lungs or pleural effusion results in fluid buildup around the lungs, leading to chest pain and difficulty breathing. Rheumatoid nodules in the lungs can cause respiratory issues as well.
Rheumatoid arthritis can cause eye complications such as Sjogren’s syndrome and inflammation of eye tissues, resulting in dry, irritated eyes, pain, and vision problems. Uveitis, inflammation inside the eye, may also occur and potentially lead to vision loss.
As this condition is closely linked to the immune system, it can lead to several blood and immune system-related disorders such as anaemia, Felty’s Syndrome, and thrombocytosis, which, in turn, can result in fatigue, infection risk, and blood clot risks respectively.
Chronic pain and disability can lead to mental health issues such as depression, anxiety, and emotional distress, with rheumatoid arthritis patients being at a higher risk.
Unfortunately, there is no permanent cure for rheumatoid arthritis at present. However, medical advancements have made it possible to manage the disease effectively, reduce symptoms, and even achieve remission in some cases. Let’s explore why RA cannot be permanently cured, the best treatment strategies available, and whether new research offers hope for a future cure.
Rheumatoid arthritis is a disorder linked to the immune system. Unlike infections, autoimmune diseases are chronic and hard to cure permanently due to various factors.
All is not glum when it comes to the treatment of this condition. Several treatment paths are available which can help you manage the symptoms effectively, live a normal life and slow down the progression of this disease.
The first line of treatment is medication. The most commonly used medication options include disease-modifying antirheumatic drugs (DMARDs) which help slow disease progression, biologic DMARDs which target specific immune pathways, nonsteroidal anti-inflammatory drugs (NSAIDs) that reduce pain and inflammation and corticosteroids which provide rapid relief but are not ideal for long-term use.
Certain lifestyle modifications can help a patient live a healthier and fuller life while dealing with the disease. These modifications include:
Stage 3 and 4 patients may require more advanced treatment such as
Alternative therapies can help obtain relief from different symptoms such as:
New advanced therapies are being developed for treating rheumatoid arthritis, beyond traditional options like DMARDs and biologics. These novel treatments could potentially revolutionise how rheumatoid arthritis is managed.
With advancements in genetic research, doctors are now able to tailor treatments based on an individual’s genetic makeup and immune response. Biomarker-based precision medicine helps predict which medications will work best for each patient, reducing trial and error in treatment.
The gut microbiome influences immune system function and can contribute to autoimmune conditions such as rheumatoid arthritis. Probiotics, prebiotics, and faecal transplants are being studied as treatments to restore gut balance and improve symptoms.
Originally developed for cancer treatment, Chimeric Antigen Receptor (CAR)-T cell therapy is now being studied for autoimmune diseases such as rheumatoid arthritis. This therapy involves modifying a patient’s T cells to selectively suppress the overactive immune response, reducing inflammation and preventing joint damage.
Janus kinase (JAK) inhibitors such as Tofacitinib and Baricitinib have transformed rheumatoid arthritis treatment. Unlike traditional biologics, these are oral medications that block inflammatory pathways inside cells, offering an alternative to injections. Newer versions of JAK inhibitors with fewer side effects are currently under development.
Stem cell therapy aims to repair damaged joint tissue by using mesenchymal stem cells (MSCs) to reduce inflammation and promote healing. While still in experimental stages, some clinical trials have shown promising results in slowing disease progression and even regenerating cartilage in affected joints.
Artificial intelligence is accelerating the discovery of new RA drugs by analysing vast amounts of medical data and predicting which compounds could be most effective. Additionally, researchers are developing immunotherapies that selectively modulate the immune system without suppressing it entirely, reducing side effects.
Scientists are exploring bioelectronic therapy, which involves stimulating the vagus nerve to regulate immune responses. Early studies suggest that electrical stimulation of this nerve can reduce inflammation in RA patients, potentially offering a drug-free treatment option.
Researchers are developing peptide-based drugs that mimic the body’s natural anti-inflammatory proteins. These treatments aim to interrupt the inflammatory process at a molecular level, offering a new approach to treating RA with fewer side effects.
Gene-editing technologies such as CRISPR are being studied to correct genetic mutations associated with autoimmune diseases. While this research is still in its early stages, it holds immense potential for permanently altering immune system dysfunction in RA patients.
Nanomedicine is being explored to deliver RA medications directly to inflamed joints with pinpoint accuracy. This method reduces systemic side effects and enhances drug effectiveness by focusing on the areas most affected by RA.
Rheumatoid arthritis is a complex autoimmune disease with no known cure, but effective treatments can significantly improve the quality of life for those affected. With ongoing research and cutting-edge medical advancements, the future looks promising for rheumatoid arthritis patients.
Staying informed, seeking early treatment, and making lifestyle adjustments can help individuals lead active, fulfilling lives despite the challenges.
The main cause of rheumatoid arthritis is an autoimmune response, where the immune system mistakenly attacks the joints, leading to inflammation and damage.
Three symptoms of rheumatoid arthritis are joint pain and stiffness, swelling and warmth in joints, and persistent fatigue.
Dr Adrian Mark Masnammany
Consultant Physician & Rheumatologist
Sources:
Call Us
Spread the love, follow us on our social media channels