Symptoms that affect your joints
Symptoms of rheumatoid arthritis include:
- pain and swelling around your joint(s), making them feel tender and warm
- stiffness in the morning, or if you sit for a long time
If you have any of these symptoms, contact your GP.
Rheumatoid arthritis usually affects the joints on both sides of your body at roughly the same time. And most people find it affects their hands and feet. But you may also get rheumatoid arthritis in your knees and shoulders, and less commonly in your hips, elbows and other joints.
Rheumatoid arthritis often develops quite slowly at first. But for some people, it comes on quickly and painfully, and can make it difficult to carry out everyday activities. The inflammation may come and go – you might have periods where your condition flares up and your symptoms get worse. This may last from several days to up to a month. In between flare-ups, the inflammation may go down and you may have barely any symptoms – this may last for months or even years.
As well as symptoms that affect your joints you may also get more general symptoms such as:
- tiredness, which can make you feel low or depressed
- flu-like symptoms, such as a fever
- weight loss
Sometimes inflammation can develop in other areas of your body, such as your lungs and eyes. If this happens, you might get symptoms such as dry eyes, shortness of breath and a cough and, later, chest pain.
If you think you have rheumatoid arthritis – even if your symptoms are mild – contact your GP. It’s important to be diagnosed as early as possible because the sooner you start treatment, the better it’s likely to work.
Your GP will ask about your symptoms and examine you. They may also ask you about your medical history. Your GP may arrange for you to have a blood test to check for a number of things, such as rheumatoid factor and anti-CCP antibodies. These are produced by a reaction in your immune system. Your doctor may also arrange for you to have an X-ray to look for changes in your joints.
If your GP thinks you have rheumatoid arthritis, they will refer you to see a rheumatologist – a doctor who specialises in identifying and treating arthritis. Your rheumatologist may suggest you have other tests such as an ultrasound or MRI scan to examine your joints further.
Although there’s no cure for rheumatoid arthritis, there are many treatments that can suppress the disease process in your joints and control your symptoms. Treatments can also slow down the development of the condition and reduce the damage to your joints. The earlier you start treatment, the more effective it will be.
Painkillers and anti-inflammatory medicines
Over-the-counter painkillers, such as paracetamol and codeine, may help to ease your pain. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
Non-steroidal anti-inflammatory drugs (NSAIDs) help to control pain and stiffness. Your doctor may prescribe the lowest dose possible for you for short periods of time. This is because using them long-term is linked with heart, kidney and stomach problems. If you take NSAIDs regularly, your doctor may suggest you take a medicine called a proton pump inhibitor as well. This will protect your stomach and reduce the risk of side-effects from NSAIDs.
Your doctor may prescribe you corticosteroids, particularly during a flare-up, to reduce inflammation. These can help to reduce pain and inflammation while you're waiting for other treatments to start working. Corticosteroids can have side-effects if you use them for long periods of time. Because of this, your doctor will give you the lowest effective dose and monitor you closely. It’s also important not to stop taking corticosteroids suddenly as this can be dangerous.
Disease-modifying antirheumatic drugs (DMARDs)
DMARDs work on your immune system and reduce the attack on your joints. If you take DMARDs early enough, it may help to reduce any long-term damage to your joints. They can take several weeks or months to have an effect, so keep taking them even if they don't seem to be working. DMARDs include:
If you’re taking DMARDs, you’ll need to have regular tests of your blood and urine to check for any side-effects.
If DMARDs don’t work well for you, or you have side-effects from them, your doctor may suggest you take a biological medicine. These work by targeting certain chemicals that cause inflammation and mimic substances produced by your own body, such as antibodies. Unlike most medicines, which are made by chemical processes, biological medicines are made from living organisms, such as cloned human white blood cells. You can take biological medicines on their own, or with a DMARD. Biological medicines include:
If other treatments haven’t worked, you may be offered surgery. Operations vary from minor procedures (sometimes keyhole surgery) to remove the inflamed lining of a joint, to more major surgery to completely replace a joint.
Talk to your doctor for more information and to find out what your options are.
Your doctor may refer you to a physiotherapist (a health professional who specialises in maintaining and improving movement and mobility). They can give you exercises that will help you to stay flexible and build up your muscle strength. They can also help you to improve your general level of fitness.
If you have problems with your feet, a podiatrist (a health professional who specialises in conditions that affect the feet) may be able to help. They can give you advice and help you to find the right footwear. If you have problems with your hands, your doctor may refer you to see a hand specialist. They will help you with strategies to manage pain and give you advice on how to keep your hands functioning. They can advise you on the aids available to help with everyday living) as well as on splints to protect your joints.
Many people with rheumatoid arthritis use complementary medicines to ease their symptoms. There’s some evidence that omega-3 oils (for example, fish oils) can help to ease joint pain and stiffness. Complementary therapies such as acupuncture, aromatherapy and massage may relieve pain and stiffness and make you feel more relaxed. Yet there isn't any evidence that they have any effect on how rheumatoid arthritis develops.
Speak to your doctor before you try any complementary therapy.
The exact reasons why you may develop rheumatoid arthritis aren’t fully understood. But if other members of your family have it, you’re more likely to get it.
Your lifestyle may also increase your risk of developing rheumatoid arthritis. For example, if you smoke you may be more likely to develop it. Other things that have been proposed as triggers for rheumatoid arthritis include stress, infection, and hormone changes.
Living with rheumatoid arthritis can be difficult. The more severe your condition is, the bigger the impact it’s likely to have on your life. As with many long-term conditions that cause pain and discomfort, having rheumatoid arthritis can affect your emotions and your relationships with those around you. Our tips and advice on mental health may help you find ways to manage.
Rheumatoid arthritis can also have an impact on your sleep, which may affect other areas of your life, or lead to depression. If you’re having trouble sleeping, our information about sleep, including tips on how to get a better night’s sleep, may be useful.
It’s important to get help if you are struggling to live with rheumatoid arthritis. If you’re finding it difficult to work because of the pain, help is out there. An occupational therapist can help you find new ways to manage. An occupational therapist is health professional who can give practical assistance to help you with everyday tasks and increase your independence. For tips on making life easier at home, see our question What can I do at home to make life easier?
Talk to your doctor about the impact rheumatoid arthritis has on your day-to-day life and what can be done to help you. They may be able to change your medicines for a while until your symptoms improve, for example. You may also find it helpful to contact support groups and talk to other people living with the condition.
How will rheumatoid arthritis affect me in the future? How will rheumatoid arthritis affect me in the future?
It's difficult to say because rheumatoid arthritis affects people differently. You may have few flare-ups and be able to lead a relatively normal life, or if it’s more severe, you might have some disability.
It’s hard to predict how your condition will be in the future. Some people are able to lead their life almost as usual but if your joints are severely damaged, over time they can become unstable. This can lead to long-term pain and disability. By starting treatment for rheumatoid arthritis early, you can help to minimise the damage to your joints.
It's also important to follow your treatment plan and lead a healthy lifestyle. This may mean making some changes, such as losing weight and stopping smoking. Your doctor can give you more advice and information.
If you make some changes to your home and car, it can help to protect your joints and reduce pain and stiffness. Finding new ways to move or lift things and pacing yourself can help to reduce the stress on your joints.
There are many things you can do at home to make everyday tasks easier and reduce the stress on your joints. If you make a few small changes, it may help to protect your joints and prevent problems from becoming worse in the future. Here are just a few tips.
- Use labour-saving gadgets and aids specially designed for people with arthritis. These include devices for turning on taps, kitchen utensils with padded handles and automatic can openers.
- Rearrange your kitchen and other rooms to make sure the things you use most are easy to reach.
- When you lift things, try to reduce the weight of the item and spread the load across more than one joint. For example, lift things with two hands instead of one. Or slide heavy things rather than pick them up – such as heavy pans across the worktop.
- Plan ahead and pace your day. Don’t do strenuous jobs all at once. Instead, split them into smaller jobs and do a little at a time. You may find it easier to leave larger jobs for the afternoons when you’re less stiff and sore.
- Adapt your car to make driving easier. A padded steering wheel, extra side mirrors or a steering wheel knob may all help. If your rheumatoid arthritis is more severe, consider a car with an automatic gearbox rather than a manual one.
An occupational therapist can assess you in your home to see whether you may be eligible for financial help to make changes to your home. Your local social services department may also be able to help with equipment, or with adapting your home. Some equipment may be available through the NHS, but you may have to pay some costs yourself.
Not if you exercise carefully. Exercise can help you manage your pain and reduce stress on your joints, as well as keep you mobile. The key is getting the balance right between rest and exercise.
If your joints are inflamed, getting some rest will help you feel better. But don’t rest for too long because if you don't keep them moving, your joints will stiffen and your muscles will get weak. Exercise won’t make your arthritis worse, as long as it’s the right kind of exercise.
Your physiotherapist can help to design an exercise programme specifically for you. This will include different types of exercise, such as strengthening exercises, flexibility exercises and aerobic exercise to keep you fit.
Here are some tips that may help you when you’re exercising.
- Exercise when you’re in the least amount of pain. If you have pain during exercise, stop and rest.
- Don’t do vigorous or contact sports, such as squash, because these can jar your joints.
- During a flare-up, just do range of movement and gentle strengthening exercises.
- Find an exercise you enjoy. Swimming and other exercises in water are particularly good if you have arthritis as your joints are supported by the water.
- National Rheumatoid Arthritis Society
0800 298 7650
- Arthritis Research UK
0300 790 0400
- Rheumatoid arthritis in over 16s. National Institute for Health and Care Excellence (NICE), 28 June 2013. www.nice.org.uk
- Rheumatoid arthritis. BMJ Best Practice. www.bestpractice.bmj.com, published 6 October 2014
- Rheumatoid arthritis. PatientPlus. www.patient.info/patientplus, reviewed 20 January 2015
- Rheumatoid arthritis. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published August 2013
- Bykerk VP, Massarotti EM. The new ACR/EULAR remission criteria: rationale for developing new criteria for remission. Rheumatology (Oxford) 2012; 51(Suppl 6):vi16–20. www.rheumatology.oxfordjournals.org
- Rheumatoid arthritis. Arthritis Research UK. www.arthritisresearchuk.org, published June 2014
- Rheumatoid arthritis and the lung. PatientPlus. www.patient.info/patientplus, reviewed 16 October 2012
- Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. www.medicinescomplete.com, accessed 9 November 2015
- Map of Medicine. Rheumatoid Arthritis. International View. London: Map of Medicine; 2012 (Issue 4).
- Rheumatoid arthritis (RA). The Merck Manuals. www.merckmanuals.com, published August 2015
- DMARDS. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published July 2015
- Smolen JS, Landewé R, Breedveld FC, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis 2014; 73:492–509. www.ard.bmj.com
- Abatacept for treating rheumatoid arthritis after the failure of conventional disease-modifying anti-rheumatic drugs. National Institute for Health and Care Excellence (NICE), 24 April 2013. www.nice.org.uk
- Adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis. National Institute for Health and Care Excellence (NICE), 22 October 2007. www.nice.org.uk
- The role of the podiatrist in the management of rheumatoid arthritis. National Rheumatoid Arthritis Society. www.nras.org.uk, reviewed 24 January 2013
- Management of rheumatoid arthritis. PatientPlus. www.patient.info/patientplus, reviewed 27 January 2015
- Useful tips. National Rheumatoid Arthritis Society. www.nras.org.uk, reviewed 28 February 2013
- Everyday living and arthritis. Arthritis Research UK. www.arthritisresearchuk.org, published April 2013
- Benefits and rheumatoid arthritis. National Rheumatoid Arthritis Society. www.nras.org.uk, reviewed May 2015
- National Rheumatoid Arthritis Society
We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.
Let us know what you think using our short feedback form Ask us a question
Reviewed by Rachael Mayfield-Blake, Bupa Health Content Team, January 2016.
Let us know what you think using our short feedback form Ask us a question
About our health information
At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.
Information StandardWe are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.
What our readers say about us
But don't just take our word for it; here's some feedback from our readers.
“Simple and easy to use website - not alarming, just helpful.”
“It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.”
“Good information, easy to find, trustworthy.”
Meet the team
Head of health content and clinical engagement
- Dylan Merkett – Lead Editor – UK Customer
- Nicholas Ridgman – Lead Editor – UK Health and Care Services
- Natalie Heaton – Specialist Editor – User Experience
- Pippa Coulter – Specialist Editor – Content Library
- Alice Rossiter – Specialist Editor – Insights
- Laura Blanks – Specialist Editor – Quality
- Michelle Harrison – Editorial Assistant
Our core principles
All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.
In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.
We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.
We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.
Here are just a few of the ways in which the quality of our information has been recognised.
The Information Standard certification scheme
You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.
It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.
Certified by the Information Standard as a quality provider of health and social care information. Bupa shall hold responsibility for the accuracy of the information they publish and neither the Scheme Operator nor the Scheme Owner shall have any responsibility whatsoever for costs, losses or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of Bupa.
British Medical Association (BMA) patient information awards
We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.
If you have any feedback on our health information, we would love to hear from you. Please contact us via email: firstname.lastname@example.org. Or you can write to us:
Health Content Team
15-19 Bloomsbury Way