Rheumatoid arthritis (RA)

Rheumatoid arthritis is a chronic joint disease affecting an estimated 10 percent of the world’s population over the age of 60. The disease cannot be cured, but it can be treated with antirheumatic drugs; there is also a lot you can do yourself to relieve the ailment.


APPOTEK can help if you suspect you have RA, by connecting you to a doctor or specialist for diagnosis and treatment.


Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints. (Autoimmune diseases are illnesses that occur when the body’s tissues are mistakenly attacked by their own immune system.) At present, it is not entirely clear what triggers rheumatoid arthritis. We do know that hormone changes, smoking and heredity are factors that increase risk of contracting the disease (both individually and in combination). Heredity and hormone changes are factors we cannot control, but quitting smoking and improving health habits we can. Rheumatoid arthritis is more common among women than men, and although the disease can affect people of all ages, the average age is 55 years.


RA primarily affects the joints, but it can also affect other organs in 15–25% of cases.


Arthritis of the joints involves inflammation of the synovial membrane. Joints become swollen, tender and warm, and stiffness limits their movement. With time, multiple joints are affected (polyarthritis).


Most commonly affected are the small joints of the hands, feet and cervical spine, but larger joints like the shoulder and knee can also be affected. Synovitis can lead to tethering of tissue with loss of movement and erosion of the joint surface, causing deformity and loss of function.


The rheumatoid nodule, which is sometimes in the skin, is the most common non-joint feature and occurs in 30% of people who have RA. It is a type of inflammatory reaction known to pathologists as a “necrotizing granuloma”. The initial pathologic process in nodule formation is unknown but may essentially be the same as synovitis, since similar structural features occur in both.


There is no known prevention and no cure for RA, but treatments can improve symptoms and slow the progress of the disease. Disease-modifying treatment has the best results when it is started early and aggressively.


The goals of treatment are to minimize symptoms such as pain and swelling, to prevent bone deformity (for example, bone erosions visible in X-rays), and to maintain day-to-day functioning. 


This is primarily addressed with disease-modifying antirheumatic drugs (DMARDs); dosed physical activity; analgesics and physical therapy may be used to help manage pain. RA should generally be treated with at least one specific anti-rheumatic medication. The use of benzodiazepines (such as diazepam) to treat the pain is not recommended as it does not appear to help and has associated risks. 


Regular exercise is recommended as both safe and useful to maintain muscles strength and overall physical function. Physical activity is beneficial for people with rheumatoid arthritis who experience fatigue.

When to consult a doctor

If you suspect that you have rheumatism, it is important for you to contact a doctor as soon as possible – both to rule out any other disease that may be causing your condition, and to get the right treatment quickly, should you be diagnosed with any rheumatic disease. Untreated rheumatic diseases, especially rheumatoid arthritis, can cause the function of the joints to deteriorate and pain to increase. Therefore, wait no longer than necessary to see a doctor and get a diagnosis.

How Appotek can help

APPOTEK can connect you to a doctor or refer you to a rheumatoid specialist for diagnosis and treatment of RA.


Vadym Diadiun, Doctor of Medicine, M.D.