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Diseases > Rheumatoid Arthritis | RA > About Rheumatoid Arthritis

About Rheumatoid Arthritis

What is it?

Rheumatoid arthritis is also known as RA. RA is one of the most common types of inflammatory arthritis. Do you know that it affects 1 in 100 people (1%). So, if you went to a hockey game with 10,000 people then you could expect about 100 people to have RA. You can see that it’s really not that rare!

RA causes pain and swelling in the joints. This causes your joints to feel stiff and sore (especially in the mornings). RA usually starts slowly adding joints over weeks to months. It might start in a knee, a wrist, your hands, or even your feet. It then spreads to other joints. Sometimes RA comes on overnight – you go to bed feeling well and wake up and can’t get out of bed. This is rare. Sometimes RA jumps around from joint to joint. People who get this sometimes think they’re going crazy. One day it will be the wrist then the next the wrist feels fine but the knee is sore and then the next day the knee and wrist are ok but the shoulder is sore. Try to explain that one!

The pain, swelling, and stiffness in the joints is caused by your own immune system! For some reason (not yet known), your immune system decides to attack your joints. So, with RA, the immune system is “activated”.

Remember when you’ve had the flu? Did you feel tired? I sure did. When you have the flu your immune system is also “activated” but it is fighting off a virus. In RA your immune system is also “activated” but it is fighting you!  So now you know why you feel tired. Your immune system is active!

How did I get it?

First thing to realize is you have done nothing wrong. Don’t blame yourself or anyone else. The truth is, nobody really knows why people get RA.

Most people who get RA do not have a family history. What? Most people who get RA don’t have a family history. Yep, it’s true although everyone thinks that most cases of RA are passed down through families. It is just not true.

Now, there are plenty of families where RA does occur. We’re not saying that.

Think of it like this. RA is like a fire burning in your joints. To make a fire you need the wood and something to light it with. Let’s think of the wood like it’s your genes. Your need the right type of wood (nice and dry) to light a fire.  Researchers have found that you need the right type of genes to light the fire of RA. But that’s not the end of the story. You also need something to light the fire with. We’re not entirely sure what lights the fire of RA. It might be the chemicals from cigarette smoke or the bacteria that live in your mouth. We just don’t know and it’s like looking for a needle in a haystack.

What is going to happen to me?

Being diagnosed with a chronic disease like rheumatoid arthritis (RA) can be a little scary. At this point there are probably a million questions running through your mind.  I’d like to say 2 things:

  1. RA is common: You probably know someone with it.
  2. There is Hope: It is probably the best time in history to get RA. Our approach to treatment has changed and the medicines we have are much more effective.

In the old days, rheumatologists used to take their time treating RA. They would start with pain killers and slowly move toward medications that could change the long-term outcome of the disease.

Today, this just isn’t the case. I’d like to say 2 things about the treatment of RA:

  1. Treat it early
  2. Treat it aggressively

Treat it early

Research has shown us if you treat RA early you are much more likely to get into remission.  Even a few months can make a difference. Here’s my analogy.  Imagine you are sitting in your living room enjoying a nice cup of coffee. You look over to the kitchen and see a fire burning on the stove. What do you think you’ll do? One option is to just sit there and wait until the fire gets worse and spreads to the walls or the ceiling. The second option is to grab the phone, dial the fire department, and grab your fire extinguisher. I don’t know about you but I’ll choose the second option. Why?

Well, you can think of RA like a fire in your joints. You want to get that fire put out as quickly as possible so it doesn’t damage your body. Once the damage from RA is done it cannot be reversed. We want to stop RA before it damages your joints.

If you or someone you know has RA, or you think has RA, please see a rheumatologist.

Treat it aggressively

So, we’ve decided to call in the fire department – great job! Now we need to make sure we have the right tools to put out the fire. We don’t want a bucket and water, we want a fire truck with a big hose. Hey, we might even want a few fire trucks. The quicker we can get that fire out the better you’ll be in the long-run.

That said, sometimes we call threel fire trucks right off the bat. Sometimes rheumatologists use 3 medications right off the bat. This is called triple therapy and I’ll talk about that strategy under “Treatments for RA”


So there you have it. You need to treat RA early and aggressively. Don’t wait. There is great treatment available that can get you back to leading a full life.

What should I do?

The first thing is don’t panic. Take a deep breath. Although you might have been diagnosed with rheumatoid arthritis, you are not alone, and there is good treatment.

The first thing you need to do is see someone who knows alot about rheumatoid arthritis – a rheumatologist. Studies show that patients who see rheumatologists regularly do much better than those managed by family doctors.

Recommendations for my patients are:

  1. Learn as much as you can about this disease. Education is very powerful.
  2. Attend your rheumatologist appointments regularly.
  3. Get your blood tests done as suggested by your rheumatologist.
  4. Learn about the medications.

Remember, we need to get that fire put out as quickly as possible.