Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease — the immune system attacks the lining of joints, causing pain, swelling, and over time joint damage and deformity. It also affects other organs (lungs, eyes, heart, blood vessels). Modern disease-modifying treatment has transformed RA — early, aggressive treatment largely prevents the disability that once defined it.

Symptoms

• Morning stiffness lasting more than 1 hour.
• Symmetrical joint pain and swelling — especially small joints of hands, wrists, feet.
• Warm, tender, swollen joints.
• Fatigue, low-grade fever, weight loss, feeling generally unwell.
• Over time — deformities, difficulty with daily tasks.
• Dry eyes/mouth, skin nodules, lung problems, heart disease risk — extra-articular features.

When to see a Health Expert — early matters

• Symmetrical small-joint pain and swelling lasting more than 2-4 weeks — see a rheumatologist, not a general physician who treats it as wear-and-tear.
• Window of opportunity — starting treatment within the first few months of disease gives the best chance of remission.
• Morning stiffness, inability to make a fist, swelling of the knuckles — don't wait.

India-specific differential — rule out TB

Tuberculosis can present with joint symptoms and with raised inflammatory markers. Before starting immune-suppressing treatment for RA, most Indian rheumatologists rule out active or latent TB (chest X-ray, IGRA/Mantoux) — this is standard. Also consider post-infectious arthritis, chikungunya-related arthritis (lasts months), and crystal arthritis.

Treatment — transformative today

• DMARDs (disease-modifying antirheumatic drugs) — start early; the commonest anchor drug is a weekly oral tablet under rheumatology supervision.
• Biologics — monoclonal antibodies and similar agents; highly effective for disease that doesn't respond; increasingly available and affordable in India.
• JAK inhibitors — oral targeted therapy.
• Short-term steroids — to control flares while DMARDs are starting.
• NSAIDs, physiotherapy, occupational therapy, joint protection, splints, appropriate aids.
• Cardiovascular risk, bone health, vaccination (flu, pneumococcal, hepatitis B) — attend to these alongside joint care.
• Surgery — for severe joint damage; less needed than a generation ago.

Living with RA

• Take medicines regularly — missed doses undo months of progress.
• Monitor blood tests as advised.
• Balanced diet, healthy weight, don't smoke (smoking worsens RA).
• Gentle regular exercise.
• Peer groups (Arthritis Foundation of India and local networks) help.
• Report early signs of flare to your rheumatologist — don't wait until joints are swollen and deformed.