- Around 17.6 million people worldwide were living with rheumatoid arthritis in 2020 (Lancet Rheumatology, 2023).
- Women are affected about 2.5 times more often than men.
- Treatment started within the first 3–6 months of onset offers the best chance of remission.
What rheumatoid arthritis is
Rheumatoid arthritis (RA) is a chronic inflammatory disease in which the immune system mistakenly attacks the membrane lining the joints. The result is persistent inflammation that causes pain and swelling and, over time, can damage cartilage and bone.
Unlike osteoarthritis, which comes from cartilage wear, rheumatoid arthritis has nothing to do with age or physical strain. It can start at any age, most often between 30 and 60, and usually affects the same joints on both sides of the body.
Early symptoms to watch for
Rheumatoid arthritis often begins quietly, in the small joints of the hands and feet. Many patients initially blame tiredness or overuse. There are, however, a few signs that set inflammation apart from simple mechanical pain.
- Morning stiffness lasting more than 30 minutes, sometimes for hours
- Swollen, warm joints that are tender to the touch, especially fingers, wrists and ankles
- Symmetrical pain: the same joints on both hands or feet
- Unusual fatigue, sometimes a low-grade fever and weight loss
- Difficulty making a fist or opening a jar in the morning
How the diagnosis is made
No single test confirms rheumatoid arthritis. The rheumatologist pieces together your story, a clinical examination of the joints, blood tests and, when needed, imaging. This is why the consultation takes time and involves detailed questions.
The usual tests include inflammation markers (ESR and C-reactive protein), rheumatoid factor (RF) and anti-CCP antibodies, which are highly specific for this disease. Joint ultrasound can show inflammation of the synovial lining before an X-ray reveals any change.
- ESR and CRP: show the degree of inflammation in the body
- Rheumatoid factor and anti-CCP: antibodies associated with rheumatoid arthritis
- Full blood count, liver and kidney function: needed before starting treatment
- Joint ultrasound and X-rays of the hands and feet
Modern treatment: the target is remission
The 2022 EULAR recommendations are clear: treatment with disease-modifying drugs (DMARDs) should start as soon as the diagnosis is made. Methotrexate remains the first option for most patients, and corticosteroids are used only short term, as a bridge until the long-term treatment takes effect.
The strategy is called treat-to-target: your doctor sets a goal with you (remission or low disease activity), reassesses you every 1–3 months and adjusts treatment if at least a 50% improvement has not been reached within 3 months. If conventional drugs are not enough, biologic therapies and JAK inhibitors are available.
What you can do beyond medication
Smoking is the only proven modifiable risk factor for rheumatoid arthritis, and it worsens the response to treatment. Quitting smoking, keeping a healthy weight, moving regularly and getting enough sleep are real parts of the treatment, not just general advice.
Many patients in Chisinau reach a rheumatologist after months of self-medicating with anti-inflammatories. These ease the pain but do not stop the disease. The sooner the diagnosis, the more joints stay intact.
When to see a doctor
- You have morning stiffness lasting over 30 minutes for more than a few weeks
- You notice swollen joints in your fingers or wrists, especially on both sides
- Joint pain has lasted more than 6 weeks and does not settle with rest
- You have a family history of rheumatoid arthritis or other autoimmune diseases and joint symptoms appear
Frequently asked questions
Can rheumatoid arthritis be cured?
There is not yet a treatment that cures it for good, but with the right treatment many patients reach remission: no pain, no swelling and no progression of damage. The goal is to live normally, with regular monitoring.
If my rheumatoid factor is positive, does that mean I have rheumatoid arthritis?
Not necessarily. Rheumatoid factor can be positive in healthy people, especially with age, or in other diseases. The diagnosis rests on the whole picture of symptoms, examination and tests, not on a single value.
Can I exercise with rheumatoid arthritis?
Yes, and it is recommended. Gentle, regular movement maintains mobility and muscle strength. During flares, reduce the intensity; your rheumatologist or physiotherapist can guide you to suitable exercises.
Sources
- GBD 2021 – Global, regional, and national burden of rheumatoid arthritis, 1990–2020 (Lancet Rheumatology, 2023)
- EULAR recommendations for the management of rheumatoid arthritis: 2022 update (Annals of the Rheumatic Diseases)
- WHO – Musculoskeletal health (fact sheet, 2022)
The data presented come from public sources and published scientific studies; they describe populations, not individuals. A diagnosis is made only after a medical consultation. Laromed Clinic updates this page periodically as new data become available.
