Rheumatoid arthritis is an autoimmune disease which means that immune cells of body are attacking its own cells and damage them. In RA they are attacking lining of the joints called as synovium leading to joint pain, swelling and redness. Patients experience joint pain, stiffness. The disease generally affects small and large joints in a symmetrical fashion. Misfiring of immune cells is not limited to the joints and there are other manifestations as well, like long standing cough when lungs are affected or nodules or dryness of mouth or eyes.

Four or more joints involved

Early morning stiffness of more 30 minutes or stiffness after a period of rest

Presence of other symptoms like nodules or dry cough or breathlessness

Dryness of mouth or eyes or tingling / numbness or an ulcer

It affects around 1% of population worldwide. It affects females more commonly and can affect any age group from children to adults to old aged individuals.

There are multiple reasons which have been explored but none alone can explain this complex disease. Genes, infection and environmental factors all play a role. Smoking definitely increases risk, worsens the disease and decreases the effect of the medications.

There is a genetic component to disease but it does not really predict the chances your relative might get the disease. In fact, even in identical twins, chances of getting RA in other twin, if one has the disease, is only 15-20%. So it is not necessary that you will transfer the disease to your future generations.

One must take a healthy diet. Avoid high fats, high sugar and refined and processed foods. If one particular food item worsens your joint pain every time you consume, you may stop it. Certain food are considered anti-inflammatory like those rich in omega 3 fatty acids. These are avocado, flax seeds, chia seeds, almonds walnuts, soyabean and fish.

Some people recollect a period of stress or trauma before the advent of these symptoms or may relate to disease flare during periods of stress. It is not clear whether such stressful events are more common or is it a recall bias.

This is another difficult question and there is no straight to answer. Generally, it is lifelong like any diabetes or hypertension. But with early diagnosis, treatment and after a period of sustained remission, it is possible to come down to minimum number of drugs(s). In a few patients medicines can be stopped completely also.

Remission or low disease activity means your disease is under control with no or minimal pain or swelling in the joint and normal blood reports.

Entire world is realising the importance of yoga and physiotherapy in general. It boosts your immune system, unnerves and relaxes it. In fact, it forms the most important part of your treatment. It is free of cost but needs lot of discipline as we often neglect this mode of treatment. Yoga, aerobics, deep breathing exercise are all very important.

Management can help attain a state similar to cure.Currently there is no cure but remission or low disease activity with available drugs are achievable. What is most important is timely diagnosis and management.

As discussed briefly, RA can affect other internal organs in the body. Discuss your symptoms with your doctor. Remember to check your blood pressure, sugar and cholesterol as long standing disease can affect your general health. With good disease control and monitoring, these can be prevented or very well taken care of.

Yes, you can get pregnant but discuss your medications with doctor. Some drugs like methotrexate, Leflunomide are not safe during pregnancy. Ideally disease should be in remission or a low disease activity status for six months before you conceive. Monitoring of fetal growth should be done.