Rheumatoid Arthritis

When people hear the word “arthritis,” they often think of the wear-and-tear type that develops later in life. But rheumatoid arthritis (RA) is different. It is an autoimmune condition, which means the body’s own immune system attacks its joints, leading to inflammation, pain, and stiffness.

Unlike osteoarthritis, which is caused by gradual changes in the joint over time, RA can appear much earlier in life and often requires medication to manage effectively.

Symptoms of Rheumatoid Arthritis

RA most often begins between the ages of 30 and 60, though it can appear earlier or later. The condition typically starts in the smaller joints, such as the fingers, wrists, and feet, before potentially progressing to larger joints.

Common symptoms include:

• Pain, swelling, and tenderness in multiple joints

• Stiffness lasting more than 30 minutes in the morning

• Fatigue or a general feeling of being unwell, especially during “flares”

• Pain that worsens after rest, but may also be aggravated by strenuous activity

Because it is systemic, RA doesn’t just affect joints. Some people experience low energy, mild fever, or weight loss when the disease is active. These symptoms can come and go in cycles, with flares followed by quieter phases.

Rheumatoid Arthritis vs Osteoarthritis

The differences between RA and osteoarthritis (OA) can be subtle in the early stages, but there are some key distinctions:

• Onset: RA can start in early adulthood or middle age, whereas OA usually develops later in life or after injury.

• Pattern: RA often affects joints symmetrically (both hands, both feet), while OA may be more localised.

• Duration of stiffness: RA stiffness lasts longer (30 minutes or more), compared to OA which often eases within half an hour of getting moving.

• General symptoms: Fatigue and flu-like feelings are more common in RA, as it is an autoimmune condition.

Long-Term Changes in Joints

Without treatment, repeated flare-ups can gradually damage the structure of affected joints. In the hands, this might lead to visible deformities such as ulnar deviation (fingers drifting sideways), or “swan neck” changes in the fingers. These changes are less common in OA, where the main feature is bony thickening at the affected joint. See the image above for a visual comparison.

Managing Rheumatoid Arthritis

It’s important to stress that RA is a medical condition requiring input from your GP and rheumatology team. Diagnosis may involve blood tests for specific inflammatory markers, and sometimes imaging such as X-rays or ultrasound. Medication is often the most effective part of treatment, working to calm the immune system and prevent damage from flare-ups. Note that the joint deformities caused by RA are permanent. After a flare up, the body lays down new bone in the wrong place, which leads to these visible changes. The flares themselves can cause localised joint hypermobility as the joint capsule is stretched and damaged. With this in mind, prevention where possible is preferable to cure. Medications are the most effective way to prevent flares, but they are strong and warrant a deep discussion with your rheumatologist.

Osteopathy can play a useful role alongside this medical care. We cannot prevent flares, but we can:

• Help ease pain and stiffness between flares

• Support surrounding muscles to reduce strain on unstable joints

• Provide exercises to maintain mobility and strength

• Check the rest of the body for compensations that might add extra stress to painful areas

Support for Neck and Spine

RA can sometimes affect the neck, particularly if hypermobility develops after joint changes. This may lead to extra muscle tension and discomfort, both locally and in the form of headaches. We can work with you to strengthen the stabilising muscles and improve function while keeping safety in mind.

Next Steps

If you are experiencing joint pain, stiffness, or fatigue that sounds like rheumatoid arthritis, it’s important to seek medical advice. Alongside medical care, we can help you stay mobile and manage discomfort.

Book an appointment online today to begin managing your joint pain.