Arthritis, also called rheumatoid arthritis, is an autoimmune disease. The immune system attacks its own tissues, especially the joints but also tendons and tendons attachments. This causes inflammation, pain, redness and stiffness in the joints, especially in the hands, wrists, feet and knees. If the disease is left untreated, it can cause joint damage and reduced mobility.

Arthritis is approximately two to three times more common in women than in men.

People of all ages can get the disease, but it is most common for people to experience symptoms between the ages of 30 and 60.

Certain genetic factors can increase the risk of developing the disease.

Smoking increases the risk of developing arthritis. Individuals with certain genetic factors who smoke have around twenty times the risk of developing arthritis compared to individuals without these risk factors.

• The symptoms of arthritis often start gradually but can appear suddenly.
• Joint pain and swelling: Joints can become swollen. Sometimes there is a fever over the joints. Characteristic of the disease are joint pain and swelling in the wrists, fingers and toes, but other joints can also become swollen, for example the elbows, hips, knees and ankles.
• Morning stiffness: People with arthritis often experience stiffness in their joints when they wake up in the morning or after sitting or lying down for a while. The stiffness often lasts for more than 30 minutes and sometimes all day. It often improves with movement.
• Reduced mobility: Joint pain and inflammation cause difficulty in bending or straightening joints. If the disease is left untreated, it can cause permanent damage to the joints, resulting in reduced mobility.
• General malaise and fatigue: Inflammation in the body places additional strain on it and can lead to significant fatigue. This can affect a person's daily life and general energy levels.
• The most common complications of extra-articular arthritis are:
  • Eye and mouth dryness due to inflammation of the tear and salivary glands.
  • Erosive nodules in the skin, which are raised, hard skin changes, most commonly appearing on the fingers, elbows or pressure areas.

Other complications outside the joints can affect the lungs, heart, kidneys and nerves, but are rare while the disease is being treated.

• If you have joint pain that worsens with rest and improves with exercise.
• If joints have at least one of the following: swelling, redness or warmth.
• If you experience stiffness in your joints, especially if it is in the morning, which lasts for more than 30 minutes.

Timely diagnosis and treatment can help to manage symptoms and prevent joint damage.

Diagnosis is made by assessing symptoms, a physical examination and the results of investigations.

• Medical history: The doctor reviews symptoms, pain patterns, medication and family history.
• Physical examination: A doctor examines the joints to check for inflammation, pain and stiffness.
• Blood tests: Measurement of inflammatory markers such as CRP and ESR, as well as measurements of rheumatic factors (rheumatoid factor, RF) and anti-CCP can help with diagnosis.
• X-rays: Show changes, such as damage to the joints.
• Ultrasound or MRI: Used to assess inflammation in joints.

• Anti-inflammatory drugs (NSAIDs): e.g. ibuprofen and celecoxib to reduce inflammation and pain.
• Steroids: Act quickly and powerfully to reduce inflammation. They are used for acute flare-ups of arthritis and to bridge the gap until disease-modifying antirheumatic drugs (see below) begin to work. Steroid injections can be given into the joints for a localised effect. If multiple joints are inflamed, steroid tablets (prednisolone) are most commonly used. It is important to limit the use of steroids as much as possible.
• Disease-modifying anti-rheumatic drugs (DMARDs) are used to halt the disease and prevent joint damage. Examples of typical drugs used in the treatment of arthritis:
  • Methotrexate is most often the first choice. It is important to follow the instructions for taking the medicine, as it is only taken once a week.
  • Biologics – If methotrexate is not effective or is poorly tolerated, treatment with TNF inhibitors is often tried. However, many drugs belong to this group. Other biologics that can be chosen include drugs that block or inhibit the IL-6 receptor, B cells and T cells.
• The correct medication is chosen according to the severity of the disease and the response to treatment. A doctor may need to adjust the treatment according to individual needs.

• Regular exercise – Activities that strengthen muscles, increase stamina and improve flexibility, e.g. walking, aqua aerobics, yoga, stretching, strength training and cycling.
• Weight management – Maintaining a healthy body weight can reduce the strain on joints.
• Heat and cold therapies – Heat and cooling can reduce joint pain.
• Protective equipment – Aids can be used on the advice of an occupational therapist or a physiotherapist.
• Diet – A healthy diet in accordance with the recommendations of the Chief Medical Officer.

Complementary therapies and self-help are important for improving quality of life and managing symptoms.

• If the treatment is conventional – Medication can help to keep symptoms under control and prevent/stop joint damage.
• Timely treatment – If the disease is diagnosed early and treatment begins quickly, the outlook is better and there is less chance of sick leave.
• Untreated – If left untreated, arthritis can lead to serious joint damage and reduced mobility. The risk of cardiovascular disease also increases due to the effects of inflammation on the vascular system.
• Lifestyle and response to treatment – Medical advice and self-help, such as regular exercise and a proper diet, have a significant impact on outlook and quality of life.

Generally, the outlook is better when treatment and management are in the hands of the patient and doctor.