Rheumatoid arthritis

Helpline 0800 5200 520 1

WE aRE
Contents
Priti’s story 4
What is rheumatoid arthritis? 6
How will it affect me? 8
What causes rheumatoid arthritis? 13
Diagnosis 14
Treatment 17
How can I manage my symptoms? 22
Living with rheumatoid arthritis 29
Research and new developments 36
Where can I find out more? 38

We’re the 10 million people living with arthritis. We’re the carers,
researchers, health professionals, friends and parents all united in
our ambition to ensure that one day, no one will have to live with the
pain, fatigue and isolation that arthritis causes.
We understand that every day is different. We know that what works
for one person may not help someone else. Our information is a
collaboration of experiences, research and facts. We aim to give you
everything you need to know about your condition, the treatments
available and the many options you can try, so you can make the
best and most informed choices for your lifestyle.
We’re always happy to hear from you, whether it’s with feedback on our
information, to share your story, or to find out more about the work of
Versus Arthritis. Contact us at [email protected]

Registered office: Versus Arthritis, Copeman House, St Mary’s Gate, Chesterfield, S41 7TD.
Registered Charity England and Wales No. 207711, Scotland No. SC041156.
 Some people don’t understand that I might wake up in the morning
and have a flare-up, which can be difficult when making plans. I might
not be able to make it that day because I can’t get on the bus or the
train. Or maybe I’m not comfortable driving that day because I’m tired
and haven’t slept all night. Every day is different though and it’s not
something I can predict.
It can be exhausting being a mum with rheumatoid arthritis. So, I think
it’s important to accept help and make things easy for yourself.
We keep batch meals in the freezer so that, on days that I’m tired or
I’m having a flare, we have easy meals on hand rather than having to
get a takeaway or cook from scratch. We also keep a bag of new toys
or colouring books so that I can sit down and play with the kids if I’m

Priti’s STORY having a flare and can’t run around after them.
My husband supports me, and my mum has been brilliant as well. She
calls me every day and helps out if I’m having a bad day. There are
I started noticing symptoms several years ago. In 2016, my dad times, where I think I could just stay in bed all day and not do anything.
passed away unexpectedly and for a few months, I was quite tired But I’ve got to keep going for my kids because they need me.
and stressed. Then I found out I was pregnant. I work as an accountant, and my workplace has been very supportive,
While I was pregnant, I had a swollen knee and was achy. I was especially because I have so many appointments. I’ve found working
exhausted but my doctors just put it down to the pregnancy. from home better too. It’s not a rush in the morning to get ready and,
It wasn’t until I was pregnant with my second baby in 2018, that on a bad day, you can lie down on the sofa if you just need 10 minutes
I knew something wasn’t right. I was in a lot of pain, so they sent me to rest.
for more tests. Then I found out I had rheumatoid arthritis. I wish I had researched more about rheumatoid arthritis when I was
Since then, I’ve been on loads of different medications. I’ve been on first diagnosed. Through Versus Arthritis and Instagram, I found a
methotrexate for about 18 months, and it helped a bit. But I was still community. It’s helped having that support, and I’ve made a few friends
in a lot of pain, so my doctor started prescribing me etanercept last as well. I felt guilty some days, especially when the kids want to do
year. The etanercept has made such a difference and I’ve got a lot things or run around, and I can’t do it. It’s helpful to feel like you’re in
more energy now. the same boat as other people. That it’s not just me.

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What is rheumatoid arthritis? A joint affected by rheumatoid arthritis

Rheumatoid arthritis (room-a-toyd arth-rye-tus) is a long-term

condition that can cause pain, swelling and stiffness in your joints. Muscles
Rheumatoid arthritis is an autoimmune condition. This means that weaken
the immune system mistakenly attacks healthy tissues in your body,
rather than germs or viruses. If untreated, this can damage your
Tendons
joints, cartilage, and nearby bones. can become
damaged Bone
How does rheumatoid arthritis affect
the joints? Bone and Capsule
A joint is where two or more bones meet. They allow you to bend, cartilage and
twist and turn freely. can become Bone ligaments
damaged slacken
The joint is held together by a capsule, which stops the bones from
moving too far, and inside the capsule, there is an inner lining called
the synovium. This makes a thick fluid, called synovial fluid, that
protects the joint.
The ends of the bones are covered with a thin layer of slippery tissue
called cartilage. This acts as a protective cushion, stopping the bones
from rubbing against each other.
Strong cords called tendons anchor the muscles to the bones. When
we move, our muscles pull the tendons, which then pull our bones in What are the symptoms?
certain directions. The main symptoms of rheumatoid arthritis are:
Inflammation is the body’s way to heal itself after an infection or • joint pain
injury. It increases the flow of blood and fluid to the affected area
making it swollen, red, painful and hot. • joint swelling, warmth and redness
• stiffness, especially first thing in the morning or after sitting still
However, if you have rheumatoid arthritis, the body mistakenly sends
for a long time
inflammation to joints, even though there’s no infection to fight. This
inflammation isn’t needed and can cause problems. Rheumatoid arthritis can affect any joint in the body, although the
small joints in the hands and feet are often the first to be affected.
When the inflammation goes down, the joint capsule can remain
stretched. This means it can’t hold the joint in its proper position, Both sides of the body are usually affected at the same time, in the
which causes the joint to become unstable. same way. But this doesn’t always happen.

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As well as joint problems, you may experience other symptoms, However, if you get diagnosed early and receive the right treatment,
such as: it’s possible to have months or even years between flares.
• tiredness and lack of energy – this is known as fatigue
You don’t need to face arthritis alone. If you need support or
• not feeling hungry
advice, call our Helpline today on 0800 5200 520. Our advisors
• weight loss can give you expert information and advice about arthritis and
• a high temperature, or a fever can offer support whenever you need it most.
• sweating
• dry eyes – as a result of inflammation Complications
• chest pain – as a result of inflammation. If you have rheumatoid arthritis, you may also have a greater risk of
Rheumatoid arthritis is sometimes called a systemic condition. This developing other conditions, such as those below.
means it can affect the whole body, rather than just one part of it.
Carpal tunnel syndrome
Carpal tunnel syndrome is when you have more pressure than
How will it affect me? normal on a nerve in your wrist.
Being told you have rheumatoid arthritis can be a shock. You Symptoms include:
might be feeling anxious about what comes next and how your life • aching
will change.
• numbness
But, thankfully, the outlook for people with rheumatoid arthritis is • tingling in your thumb, fingers and part of the hand
improving all the time, as new and more effective treatments become
available. So, you can still lead a full and active life with rheumatoid You can often control it yourself using wrist splints, hand exercises
arthritis, if you take your medication and make any necessary and painkillers. But, in some severe cases, you may need a steroid
lifestyle changes. injection or surgery.
The symptoms of rheumatoid arthritis usually develop slowly over Inflammation in other parts of your body
time. But, in some cases, it can progress quickly over a few days. As well as your joints, rheumatoid arthritis can cause inflammation in
These symptoms can vary from person to person. They may come other parts of your body, such as your:
and go, change over time or you may have periods where the
symptoms of your condition come back or get worse. This is called • heart – Your heart is surrounded by a fluid-filled sac called the
a flare-up or flare. pericardium. If this becomes inflamed, it can lead to a condition
known as pericarditis. This causes chest pain and a high
temperature.

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• eyes – Inflammation in your eyes can lead to scleritis or Sjögren’s It’s a serious condition that can affect your mobility, so it should be
syndrome. Scleritis can cause pain, redness, sensitivity to light and treated as soon as possible. Symptoms include neck pain, loss of
blurry vision. Sjögren’s syndrome can cause dry, sore eyes and you balance, trouble walking and weakness or numbness in the limbs.
might find that your eyes become sticky with mucus when you
wake up. Joint damage
If you don’t get treatment early enough, or your rheumatoid arthritis
• lungs – Inflammation in your lungs can lead to conditions such
isn’t controlled, this could lead to joint damage. If this happens, you
as pleurisy, pulmonary fibrosis or chronic obstructive pulmonary
may need to have surgery.
disease (COPD). This can cause chest pain, a cough that won’t go
away and shortness of breath. Rheumatoid nodules
• blood vessels – In rare cases, rheumatoid arthritis may cause A few people with rheumatoid arthritis may develop fleshy lumps
inflammation in your blood vessels, known as vasculitis. This can called rheumatoid nodules (room-a-toyd nod-yools). Around 20%
cause the walls of your blood vessels to become thick, narrow and of people with rheumatoid arthritis will get these nodules and they
weak. In serious cases, this can affect blood flow to your body’s most commonly occur in joints such as the hands, fingers, knuckles
organs and tissues. For more information, visit vasculitis.org.uk or elbows.

Cardiovascular disease Rheumatoid nodules usually don’t hurt. If they’re small, they can be
If you have rheumatoid arthritis, you’re at a higher risk of developing ignored. But if these nodules interfere with your day-to-day life, it’s
cardiovascular disease (CVD). This is a general term used to worth speaking to your GP.
describe conditions that affect the heart or blood vessels, such as There’s little research on how to reduce these nodules. But some
heart attacks and strokes. disease-modifying anti-rheumatic drugs (DMARDs) and biological
You can reduce your risk by: therapies may reduce the chance of these nodules forming.
Sometimes a steroid may be injected under the nodule to help
• making sure your condition is controlled reduce its size and surgery is another option. However, the nodule
• taking your medication may return to the same spot again.
• eating a healthy, balanced diet
• keeping active
• stopping smoking. If you don’t get treatment early enough, or
Cervical myelopathy your rheumatoid arthritis isn’t controlled,
If you’ve had rheumatoid arthritis for a while, you have a greater risk
of getting cervical myelopathy. This is caused by the joints at the top
this could lead to joint damage. If this
of your spine dislocating and putting pressure on your spinal cord. happens, you may need to have surgery.

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Rheumatoid arthritis What causes rheumatoid arthritis?
affects around Rheumatoid arthritis affects around 400,000 people in the UK. We
don’t know what causes it. But several factors may increase your risk
400,000 people of developing the condition. These include:
in the UK. Age
Rheumatoid arthritis can affect you at any age, but most people are
diagnosed between the ages of 40 and 60.

Sex
Rheumatoid arthritis is two to three times more common among
women than men. We don’t know why. It may be because of the
hormone oestrogen but the link hasn’t been proven.

Genes
There’s no single gene that causes rheumatoid arthritis, although,
there’s some evidence that suggests that rheumatoid arthritis can
run in families.
However, the risk of inheriting rheumatoid arthritis is thought to be
low, because genes are thought to only play a small role in developing
the condition.

Weight
If you’re overweight, you have a greater chance of developing
rheumatoid arthritis than if you’re a healthy weight.
Eating a balanced diet and exercising is a good way to manage
your weight.

Smoking
Some research suggests that people who smoke have a greater risk
of developing rheumatoid arthritis.
Stopping smoking can be tough. But it could really improve your
condition. For more advice, visit nhs.uk/better-health/quit-smoking

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Diagnosis C-reactive protein (CRP) test
This test also helps to measure inflammation in your body.
You will be diagnosed with rheumatoid arthritis based on:
Full blood count
• your symptoms
A full blood count can rule out other possible causes for your
• a doctor examining you and your joints in person symptoms. A full blood count measures how many red blood cells
• the results of x-rays, scans and blood tests. are in your blood. Red blood cells carry oxygen around the body in
your blood and if you don’t have enough, you may have anaemia.
First, your doctor will ask about your symptoms. They will look for
swollen joints and check how well your joints move. Anaemia is common in people with rheumatoid arthritis. But if you
have anaemia, it doesn’t prove you have rheumatoid arthritis. For
Rheumatoid arthritis can affect different parts of your body at once,
example, you might have anaemia because there’s not enough iron
so it’s important to tell your doctor about any symptoms you’ve
in your diet.
had, even if they don’t seem to be related. If they think you have
rheumatoid arthritis, you will be referred to a rheumatologist who Seropositive and seronegative (rheumatoid factor and
may arrange blood tests to confirm a diagnosis. anti-CCP antibodies)
It may take a while to get your results so ask your healthcare team If you have been diagnosed with rheumatoid arthritis, you may have
when you’re likely to hear back from them. Your doctor may start been told that you are seropositive or seronegative.
your treatment or give you medication before you get a diagnosis. If you’re told you’re seropositive, it means that you have one or both
antibodies present in your blood:
If you’re waiting for a diagnosis, there are plenty of ways • rheumatoid factor (RF)
you can help to manage your symptoms. For advice, visit
versusarthritis.org/about-arthritis/managing-symptoms/ • anti-cyclic citrullinated peptide (anti-CCP).

Antibodies are produced by your immune system in response

Blood tests to things that your body sees as dangerous, such as germs and
There is no single blood test that confirms you have rheumatoid viruses. Antibodies attack them and make them harmless.
arthritis. However, there are a few tests that can show possible signs
of the condition.
About 85% of people with rheumatoid arthritis have one or both
Usually, you don’t have to avoid eating or drinking before these tests, antibodies. But you can still be diagnosed with rheumatoid arthritis
but your doctor will let you know if you do. if you don’t have them. Because of this, some rheumatology doctors
don’t think it’s a useful term and it won’t affect your treatment.
Erythrocyte sedimentation rate (ESR)
This test shows the level of inflammation in your body.

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Disease Activity Score (DAS28) Treatment
Your doctor may also measure how active your condition is using a Once you have been diagnosed, you will be seen at a rheumatology
Disease Activity Score (DAS). A Disease Activity Score is a scoring clinic in a hospital. You’ll usually see a specialist doctor, known as a
system that helps your doctors see how your condition affects your rheumatologist, and a rheumatology nurse specialist.
body, and how it reacts to treatment.
There are three main ways to treat rheumatoid arthritis:
For rheumatoid arthritis, this assessment is called the DAS28.
• drugs
DAS stands for ‘disease activity score’ and the number 28 refers to
the 28 joints your doctor will look at in your assessment. • physical therapies
• surgery.
This tool allows your doctor to monitor how your condition changes.
Plus, it can also be used to check if you’re suitable for certain
treatments. Drugs
Drugs used to treat rheumatoid arthritis include:
The DAS28 score isn’t necessarily black and white though. Because
of this, your rheumatologist will consider if you have any other • painkillers
medical conditions too. • non-steroidal anti-inflammatory drugs (NSAIDs)
• conventional disease-modifying anti-rheumatic drugs (DMARDs)
Scans
• biological treatments
You may also have some scans to check if you have any joint
inflammation or damage. These include: • janus kinase inhibitors (JAK inhibitors)
• steroid treatments, as needed.
• x-rays – a test that creates images of the inside of the body. It’s
used to look for injury or damage to the bones or joints. You may need to take more than one drug at a time because
• ultrasound scans – uses sound waves to build up pictures of the different drugs work in different ways. Over time, you may also
inside of the body change what drugs you take. This will depend on how bad your
symptoms are, or if your condition has changed.
• magnetic resonance imaging (MRI) scans – a scan that uses
magnets to look at what is happening inside your body. An MRI You should carry on taking the drugs given to you by your doctor,
scan can show soft-tissue damage - in the muscles, ligaments or even when you’re feeling a bit better. This will reduce the risk of
nerves - as well as any problems with the bones. flares. If you’re thinking about stopping your treatment, you should
discuss this with your doctor first.
• computerised tomography (CT) scans – a scan that uses x-rays
and a computer to create detailed images of the inside of your
body. These are sometimes called CAT scans. For more information, visit versusarthritis.org/about-
arthritis/treatments/drugs/

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Disease-modifying anti-rheumatic drugs (DMARDs) Janus kinase inhibitors (JAK inhibitors)
Disease-modifying anti-rheumatic drugs (DMARDs) change the way Janus kinase inhibitors (JAK inhibitors) are newer types of drugs.
a condition progresses, rather than just treating symptoms. They are usually offered to people who can’t take DMARDs or
They’re not painkillers, but they’ll reduce pain, swelling and stiffness biologics, or people who haven’t benefitted from them.
by slowing down the condition and its effects on the joints. JAK inhibitors include:
They’re long-term medications, which means it often takes weeks • tofacitinib
or months for them to work. You will usually need to keep taking • baricitinib.
them, even if they don’t seem to be working at first. And you’ll need
to continue them, even when you start to feel better, in order to keep Painkillers
your condition under control. Painkillers can help to relieve the pain caused by rheumatoid
There are two types of DMARDs: conventional DMARDs and arthritis. But they shouldn’t be the only treatment you receive.
biological therapies. There are many types and strengths of painkillers available.

Conventional DMARDS include drugs such as: Some painkillers, such as paracetamol, can be bought over the
counter from a pharmacy or supermarket. Other painkillers, such as
• hydroxychloroquine codeine, are only available on prescription.
• leflunomide
Non-steroidal anti-inflammatory drugs (NSAIDs)
• methotrexate
NSAIDs are used to relieve pain and reduce inflammation. But they
• mycophenolate will not stop your rheumatoid arthritis from getting worse over time.
• sulfasalazine. NSAIDs start working within a few hours, and the effects can be felt
for up to a whole day.
Biological therapies (sometimes called biologics) are newer drugs
used to treat some long-term conditions, such as rheumatoid Some can be bought from supermarkets or chemists, but others are
arthritis. They reduce the effects of key parts of the immune system, only available on prescription. They’re available as tablets, creams
that might be attacking the body’s healthy tissues. and gels, injections and patches.
Biological therapies target individual molecules and tend to work NSAIDs include aspirin, ibuprofen and naproxen. You can take them
more quickly than conventional DMARDS. They’re only given to along with painkillers.
people who have tried other drugs and not responded well to them.
Steroids
Biologics include drugs such as: Steroids help to ease symptoms such as swelling, pain and stiffness.
• abatacept They are usually given to provide short-term relief. This might
• rituximab be during a flare-up or while you’re waiting for a DMARD to start
working.
• tocilizumab.

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Steroids are also sometimes known as corticosteroids. These are Surgery
different to the anabolic steroids that bodybuilders and athletes use.
Not everyone with rheumatoid arthritis will need surgery, but
Steroids can be used as: sometimes it can help to reduce pain, correct the shape of your joint
• a tablet or liquid you drink or improve your mobility.
• an injection directly into a joint Foot surgery
• an injection into a muscle. Examples of this type of surgery include:
• removal of inflamed tissues from the forefoot (the front
Physical therapies of your foot)
You might also be offered physical therapies to ease your • removal of the small joints in the ball of the foot
symptoms and improve your mobility. These include physiotherapy,
• straightening of toes
hydrotherapy and occupational therapy.
• fixing of joints.
Physiotherapy
Physiotherapy is given by trained specialists, known as Finger, hand and wrist surgery
physiotherapists, to help people with an injury or long-term health Examples of this type of surgery include:
condition be active and independent. • carpal tunnel release (used to treat carpal tunnel syndrome)
It involves movement, exercise, manual therapy, education and • removal of inflamed tissue in the finger joints
advice to help ease your pain and help your muscles and joints move • release of tendons in the fingers.
more easily.
Arthroscopy
Hydrotherapy Arthroscopy is a type of keyhole surgery that’s used to diagnose and
Hydrotherapy, also known as aquatic therapy, is exercise that takes treat joint problems. It’s often used to repair damaged cartilage, drain
place in a warm water swimming pool, with a physiotherapist. It excess fluid or remove bits of loose bone or cartilage.
normally takes place in a physiotherapy department at a hospital.
The equipment is very small, so only small cuts are needed. Because
Occupational therapy of this, it has a faster healing time and a lower risk of infection.
Occupational therapy provides practical support to help you keep Sometimes you can go home on the same day as the surgery, but
your independence and carry on doing everyday activities. An you will need to rest your joint.
occupational therapist can look at your work, home or school and
offer suggestions to make tasks easier.

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Joint replacement
Some people with rheumatoid arthritis might need surgery to
replace part, or all, of a joint. This is known as a joint replacement,
or arthroplasty.
Common joint replacements include the hip, knee and shoulder.
Thousands of people have joint replacement surgeries each year.
But, as with any surgery, it’s important to think about the possible
risks and to discuss them with your surgeon before you decide
to go ahead.

For more information, visit versusarthritis.org/about-

arthritis/treatments/surgery/

How can I manage my symptoms?

Flare-ups
When your symptoms come back or get worse, this is known as
a flare-up or a flare. These can happen at any time, but it often
happens at times when you’ve been stressed or had an infection.
Over time, you may get better at noticing the early signs of a flare-
up. But if you’re having regular flare-ups, you should talk to your Keeping active
doctor because they might need to look at your treatment. It can be hard to keep moving if you have arthritis. Many people
Here are a few things you can do to help yourself during a flare-up: worry that they’ll hurt themselves or further damage their joints.
But the truth is staying as active as possible could actually help
• Keep taking your medication at the doses you’ve been prescribed. your symptoms.
• Do gentle exercises to help reduce stiffness. Keeping moving will make your muscles strong, your joints mobile
• Use a hot water bottle or heat pad. and help to improve symptoms such as fatigue and pain. Plus, it’s
• Put cold items on your joint – for example, a bowl of cold water good for your mental health.
with ice cubes, a pack of frozen peas wrapped in a towel, or a If you’re new to exercise or haven’t exercised in a while, you might
damp towel that has been kept in the fridge. feel a bit sore the first few times you try it. But, if you stick with it,
• Let people around you know, so they can give you a helping hand. it will get easier.

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You don’t need any special gear to get started, and a lot of physical
activity can be done at home. For more advice, check out these
exercises for healthy joints versusarthritis.org/about-arthritis/
exercising-with-arthritis/exercises-for-healthy-joints/
Start small and remember that any exercise is better than nothing.
Your body is designed to move and resting too much could actually
harm your joints and the tissues around them.
If you’re finding it difficult to stay motivated, it might help to exercise
with a friend or in a group. It can be a great way to socialise and meet
new people too.
We run activities across the country specially designed for people
with arthritis, such as walking groups and Chair Chi. To see if we host
any physical activity classes in your area, visit versusarthritis.org/
in-your-area/
If you’d rather exercise from the comfort of your own home, be sure Your plate should include a variety of foods from all five food groups.
to check out our free exercise programmes on our website. From tai This includes:
chi to quick gym workouts, it’s packed full of free, online exercise
classes, specially designed for people with arthritis. • fruit and vegetables, such as apples and carrots
• carbohydrates, such as wholewheat pasta or brown rice
For more advice on getting some more movement in • proteins such as fish or pulses
your life, check out our Keep moving booklet or visit • dairy or dairy alternatives, such as cheese and yoghurt
versusarthritis.org/exercise
• oils and spreads, such as olive oil.
Eating a Mediterranean-style diet is a good option, for instance,
Healthy eating because it is packed with lots of fruit and vegetables, oily fish, nuts,
It’s important to eat a healthy, balanced diet if you have arthritis. seeds and olive oil.
This will give you all the nutrients you need such as calcium,
vitamin D and iron. Plus, it’ll help you maintain a healthy weight. For more information, see our Eating well with arthritis
Being overweight can put extra burden on the joints in your knees, booklet or visit versusarthritis.org/about-arthritis/
hips ankles and feet, causing pain and mobility problems. managing-symptoms/diet/

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Complementary treatments Here are a few tips to help you sleep better:
Some people find complementary and alternative treatments, such • Keep your bedroom dark, quiet and clutter-free.
as acupuncture and aromatherapy, useful. • Have a warm bath or shower an hour before bedtime to help ease
However, they shouldn’t replace your prescribed medicines and you stiff joints.
should always talk to your doctor before starting treatment. • Follow a routine – try to go to bed and wake up at a similar time
each day.
For more information, visit versusarthritis.org/about- • Gentle exercise can ease swollen joints and help you unwind, but
arthritis/complementary-and-alternative-treatments it’s best to avoid energetic exercise close to bedtime.
• Avoid drinking tea, coffee or alcohol for a few hours before
Sleep and fatigue bedtime.
Getting a good night’s sleep can be tough at the best of times. • Avoid eating main meals close to bedtime.
But it can be particularly hard to get enough rest when you have • Turn off your screens (e.g. phone, tablets and laptops) an hour
rheumatoid arthritis. before bed.
You might find it difficult to sleep if your joints are achy and swollen. • Don’t keep checking the time during the night.
Or you might wake up in the middle of the night with pain.
For more information on how to get a good night’s sleep,
see our Sleep booklet, or visit versusarthritis.org/about-
arthritis/managing-symptoms/sleep/

For more advice on fatigue, check out our Fatigue and

arthritis booklet or visit versusarthritis.org/about-
arthritis/managing-symptoms/managing-fatigue/

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Foot care Stop smoking
If you have rheumatoid arthritis, you’re more at risk of developing Stopping smoking can be tough. But if you have rheumatoid arthritis,
problems in your feet. But getting into a good footcare routine can it could really help your condition.
reduce this risk and allow you to spot any problems early on. Smoking can make your symptoms worse and increase your risk
Wearing good, supportive, properly fitting footwear can help improve of having a heart attack or stroke. Plus, it can also reduce the
your balance and posture. This reduces strain on your joints too. effectiveness of some drugs used to treat your condition.
It’s also worth getting your feet measured each time you shop for You’re more likely to quit with support. So, if you’re struggling, speak
new footwear. Remember that your feet change shape throughout to your doctor or rheumatology team as they’ll be able to help.
your life.
If you’re having trouble with your feet, it’s worth speaking to a
podiatrist. This is a healthcare professional who treats foot problems. For more advice, visit nhs.uk/better-health/quit-smoking
They can give you advice on footwear, show you how to treat foot
problems, and can provide special insoles called orthotics.
Living with rheumatoid arthritis
For more advice, check out our Footcare booklet or visit
versusarthritis.org/about-arthritis/managing-symptoms/ Work
footcare-and-footwear/ for more information. For footwear Having rheumatoid arthritis can make work a bit more challenging.
recommendations from people with arthritis, join our online But there are things in place to support you.
community at community.versusarthritis.org
Anyone working with a disability in the UK has a right to equal
treatment at work. The Equality Act 2010 protects you from
discrimination. This also means that your employer should work
with you to make the workplace accessible to you by making
reasonable adjustments.
Reasonable adjustments can be anything from adjusting your
working hours or providing you with special equipment that helps
you do your job.
If your employer can’t make all the adjustments you need, you may
be able to get help through Access to Work. This can cover grants
to pay for equipment or adaptations, support workers to help you,
or help to get to and from work.

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Access to Work operates in England, Scotland, Wales and Northern At times like this it’s important to let your loved ones know what
Ireland. But the application process differs from place to place. you’re going through and, if your mood doesn’t improve, talk to your
doctor. They can signpost you to useful services such as therapy, or
For more information on working with arthritis, visit they may prescribe you an antidepressant.
versusarthritis.org/about-arthritis/living-with-arthritis/ There are also plenty of small ways you can look after your mental
work wellbeing and build emotional resilience. For instance, you could:
• Practice deep breathing or mindful meditation to help reduce any
Rheumatoid arthritis is mostly commonly anxiety you may have.
• Write your thoughts down in a diary to help you make sense of
diagnosed between the ages of 40 and 60. your emotions.
But it can also affect younger people too. • Keep active – exercise can give you a boost of feel-good
hormones called endorphins.
If you’re facing different challenges at school and university, there’s
support in place to help you. • Make time for activities that you enjoy, or which help you relax.
• Connect with friends – grab a coffee with a friend, have a phone
call with a family member or join an online community.
For tips and advice, visit
versusarthritis.org/about-arthritis/young-people
If you need a bit of extra support,
Emotional wellbeing remember you’re not alone. We’re here
Living with rheumatoid arthritis can cause pain and fatigue, but it can to help you, every step of the way.
also take a toll on your mental health too.
• You might find it helpful to join a Versus Arthritis support group
Depression is a common condition among people with rheumatoid where you can connect with like-minded people and talk about
arthritis, affecting roughly one in six people. Yet it often goes what you’re going through. To see if we run a local support group
undiagnosed. in your area visit versusarthritis.org/in-your-area/
Everyone has spells where they feel a little low. But this often passes • Or you could join our Online Community where you could connect
when we have a good cry or a heart-to-heart with a friend. with real people who share the same everyday experiences as you.
On the other hand, depression is a low mood that can last a long time For more information visit community.versusarthritis.org
or keeps returning, affecting your everyday life.
You might feel sad, hopeless and lose interest in things you used to You can also call the Versus Arthritis Helpline for free on
enjoy. But, worst of all, it can make you feel isolated, like no one could 0800 5200 520, where our trained advisors can lend a listening ear.
imagine or know what you’re feeling.

30 versusarthritis.org Helpline 0800 5200 520 31

Gadgets and equipment
If you have trouble doing everyday tasks, you may find it useful to
use aids and adaptations.
Aids are items of equipment that can help you manage everyday tasks
such as bathing, dressing, and cooking. They can include shoehorns,
easy-to-use kitchen utensils, and cutlery with large handles.
Adaptations are changes made to your home to help you move
around. They can include fixed ramps and baths with built-in handles.
In England, many people with arthritis are eligible to have aids and
adaptions provided, free of charge, by their local authorities. Your
council may call this community equipment. Dealing with the weather
To see what you’re eligible for, ask your council for a free needs Some people with arthritis say that changes in the weather can make
assessment. If you live in Wales, Scotland or Northern Ireland, their symptoms worse.
contact your GP or local council for more support. If you struggle with cold weather, it might help to:
It varies a lot depending on your needs and where you live. If you’re • Take a warm bath or shower to ease soreness and stiff muscles.
already seeing a rheumatology occupational therapist, they will • Do gentle stretches.
assess your needs and may provide you with aids, where needed./
• Find ways to stay warm – wear scarves and gloves or wrap up with
blankets (if you have Raynaud’s phenomenon, you may find that
For more information, check out our Gadgets and your hands and feet are more sensitive to the cold).
equipment for your home booklet or visit versusarthritis.
org/about-arthritis/living-with-arthritis/your-home If you struggle with hot weather:
• Keep cool and stay in the shade.
You can also find gadgets that have been specially • Wear light, breathable clothing.
designed for people with arthritis at our social venture, • If you find that your feet swell up a little in hot and humid weather,
arthr.com find a sandal or breathable shoe that gives you support.
• Wear SPF sunscreen, as some rheumatoid arthritis drugs can
make your skin sensitive to sunlight.

For more tips from people with arthritis, join our online
community at community.versusarthritis.org

32 versusarthritis.org Helpline 0800 5200 520 33

Sex and relationships
If you’re feeling sore or fatigued, sex might be the last thing on your
mind. But there are things you can do to maintain intimacy and
relationships, and to have an enjoyable sex life.
• Talk openly with your partner about how you feel.
• Try to plan intimacy around times of the day when you generally
feel better. Or take painkillers about half an hour before having sex.
• Try different positions. If one position puts a strain on your joints,
try experimenting with others. You could use cushions, pillows or
furniture to support you too.
• Have a warm bath or shower beforehand to ease your joints.

For more advice, check out our Sex, relationships and

arthritis booklet or visit versusarthritis.org/about-
arthritis/living-with-arthritis/sex-relationships-and-
arthritis/ If you’re already on a pregnancy-friendly drug, you won’t have to
worry about coming off it or switching medications when you decide
to start trying for a baby.
Pregnancy, fertility and breastfeeding We know that it’s not always possible to plan ahead though. In this
It’s completely natural to be nervous about how rheumatoid arthritis case, it’s important to let your rheumatology team know as soon you
will affect pregnancy. But if your condition is under control there’s no become pregnant. They can check everything is fine and make sure
reason why you shouldn’t be able to get pregnant and have a baby. you’re on the right medication.
As with any pregnancy, planning ahead will make you feel more There’s no specific reason why having rheumatoid arthritis should affect
comfortable and in control. Remember it’s never too early to start your ability to breastfeed. Some drugs, such as methotrexate, can pass
the conversation with your doctor so that you can get on the right through the breast milk though, so just make sure you discuss which
treatment plan. drugs are best to take with your healthcare team beforehand.
Once you speak to your doctor, you may be referred to an obstetric
rheumatology clinic. This may be something your local hospital For more information on pregnancy, fertility and
offers, or you may be referred to a nearby specialist centre. breastfeeding, check out our Pregnancy and Arthritis
Booklet or visit versusarthritis.org/about-arthritis/living-
with-arthritis/pregnancy/

34 versusarthritis.org Helpline 0800 5200 520 35

Research and new developments
Our research has helped make breakthroughs and changed the lives
of many people with rheumatoid arthritis.
Our previous research has:
• led to the development of a new class of drugs, known as
biologics, which have transformed the treatment of inflammatory
arthritis and improved the lives of almost 2 million people
worldwide. At first, biologics were only used to treat severe cases
of inflammatory arthritis, but now they have been approved to
treat moderate rheumatoid arthritis, allowing thousands more
people to use these treatments.
• showed that early, intensive treatment for inflammatory arthritis,
started within 12 weeks of symptoms starting, increases the
chances of remission, as well as reducing pain and long-term
joint damage.
We’re currently funding research projects to find out what causes
rheumatoid arthritis, and to develop new and improved treatments.
For example:
• Our Centre for Genetics and Genomics Versus Arthritis is trying to
understand how genetic factors play a role in whether people are
at risk of developing inflammatory arthritis.
• Our Research into Inflammatory Arthritis Centre Versus Arthritis
(RACE) is looking at why rheumatoid arthritis starts, why it
attacks the joints, and why the inflammation carries on rather
than switching off.
• Our researchers are developing an online tool to help people with
rheumatoid arthritis stay active.
• Our researchers are investigating how changes to the bacteria
that live on the gut can lead to rheumatoid arthritis in people who
are considered at risk.

36 versusarthritis.org Helpline 0800 5200 520 37

Where can I find out more? Talk to us
If you’ve found this information useful, you might be interested in
other titles from our range. You can download all of our booklets
from our website www.versusarthritis.org or order them by
Helpline
contacting our Helpline. If you wish to order by post, please see You don’t need to face arthritis alone. Our advisors aim
our address below. to bring all of the information and advice about arthritis
into one place to provide tailored support for you.
Bulk orders
For bulk orders, please contact our warehouse, APS, directly Helpline: 0800 5200 520
to place an order:
Phone: 0800 515 209
Email: [email protected]
Email: [email protected]
Our offices
Tell us what you think We have offices in each country of the UK. Please get in touch
All of our information is created with you in mind. And we want to find out what services and support we offer in your area:
to know if we are getting it right. If you have any thoughts or
suggestions on how we could improve our information, England
we would love to hear from you. Please send your views to Tel: 0300 790 0400
[email protected] Email: [email protected]
or write to us at the following address:
Versus Arthritis, Copeman House, St Mary’s Court, Scotland
St Mary’s Gate, Chesterfield, Derbyshire S41 7TD. Tel: 0141 954 7776
Email: [email protected]
Thank you! Northern Ireland
A team of people helped us create this booklet. We would like to Tel: 028 9078 2940
thank Dr Raj Amarnani, Deborah Bond and Paul Gibson for helping Email: [email protected]
us with reviewing this booklet.
We would also like to give a special thank you to the people Wales
who shared their opinions and thoughts on the booklet. Your Tel: 0800 756 3970
contributions make sure the information we provide is relevant Email: [email protected]
and suitable for everyone.

38 versusarthritis.org Helpline 0800 5200 520 39

Rheumatoid arthritis
Rheumatoid arthritis is a condition that can cause
pain, swelling and stiffness in joints. In this booklet,
we explain what rheumatoid arthritis is, how it develops
and how it’s treated. We also give some hints and tips
on managing arthritis in your daily life.

For more information please visit

our website: versusarthritis.org
0300 790 0400
/VersusArthritis
@VersusArthritis
@VersusArthritis

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