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1. Why is rheumatoid arthritis (RA) sometimes called an autoimmune disease?

   Autoimmune diseases are characterized by an immune system attack on healthy tissues. In RA, white blood cells travel to the synovium (the membranes that surround joints) and cause inflammation, or synovitis. The ensuing warmth, redness, swelling and pain are typical symptoms of rheumatoid arthritis, which usually affects the wrists, fingers, knees, feet, and ankles.

2. What causes rheumatoid arthritis?

   A combination of factors—genetic, environmental and hormonal—probably play a role in the onset of the disease. Those with a genetic susceptibility may develop RA when it is triggered by an environmental agent, perhaps a virus or bacterium, although no pathogenic agent has yet been identified. Hormones also appear to have a role.

3. Is RA preventable?

   No one has found a course of action that can prevent RA.

4. What can be done to reduce the pain or slow the disease?

   The symptoms of RA are highly treatable in most cases, and new research shows that the long-term outcome can be affected by how quickly the disease is diagnosed and treatment initiated. Consulting with your health care professional, you will find that there is a wide range of options—medical, surgical and lifestyle—available for modifying the disease and treating pain, swelling and other symptoms.

5. How can I find out if I have RA?

   The symptoms you describe to a health care professional are the foundation of an RA diagnosis. The most common symptoms are tender, warm, swollen joints; symmetrical pattern of pain; joint inflammation; fatigue; occasional fever; a general sense of malaise; pain and stiffness lasting for more than 30 minutes in the morning or after a long rest; and rheumatoid nodules (bumps under the skin). Because many of these symptoms are also indicative of other diseases (for example, lupus), your health care professional may recommend lab tests for those diseases or for confirmation of an RA diagnosis, as well as x-rays to detect any joint damage. A full medical history and physical exam are also part of a typical diagnostic workup for RA.

6. Is it safe to exercise if I have RA?

   Yes, although you should consult with a health care professional before beginning any new exercise regimen. Moist heat applied before an exercise session and a cold pack applied afterward can help alleviate pain. Exercising in a pool is also a good option for preventing joint stress during a workout.

7. Can diet make a difference in preventing or managing RA?

   There is no scientific evidence that any specific food or nutrient helps or harms most people with rheumatoid arthritis. However, an overall nutritious diet with enough—but not an excess of—calories, protein and calcium is important. Some studies have shown that the omega-3 fatty acids in certain fish or plant seed oils also may reduce rheumatoid arthritis inflammation. However, many people are not able to tolerate the large amounts of oil necessary for any benefit. Some people may need to be careful about drinking alcoholic beverages because of the medications they take for rheumatoid arthritis. Those taking methotrexate may need to avoid alcohol altogether. Patients should ask their health care professionals or a registered dietitian for guidance on the issue of diet.

8. If I have the "RA gene," does that mean I will develop the disease?

   There is no single RA gene. HLA-DR4 is a genetic marker that turns up frequently in people with RA, but other genes also play a role in the onset of disease. Having any of these genes is no guarantee that you'll develop RA, and their absence doesn't rule out the possibility of developing the disease. It appears that a person's genetic makeup is an important part of the story, but not the whole answer.