Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune condition where the immune system mistakenly attacks the lining of the joints.

What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a chronic autoimmune condition where the immune system mistakenly attacks the lining of the joints. This abnormal immune response leads to ongoing inflammation, which damages cartilage, bone, and surrounding soft tissues over time. Unlike wear-and-tear conditions such as osteoarthritis, RA can affect multiple joints simultaneously and often develop symmetrically, for example, both wrists or both knees at the same time.

If left untreated untreated, rheumatoid arthritis can cause progressive joint deformity, chronic pain, and disability. Because it is systemic, RA may also affect other organs such as the eyes, lungs, and heart.

rheumatoid arthritis treatment in Singapore.
Rheumatoid arthritis is an autoimmune condition that causes joint pain, swelling, and long-term damage if it is left untreated.

How does Rheumatoid Arthritis impact quality of life?

The effects of RA extend beyond joint discomfort. Persistent pain, swelling, and stiffness can make everyday activities such as dressing, cooking, or climbing stairs increasingly difficult. Many patients experience morning stiffness that lasts for an hour or more, disrupting routines and reducing productivity.

Over time, uncontrolled RA can lead to permanent joint damage, visible deformities, and functional loss. Fatigue is another common symptom, often compounded by sleep disturbance from night-time pain. These challenges can affect not only physical health but also mental well-being and social participation, highlighting the importance of early diagnosis and tailored care.

What causes Rheumatoid Arthritis?

The exact cause of RA is not fully understood. But it is believed to result from a combination of genetic, hormonal, and environmental triggers that activate an abnormal immune response. Instead of protecting the body, the immune system targets the synovium, which is the joint lining, leading to inflammation and joint damage.

Some of the factors that may contribute to the development of the condition include:

  • Genetic predisposition certain genes increase susceptibility to autoimmune reactions.
  • Immune dysregulation overactive immune cells release chemicals that attack joint tissues, driving inflammation and progressive damage.
  • Hormonal influences RA is more common in women, suggesting a role for hormonal changes.
  • Environmental factors smoking, chronic stress, or infections may trigger disease onset in genetically predisposed individuals.
rheumatoid arthritis causes.
Rheumatoid arthritis develops when the immune system mistakenly attacks joint tissues.

Where can Rheumatoid Arthritis develop?

RA most commonly affects the small joints of the hands, wrists, and feet. But as the disease progresses, it can involve larger joints and even areas beyond the musculoskeletal system.

  • Hands and wrists one of the earliest and most typical sites, leading to stiffness, swelling, and reduced grip strength.
  • Shoulders and elbows these larger joints may become painful and limit arm movement, particularly in long-standing RA.
  • Hips though less common in the early stages, hip involvement may occur later and cause difficulty with walking and balance.
  • Feet and ankles pain and inflammation can make walking or standing difficult, often affecting both sides equally.
  • Knees swelling and stiffness in the knees may interfere with climbing stairs, bending, or sitting for long periods.
  • Jaw (temporomandibular joint) some patients develop pain and stiffness in the jaw, making chewing uncomfortable.

What are the symptoms of Rheumatoid Arthritis?

RA symptoms usually develop gradually and can flare up or settle down unpredictably. Some of the common signs include:

  • Joint pain and swelling most noticeable in smaller joints such as fingers, wrists, and ankles.
  • Morning stiffness Stiffness lasting more than an hour, often easing with movement.
  • Warmth and redness inflamed joints may feel hot or tender to the touch.
  • Symmetrical joint involvement both sides of the body are typically affected, such as both knees or both hands.
  • Fatigue a persistent feeling of tiredness, often out of proportion to activity level.
  • Systemic symptoms some people may experience weight loss, low-grade fever, or general malaise.

Who is at risk of developing Rheumatoid Arthritis?

While RA can affect anyone, certain factors increase the risk:

  • Age while RA can occur at any age, it is most commonly diagnosed between 30 and 60 years old. This is thought to be the period when the immune system is more likely to misfire, leading to autoimmune activity that damages the joints.
  • Gender women are 2 to 3 times more likely to develop RA than men. Hormonal influences, particularly oestrogen and other reproductive hormones, are believed to affect immune system function and increase susceptibility.
  • Family history genetics play a role in RA. Having a parent or sibling with the disease suggests you may carry certain genes, such as HLA-DR4, that predispose the immune system to attack the body’s tissues.
  • Hormonal changes shifts in hormone levels, such as during pregnancy, postpartum, or menopause, can influence immune activity. These changes may either trigger the onset of RA or affect the severity of existing diseases.
  • Obesity excess body weight promotes chronic, low-grade inflammation throughout the body. This not only increases the likelihood of developing RA but also worsens symptoms and reduces the effectiveness of certain treatments.
  • Smoking tobacco use is one of the strongest modifiable risk factors. Smoking triggers inflammation, alters immune system regulation, and increases the production of antibodies linked to more severe and aggressive forms of RA.
rheumatoid arthritis risk factors.
Women and individuals with a family history are at higher risk of developing rheumatoid arthritis.

How is Rheumatoid Arthritis diagnosed?

Diagnosing RA involves more than identifying joint pain. Our doctor will take a detailed history of your symptoms, examine the affected joints, and may order blood tests or imaging to confirm the diagnosis and rule out other conditions.

The process often involves:

  • Physical examination during the consultation, your doctor will assess joints for swelling, tenderness, warmth, and range of movement. They may also check whether symptoms affect both sides of the body, which is a hallmark of RA.
  • Blood tests laboratory tests are often essential for diagnosis. These may include rheumatoid factors (RF), anti-CCP antibodies, and markers of inflammation such as ESR and CRP. These results help support the diagnosis and guide treatment.
  • Ultrasound ultrasound scans can detect early joint inflammation and synovial thickening that may not be visible on X-rays. They also help assess disease activity and monitor response to treatment.
  • Magnetic resonance imaging (MRI) MRI provides a detailed view of joints and surrounding tissues, identifying early erosions or subtle inflammation that cannot be seen on X-rays.
  • X-ray imaging X-rays are often used to monitor disease progression rather than for initial diagnosis. They can show joint space narrowing, bone erosion, or deformities in more advanced RA.

How is Rheumatoid Arthritis treated in Singapore?

While RA cannot be cured, effective treatments are available to control inflammation, prevent joint damage, and improve quality of life. Our doctor will usually begin with medical therapies and lifestyle strategies, then consider advanced interventions if symptoms persist.

Medications

  • Disease-modifying antirheumatic drugs (DMARDs) Methotrexate and similar agents slow disease progression and protect joints.
  • Biologic therapies targeted treatments that block specific immune pathways for patients with moderate to severe RA.
  • NSAIDs and corticosteroids reduce pain and inflammation, often used during flare-ups.

Minimally invasive procedures

  • Steroid injections delivered directly into affected joints to reduce inflammation and pain.
  • Synovial fluid aspiration removing excess joint fluid can relieve discomfort and swelling.

Physical and rehabilitative therapies

  • Physiotherapy improves joint flexibility, strength, and mobility.
  • Occupational therapy – Teaches joint-protecting techniques and adaptive strategies for daily tasks.
  • Assistive devices splints or braces support joint alignment and reduce strain.

Lifestyle modifications

  • Regular low-impact exercise swimming, cycling, or yoga helps maintain mobility.
  • Healthy diet anti-inflammatory diets rich in omega-3 and antioxidants may reduce flare-ups.
  • Weight management reducing excess body weight lessens pressure on joints.
  • Smoking cessation essential to slow disease progression and improve treatment response.
ALT-text: rheumatoid arthritis diagnosis and care.
Early treatment can help prevent long-term joint damage and disability in rheumatoid arthritis.

Summary

RA is more than just joint pain. It is a chronic autoimmune disease that can affect overall health, mobility, and quality of life. With early diagnosis and personalised treatment, many patients achieve good symptom control, reduced flare-ups, and preserved joint function.

At Apicare Pain Clinic, we provide comprehensive care using evidence-based, minimally invasive treatments tailored to your needs. Book a consultation for a detailed diagnosis and personalised treatment plan. 

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