Rheumatoid arthritis 

Rheumatoid arthritis (RA) is a very different condition to OA. The body’s immune system accidentally attacks the lining of some of the joints, making them stiff and painful. The most commonly affected joints are those in the hands, feet and wrists. The disease is usually episodic, with sufferers experiencing periods when their symptoms flare up in between longer stretches of time when everything seems normal. The cause is unknown, but there is a higher risk in people with a family history of the condition, as well as among smokers and women.

Early diagnosis and treatment is vital in RA because if it is left unchecked, it can cause damage to joints, cartilage and bones. An important part of management is the use of disease-modifying anti-rheumatic drugs (DMARDS), which ease symptoms and slow the progression of the condition. Medicines commonly used include methotrexate, leflunomide, hydroxychloroquine and sulfasalazine. If these are not effective, a biological treatment such as etanercept or infliximab may be used (see Biosimilars on the menu for moderate rheumatoid arthritis), and a few people require a newer type of medicine called a JAK inhibitor, such as tofacitinib. Painkillers may also be used, as well as supportive treatments such as physiotherapy. Occasionally, surgery is required.