What is Rheumatoid Arthritis
Rheumatoid arthritis (RA) is an autoimmune condition that causes joint pain and swelling. It develops when the immune system attacks tissues lining the joints. It usually starts in smaller joints like fingers and wrists, but the damage can affect other parts of the body too, like the heart and lungs.
In line with other autoimmune conditions, RA affects more women than men. It can develop at any age, but most often starts between the ages of 30 and 50 (American College of Rheumatology, 2025).
What Causes Rheumatoid Arthritis
It’s not known exactly why the immune system attacks healthy cells, but there are links with genes, hormones, and lifestyle factors:
Genes: Certain genes can increase the risk of developing RA, and the condition often runs in families.
Gut health: Your gut holds a large part of your immune system, which means digestive health has an impact on immune activity. This includes the billions of bacteria and other microbes that make up your gut microbiome. Research shows there are certain types of bacteria that may trigger the autoimmune response that causes RA (Chriswell et al, 2022).
Nutrition: An anti-inflammatory diet is a key part of managing RA. Identifying food sensitivities can help, too. Diets high in ultra-processed foods link to a greater risk of developing the condition (Zhao et al, 2024).
Stress: Some people develop RA after a stressful event like an injury, illness, or work stress.
There isn’t one clear trigger for RA, but rather a combination of factors that activate the immune response. Understanding these triggers can help you choose therapies that provide a whole-body approach to managing your symptoms.
Who is at Risk
RA affects many more women than men. It can develop at any age but is most common between ages 30 and 50. You may be more at risk of RA if you have another autoimmune condition and/or a close family member with RA.
What Are the Symptoms
Early signs of RA include:
Joint pain, redness, swelling, and tenderness that lasts for more than six weeks.
Joints that feel stiff for more than 30 minutes first thing in the morning.
P ain and swelling typically affecting smaller joints in the wrists, hands, and feet.
Joint symptoms that affect both sides of the body in a symmetrical way.
Body-wide symptoms of fatigue, loss of appetite, low-grade fever, and unexplained weight loss.
The symptoms of RA can move through four stages, although not everyone will progress in the same way. How the disease develops depends on many things, including how old you were when it began, how active the condition is, and how your symptoms are being managed.
Stage 1
Your joints feel stiff and painful, and there may be some swelling in the tissues around your joints. If you have X-rays at this stage, there won’t be any visible bone damage.
Stage 2
The inflammation begins to damage your cartilage. This is the spongy material that acts like a shock absorber in your joints. There may be some bone damage, and you might develop small lumps under the skin called rheumatoid nodules. It can feel harder to move the affected joints.
Stage 3
The affected joints might start to look deformed. You will be able to see the damaged cartilage and bone on an X-ray.
Stage 4
This is the most severe stage of the condition. There is significant pain, swelling, and inflammation. You may need joint replacement surgery to restore movement to the damaged joints.
How is Rheumatoid Arthritis Diagnosed
It can be hard to diagnose RA when it’s in the very early stages. If you think you may have RA, see a rheumatologist for a physical examination. They will be able to assess the swelling, redness, inflammation, and how well your joints can move.
Blood tests can help with a diagnosis. A rheumatologist will check for an elevated erythrocyte sedimentation rate (ESR) and elevated C-reactive protein (CRP) level. They may also look for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies.
Your specialist may also recommend x-rays, an ultrasound, or an MRI (magnetic resonance imaging) scan to aid with the diagnosis. These tests can help detect early changes in joint tissues and monitor the progression of RA.
How is Rheumatoid Arthritis Treated with Regenerative Therapies
Conventional care for RA follows a plan of:
NSAIDs: Non-steroidal anti-inflammatory drugs.
Glucocorticoids: steroid drugs.
Disease-modifying anti-rheumatic drugs like methotrexate and hydroxychloroquine.
Biologic response modifiers like etanercept and infliximab.
These medications are designed to dampen the immune response and relieve pain and inflammation. They are especially helpful when symptoms flare up.
While these drugs can help manage the pain and inflammation, they don’t act on the drivers behind the autoimmune response. Regenerative therapies offer a more foundational approach to RA. They can be safely used alongside conventional treatments for whole-body support.
Nutritional Therapy
Nutrition plays a key role in managing RA, but it’s often overlooked. A 2023 review by Dinas et al looked at how diet affects RA pain. It found that vegetarian, vegan, and Mediterranean diets led to significant improvements in pain compared to standard diets. However, only a small number of studies were included, and the authors noted some limitations. Nutrition studies are hard to run in a truly unbiased way because you can't hide what someone is eating.
This doesn't mean nutrition isn't effective. It just doesn't fit neatly into the standard model used to test medicines. Working with a nutritionist can help you find your personal food triggers and build an anti-inflammatory eating plan that supports gut and immune health.
As a nutritionist myself, I’ve seen how much a personalized approach to eating can help people with RA. Research supports this view. A 2024 review by Sharma et al explored the links between food, gut bacteria, and the immune system, and how they connect to inflammation in RA.
Everyone has a unique mix of bacteria in their gut. This affects how they respond to different foods and how their immune system works. Knowing your own triggers and food sensitivities is an important part of managing RA holistically.
Some people with RA react to gluten or other foods, which can make their symptoms worse. A small study by Barnard et al (2022) followed 44 adults for 16 weeks while they followed a vegan diet for 4 weeks (no meat, fish, dairy, or eggs), then an elimination diet for 3 weeks, and a gradual reintroduction of foods over 9 weeks. The elimination diet cut out gluten-containing grains (wheat, barley, and rye), soy, white potatoes, sweet potatoes, chocolate, citrus fruits, nuts, peanuts, onions, corn, tomatoes, apples, bananas, celery, peppers, coffee, alcohol, and sugar.
All the excluded foods were slowly reintroduced, one at a time. If the participant noticed any pain or worsening of their symptoms, the food was removed for the rest of the diet phase.
After the diet phase, the group followed an unrestricted diet while taking a placebo supplement for a further 16 weeks. The diet plans led to significant reductions in disease activity and the number of swollen joints, compared to the placebo supplement.
Platelet-rich Plasma
Platelet-rich plasma therapy uses platelets from your own blood to ease joint pain and inflammation. The platelets are mechanically separated from blood and injected back into joint tissues. Because it uses your own blood, there’s no risk of an allergic reaction.
Research into platelet-rich plasma for RA is promising but limited, with very little human data. A systematic review of 8 studies (preclinical, animal, and one human study) shows that it has a good safety profile and can reduce disease activity (Chellamuthu et al, 2021). The authors note that larger trials are needed to better understand how platelet therapy can help treat RA.
Traditional Chinese Medicine Acupuncture
Acupuncture may help RA by reducing inflammation and helping to regulate immune function. A review of 43 studies by Chou & Chu (2018) found that acupuncture on its own or in combination with other treatments can improve joint function and quality of life for people with RA. No adverse effects were reported.
Photobiomodulation
Photobiomodulation (PBM) uses low-intensity lasers to relieve pain and inflammation and stimulate tissue repair. A systematic review (Lanza et al, 2025) found that PBM shows potential in controlling inflammation and pain in RA. However, larger and longer-term studies are needed to strengthen the evidence base.
What Are Possible Complications
Rheumatoid arthritis affects joint tissues, but the inflammation and damage can affect other parts of the body, too. Around 40% of people with RA experience other complications (Wu et al, 2022), including:
Cardiovascular disease.
Lung disease.
Osteoporosis.
Sleep problems.
Metabolic syndrome.
Dry eyes.
Gum inflammation and dry mouth.
Early diagnosis and effective management of the disease can help reduce the risk of complications.
Can Rheumatoid Arthritis Be Prevented
It’s not possible to prevent RA. It’s thought to be triggered by a combination of factors, including genes, nutrition, gut health, and lifestyle, that are unique to each person.
RA is a lifelong condition that is always there. Symptoms can flare up or settle down of their own accord. This can be hard to manage and can interfere with work, socializing, and daily life.
During a flare, it can help to:
Rest as much as possible.
Take painkillers immediately, don’t wait until the pain is severe.
Use cool packs or heat packs to relieve joint pain and stiffness.
If possible, do gentle exercises to support joint movement and relieve stiffness.
Wear comfortable clothing and supportive shoes.
If flare-ups are becoming more frequent, speak to your healthcare provider about a medication review.
Takeaway
RA is a life-long autoimmune condition that affects the joints. It causes pain, inflammation, swelling, and stiffness. The inflammation and damage can affect other parts of the body too, such as the heart and circulatory system.
The cause of RA isn’t known but there are links to genes, lifestyle factors, and gut health. Conventional treatments include painkillers and drugs to dampen the immune response. Regenerative therapies like nutritional therapy, acupuncture, and platelet rich plasma therapy help to address the deeper root causes of the condition. You can use them alongside conventional treatments for a whole-body approach to care.
