Rheumatoid Arthritis – or RA – is an autoimmune disease affecting approximately 2-3% of the population in Australia and New Zealand. The immune system starts attacking joints, causing inflammation and joint damage. The underlying cause is not fully understood. However, a number of risk factors have been identified which can increase the chances of RA. Knowing what these risk factors are, just how much is in your control to prevent or reduce the risk of flare ups or worsening of RA?
Genetics and some environmental factors can increase your risk of RA
For RA, we know is that a combination of genetics (e.g., family history, female gender) and certain environmental , dietary and lifestyle factors can increase the risks of developing RA. These include smoking, obesity, poor oral health and low fish intake.
The facts about predicting and preventing RA
If you have a family history of RA, but currently don’t have any symptoms, you might be interested in knowing your chances of developing the condition. Unfortunately, predicting the development of RA is still in its early days. If we look at the way we approach heart disease, doctors can assess your risk by looking at things such as your blood pressure, your cholesterol level, and whether you smoke or not, among other things. By doing this, they can identify those risk factors and make recommendations to help reduce your likelihood of developing heart disease.
However, for RA, because the underlying causes are not fully understood, the ability of your doctor to accurately predict your chances of developing RA is difficult. Extensive research is currently underway to identify a reliable prediction method. Some research suggests that the appearance of specific biomarkers - a measurable molecule in the body that signals the presence of a disease – could predict the possibility of developing of RA. These include auto-antibodies to Rheumatoid Factor (RF) and particularly, antibodies to citrullinated protein antigens (ACPAs). Before you head off to the doctor and ask for a test for these biomarkers, you need to know that the technology is not quite there yet. Watch this space!
What can you really do?
There is no single fix unfortunately to prevent RA. However, one of the best things you can do to reduce your risk, is to quit smoking. It is also critical to see your doctor at the first signs of joint pain, stiffness or swelling for a proper diagnosis. RA is a chronic condition and those living with it may need ongoing treatment to help reduce the signs and symptoms and to help you keep active.
If you have RA, here are 5 things you can do to help yourself:
- Develop a good partnership with your GP and rheumatologist.
Have an open and honest conversation with your doctors about your symptoms to work out a treatment plan that works for you.
- If you smoke, seek help to quit smoking.
Smoking is not only strongly linked to the development of RA, it is also linked to more severe joint damage in people who have the condition.
- Keep active.
Research has shown that regular exercise is one of the best things you can do for arthritis. Not only is keeping mobile good for your joints, exercise boosts your general health and helps you feel better. Before you begin any new form of exercise, make sure to talk with your doctor for help. Arthritis Australia also provides some helpful tips with exercise.
- Maintain a healthy weight.
Being obese and overweight is a double whammy, putting extra stress on already strained and inflamed joints. In addition, people who are obese are more likely to report higher pain, and have higher levels of inflammatory markers in their blood. They are also less likely to achieve remission.
- Take care of your teeth!
You may be surprised to hear that poor oral health, specifically gum disease, has been linked to increased risk of RA. If you haven’t been for a dental check-up recently, make sure to book an appointment!
- 1. Australian Institute of Health and Welfare 2015. Musculoskeletal fact sheet: rheumatoid arthritis. Arthritis series no. 24. Cat. no. PHE 188. Canberra: AIHW
- 2. Ministry of Health New Zealand. New Zealand Health Survey 2016/17: Rheumatoid Arthritis. Accessed 19 Sep 2018
- 3. Deane KD, et al. Can rheumatoid arthritis be prevented? Best Practice & Research Clinical Rheumatology. 2013;27:467-485
- 4. Deane KD, et al. Preclinical rheumatoid arthritis and rheumatoid arthritis prevention. Current Rheumatology Reports 2018;20(50):1-7
- 5. de Rooy DPC, et al. Smoking as a risk factor for the radiological severity of rheumatoid arthritis: a study on six cohorts. Ann Rheum Dis 2014;73:1384–1387.
- 6. Metsios G, et al. The role of exercise in the management of rheumatoid arthritis. Expert Rev. Clin. Immunol. 2015;11(10):1121-1130
- 7. Liu Y, et al. Impact of Obesity on Remission and Disease Activity in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Arthritis Care & Research 2017;69(2):157-165