A DIAGNOSIS of rheumatoid arthritis can be a very emotional time, with possible feelings of fear, anxiety, low mood and isolation. For those affected or awaiting a potential diagnosis, the message is clear; you are not alone, help is always available.

Indeed in the last 30 years the diagnosis and treatment of rheumatoid arthritis, often abbreviated to RA, has gone from simple painkillers with multiple side effects to some of the most sophisticated drugs available in medicine today.

Rheumatoid arthritis is an autoimmune condition. This means the body attacks its own tissues mistakenly, in this case the lining of the joints, also known as the synovium.

One of the first symptoms is joint pain. Often the small joints of the hands and feet are affected, but any joint can be involved.

Joint stiffness first thing in the morning or after rest, which takes 30 minutes or more to go is typical. You may suffer with fatigue to a level much greater than normal tiredness.

Rheumatoid arthritis is a systemic condition so in addition to the joints it can also affect your eyes, heart and lungs.

RA affects one per cent of the UK population. It is two to three times more common in women. Symptoms first start roughly between the ages of 40-60.

A type of RA affects children, typically commencing during the teenage years.

Both genetic and environmental factors play a role in the development of RA.

It can arise after a particularly stressful life event, be that physical or psychological, and smoking increases the risk of rheumatoid arthritis.

If you have any symptoms that sound like those of rheumatoid arthritis, please seek medical advice as soon as possible, ideally within three months of them first starting.

In addition to examining you, your doctor may order blood tests to look for raised markers of inflammation in the blood stream.

Rheumatoid factor is another blood test but it may be negative in those with the disease, yet positive in those with no symptoms.

A newer blood test called anti-CCP is more sensitive. X-rays and MRI scans are used to assess the level of damage to your joints.

The treatment of rheumatoid arthritis is now under the care of specialist teams which includes doctors specialising in rheumatology, dedicated nurses, physiotherapists and clinical psychologists.

Medication starts with painkillers including paracetamol, Nonsteroidal Anti-inflammatory Drugs (NSAIDs) and morphine based products. Steroids, either given orally or injected, are used to control “flares” of the disease.

Disease modifying anti-rheumatic drugs, (DMARDs), are the mainstay of trying to reduce long term joint damage, and work by dampening down the immune system.

The most commonly used is methotrexate. Newer agents known as Biologics work in a similar manner.

The latest and most exciting developments in the treatment of rheumatoid arthritis are Janus Kinase Inhibitors, or JAK inhibitors, which in a recent large study produced sustained remission in some patients, which is almost equivalent to a cure.