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Rheumatoid arthritis

Arthritis rheumatoides · Revmatoidní artritida

What it is

The immune system attacks the joint lining symmetrically and erodes bone.

Symptoms & signs

  • Symmetrical small-joint pain
  • morning stiffness over an hour
  • swelling
  • fatigue
  • nodules
  • joint deformity if untreated

🚩 Get help if…

  • call 112 / 911 now Neck pain with tingling, weakness or clumsiness in arms or legs
  • call 112 / 911 now Chest pain or sudden shortness of breath
  • see a doctor soon Fever, cough or sore throat on methotrexate or biologics
  • see a doctor soon One joint far hotter and more swollen than the rest

Where it strikes

Medical treatment

  • Methotrexate early
  • biologics (adalimumab, etanercept, tocilizumab, rituximab)
  • JAK inhibitors
  • steroid bridging
  • treat-to-target reviews

Natural & lifestyle

  • Stop smoking (drives the disease)
  • Mediterranean diet
  • omega-3 2–3 g
  • exercise and hydrotherapy
  • hand therapy
  • dental care

Emerging & experimental

  • Vagus nerve stimulation implants
  • CAR-T against autoreactive B cells
  • tolerogenic vaccines
  • difficult-to-treat RA algorithms

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Gamma-linolenic acid (evening primrose, borage oil) — trials show modest benefit mixed evidence
  • A fast followed by a vegetarian diet — a 1991 trial showed lasting improvement early / small studies
  • Turmeric — small trials early / small studies
  • Bee-venom therapy — traditional; allergic reactions anecdotal / traditional
  • Copper bracelets — a controlled trial found no effect not confirmed in trials

ICD codes