Diagnosed With Rheumatoid Arthritis? Here's What to Do Next

If you have just been diagnosed with rheumatoid arthritis (RA), it is natural to wonder what will come next in addressing this condition and what choices you can make.

RA is an autoimmune disease that occurs when the immune system malfunctions and starts to attack healthy tissues, mainly the synovium, the lining of the joints. The most common symptoms of RA are pain, stiffness, and swelling in the joints.

The smaller joints of the hands and feet are typically the most affected by RA, but RA can also affect large joints, including the knees, hips, and shoulders. Additional symptoms of RA are fatigue, low-grade fevers, and rheumatoid nodules, which are benign (noncancerous) lumps under the skin near the joints. 

This article will cover what you need to do after getting an RA diagnosis, including choosing a physician and other specialists to treat you, treatment options, and lifestyle changes. 

Doctor-Patient

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Choose Healthcare Providers You Trust 

RA affects more than 1.36 million adults in the United States, according to a 2017 Rheumatology International report. It is a progressive condition, which means it will worsen with time. An early diagnosis and appropriate treatment are necessary to prevent severe joint damage.

It is best to see a healthcare provider knowledgeable about RA even if your RA is mild. Ideally, that person should be a rheumatologist. A rheumatologist is a medical doctor who has had additional training in diagnosing and treating musculoskeletal diseases and rheumatic diseases.

What Are Rheumatic Diseases?

Rheumatic diseases are autoimmune and inflammatory diseases in which the immune system attacks the joints, muscles, bones, and organs.

If you cannot see a rheumatologist for your RA, your primary healthcare provider can manage your RA care if they are knowledgeable about the condition. If you live in a remote area or do not have access to a rheumatologist locally, consider seeing one remotely using telehealth options. 

In addition to your rheumatologist and primary care provider, you might need to include additional specialists to your care team as the need arises. Additional healthcare professionals you may need to see include pain specialists, physical therapists, occupational therapists, mental health professionals, orthopedists, surgeons, and dietitians.

Questions to Ask

As a newly diagnosed person with RA, you probably have many questions. Prepare for your first RA appointment by having a list of questions ready. Some questions you may want to pose are: 

  1. What are the benefits of starting treatment right away?
  2. What are my treatment options?
  3. What are the side effects of these treatments?
  4. How can I manage RA pain?
  5. What lifestyle changes should I try in managing symptoms?
  6. What are the long-term complications of RA?
  7. Will I need surgery eventually?
  8. What strategies can minimize RA's effects and reduce disease progression?

Discuss Treatment Options  

You and your healthcare provider will work together to develop a treatment plan that best works for your life and a strategy for reaching treatment goals. A common approach for treating RA is "treat-to-target" (T2T). T2T aims to achieve remission or low disease activity quickly and safely.

RA remission occurs when symptoms of the condition are improved or at low enough levels that they no longer affect your ability to move and function. Remission also means you are not experiencing damaging inflammation.

The T2T approach requires the rheumatologist to measure patient disease activity every one to three months until the desired goal is reached. After that, disease activity is measured every three to six months. If symptoms return, treatment is adjusted, and more frequent monitoring begins again.  

Research shows RA remission is more likely to occur when treatment begins early using disease-modifying antirheumatic drugs (DMARDs). These drugs can slow down the progression of RA and save the joints from permanent damage and disability. Common DMARDs include Trexall (methotrexate), Plaquenil (hydroxychloroquine), and Azulfidine (sulfasalazine).  

Additional medications used to treat RA include:  

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs can relieve RA pain and inflammation. Some, like Advil (ibuprofen) and Aleve (naproxen sodium), are available over the counter, without a prescription. Your healthcare provider can also prescribe a stronger NSAID if needed.
  • Corticosteroids: These medicines can reduce inflammation to improve pain and slow down joint damage. Corticosteroid medicines, like prednisone, are often prescribed when someone experiences an RA flare, a period in which symptoms are more active. A corticosteroid can improve flare symptoms quickly.
  • Biologics: Biologics are a newer class of DMARDs that target parts of the immune system responsible for promoting inflammation. They are considered aggressive treatments and are most effective when combined with a conventional DMARD like methotrexate. Examples of biologics used to treat RA are Orencia (abatacept), Humira (adalimumab), Actemra (tocilizumab), Enbrel (etanercept), and Rituxan (rituximab). 
  • Janus kinase (JAK) inhibitors: JAK inhibitors are the newest treatments for RA. They prevent inflammation by blocking the response or activity of certain enzymes. Currently, there are three JAK inhibitors available for treating RA—Olumiant (baricitinib), Xeljanz (tofacitinib), and Rinvoq (upadacitinib).

Your RA treatment plan may include physical therapy or occupational therapy, or both. Physical and occupational therapists can help you learn to exercise in a way that keeps joints flexible. They might also suggest ways to protect your joints as you do daily tasks or with assistive devices.  

If you experience joint damage, your healthcare provider might suggest surgery to repair the damage and restore joint function. Surgery can also reduce pain.

Make Healthy Lifestyle Changes  

You will want to make healthy lifestyle choices to manage RA. These measures can help relieve pain and other symptoms, along with your RA medicines.  

Eat a Healthy Diet 

While there have been plenty of studies about RA and diet, there is no substantial evidence that a special diet might help. Even so, it is still wise to eat a healthy and balanced diet that helps fight inflammation.

Add fatty fish like salmon, tuna, and sardines loaded with omega-3 fatty acids to curb inflammation. Eat various colorful vegetables and fruits to get the many benefits of antioxidants, including fighting off damage from free radical molecules. And whole grains like brown rice and oatmeal bring down C-reactive protein responsible for inflammation.

Keep Moving  

Gentle exercise can help to strengthen the muscles around the joints and reduce fatigue. Healthcare providers recommend range-of-motion exercises to improve joint and muscle flexibility.

Strength training can also help build muscle and tendon strength for further joint support. Rheumatologists also recommend endurance exercises, including walking and swimming.  

Don't Smoke  

Smoking when you have RA increases your risk for a more severe disease course, while quitting might improve symptoms. According to a 2015 study, smoking is a significant independent risk for radiologic progression (advancement of damage seen on X-ray) in the earliest stages of RA. Your primary care provider can offer you information, tools, and support to help you quit.  

Limit Alcohol Intake

Some RA medications can increase the risk for liver damage, especially in people who consume alcohol regularly. Talk to your healthcare provider about whether it is safe for you to drink alcohol with your RA medications and how much and how often you can consume alcoholic beverages.

Manage Stress  

It is essential to find ways to cope with RA pain by reducing the amount of stress you experience. Try simple deep breathing techniques or yoga to help control pain and when feeling overwhelmed.  

A Healthy Lifestyle With RA

Living a healthy life is an integral part of managing RA. The daily lifestyle strategies you implement help you maintain your physical and mental health, prevent disease complications, and protect and strengthen your joints.

People who live with long-term conditions like RA benefit when they prioritize a healthy lifestyle. They can live longer, have a better quality of life, remain independent, and continue to be active even years and decades later after their diagnoses.

Get Support  

Depression and anxiety are two of the most common mental health conditions affecting people with RA, according to a 2020 report. Depression is 2 times more likely to affect someone with RA than someone without the condition.

Researchers believe chronic inflammation might be to blame, along with ineffective coping. Depression, ineffective coping, and ongoing inflammation can worsen RA's long-term outcomes.  

People with RA need to care for their mental health the same way they do their physical health. Seeking treatment for depression and anxiety might help you manage RA more effectively. If you are concerned about your mental health, talk to your primary care provider or rheumatologist about treatments or resources to help you better cope.

Often, loved ones might worry about you but are uncomfortable asking what you need help with or what you might be experiencing. Try to keep family and friends aware of how you are feeling or how RA might be affecting you. They can't help you if they don't know what you need.

You can also benefit from connecting with others living with RA who better understand your struggles and can share experiences and advice about living with RA. You might be able to find a local RA support group within your community, or you might consider seeking online support.  

Summary  

Rheumatoid arthritis is an autoimmune disease in which the immune system malfunctions and attacks the lining of the joints. Getting a new diagnosis of RA can seem scary and overwhelming, but there is plenty you can do to learn about RA, including how to manage it and ways to improve your quality of life.

That will involve some work on your part, including finding the right healthcare provider, investigating your treatment options, implementing lifestyle changes, and seeking out support.  

A Word From Verywell

Rheumatoid arthritis is a lifelong condition without a cure. However, the outlook for RA continues to improve as researchers look for new and better ways to manage and treat the condition. While there is no cure for RA, available treatments can relieve symptoms and prevent disease progression, and it is possible to experience remission.

So, it is OK to be optimistic about the future. The outlook for RA can be good and staying positive and on top of your treatment plan can help you manage your disease successfully.

Frequently Asked Questions

  • What are the early symptoms of rheumatoid arthritis?

    The earliest symptoms of RA usually affect the hands, wrists, and feet. Joint pain can affect the fingers and wrists early on, and you might experience joint stiffness, especially in the morning and after long periods of inactivity. Fatigue and low-grade fever are also common in early RA.

  • How does rheumatoid arthritis affect life expectancy?

    Rheumatoid arthritis is not a fatal condition, but it can affect a person's life expectancy if they experience severe disease complications, including heart disease and severe infections. Fortunately, newer and more aggressive treatments have reduced the potential for disease complications, and people with RA are living longer, healthier lives.

  • Is rheumatoid arthritis curable?

    There is no cure for rheumatoid arthritis, but early treatment with DMARDs can effectively reduce inflammation and even push the condition into remission. DMARDs aren't your only options. There is a variety of medicines to treat RA that might force the disease into remission.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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