It is one of the most common cause for joint pains. It affects commonly middle aged females though any age and sex is not an exception. The hallmark of this disease is symmetrical involvement of multiple joints. Importantly small joints of hands and feet like those of fingers, toes, wrists are involved initially followed by involvement of large joints like elbows, shoulders, knees and ankles. Most of the patients experience prolonged early morning stiffness which gradually improves as the activity sets in. Apart from joint pains these patients can also have skin rash, nodules, tingling/ numbness of fingers/toes, dry mouth, dry eyes, and skin ulcers. When not diagnosed early rheumatoid potentially affects every organ of the body like brain, lungs, heart, liver, kidney when it is called as extra articular involvement and is life threatening. There are plenty of tools available to diagnose rheumatoid arthritis like ESR, CRP, rheumatoid factor, anti ccp along with modern methods like ultrasound, MRI.

Early diagnosis is critical to prevent disabling deformities and irreversible damage. Prompt initiation of treatment takes the advantage of preventing major organ damage apart from joint protection. Many potent modalities are available for treatment. They include anti-inflammatory drugs like NSAIDS, disease modifying anti rheumatic drugs, low dose steroids.

Recently available drugs like biologics are used in patients who cannot tolerate or who have contraindications to use baseline drugs or for patients with severe complicated disease. These drugs help in reducing suffering, prevent deformities, improve well being and life span of individual.

Due to great deal of fear regarding the side affect profile of allopathic drugs, many patients settle on alternative treatment modalities. There are no drugs in the universe which are free of adverse effects; Treatment is balanced according to risk benefit ratio. All these drugs should be taken under supervision of rheumatologist and many of them do better without major adverse effects of drugs.