What you can do

• Rheumatoid arthritis can lead to deformity and destruction of joints, as well as such complications as heart, eye and lung problems, so it's crucial to notice early warning signs and seek treatment to help prevent the disease from progressing.
• The right medications, if prescribed early enough, can not only help with symptoms, should they develop, but also slow or stop disease progression. That means that joint destruction is not inevitable.

• Achiness or stiffness in your muscles and joints for more than 30 minutes after you wake up in the morning or have been resting
• Relief from the ache and stiffness with activity or a hot shower
• Swelling and pain in your joints, often in the wrist and finger joints
• Tenderness, redness and heat in your joints
• Skin nodules near the affected joints
• Symmetric symptoms, meaning the same joint on each side of your body is affected at the same time
• Low-grade fever
• Fatigue, weight loss or generally not feeling well
• Decreased motion in affected joints
• Weakness in the muscles attached to affected joints
• Deformities in fingers (later-stage symptom)

• X-rays of joints. With time the bone becomes whittled away as inflamed joint tissues secrete chemicals that eat away bone.
• Blood tests for Rheumatoid Factor, an antibody produced by the body's immune system. Autoantibodies usually attack the patient's own tissues, mistakenly identifying them as "foreign." RF is thought to promote the body's inflammation reaction, which in turn contributes to autoimmune tissue destruction.
• A new, more specific test that looks for antibodies to cyclic citrullinated peptides (CCPs).
• Other possibly useful lab tests include the erythrocyte sedimentation rate and C-reactive protein, which detects inflammation.

Don't smoke. To date, the only proven preventive strategy against RA is to stop smoking — or never start. Smoking not only increases the risk of developing RA, it may make the disease more severe. The effect of smoking varies depending on the genes you inherit. Scientists are still trying to understand the precise mechanisms behind cause and effect.

Eat your omega-3's. Consider incorporating omega-3 fatty acids into your diet. Two servings a week of fatty fish, such as salmon, trout, herring, sardines, tuna and mackerel, are a good source of these fats, which can help reduce inflammation. (You will need to be aware of the mercury content of some of these fish, especially if you are pregnant or might get pregnant. Check our chart for help selecting fish high in omega-3s but low in mercury.) If you don't eat much fish, ask your doctor whether you should take a dietary fish oil supplement of about 1,000 or 1,200 mg daily. The supplements may cause stomach upset and excessive bleeding in some people.

Get plenty of fruits and vegetables. Antioxidants are believed to protect tissue from damage by free radicals, and evidence of free-radical activity has been found in the joint fluid of people with RA. This and other factors have led researchers to look at the effects of antioxidants on the development and severity of RA. Although inconclusive, some research suggests that beta-cryptoxanthin, a compound that our bodies use to make vitamin A, may reduce risk. Beta-cryptoxanthin is present in high amounts in pumpkin, red peppers, and citrus fruits. (Check this list for other foods containing this nutrient.) A diet high in cruciferous vegetables, such as broccoli, cauliflower and cabbage, may help as well.

Try green tea. Watch for further news about possible protective effects of green tea and preventing RA. Laboratory studies in animals indicate that EGCG, a substance found in this type of tea, may lessen or even prevent the inflammatory response that characterizes RA.

If you drink moderately, no need to stop. (Though we don’t recommend starting if you are not a drinker.) Research in both animals and people suggests that alcohol may protect against the development of RA. Remember that moderate consumption is usually defined as no more than one drink a day for women and no more than two per day for men.

If you're taking statins, your joints may benefit. One recent study found that these drugs, typically prescribed to bring down high cholesterol, may protect against the development of RA. It's not likely that your doctor would prescribe a statin for RA alone, but if you are at risk for  RA and need to get your cholesterol numbers in order, it's worth discussing statins with your doctor.

Consider a Chinese herb. A small study done in mice found that a compound from the Chinese herb Tylophora atrofolliculata delayed the onset of RA and lessened its severity. Keep an eye out for further studies. Note that herbal supplements should be treated as medications and taken under supervision. Like medications, they have side effects as well as potential benefits.

• Are your joints swollen, warm or tender? Are you stiff in the mornings? What makes the pain and stiffness go away? Activity? A hot shower?
• Is your range of motion more limited than it used to be?
• Are you tired? Have you lost weight? Do your muscles ache?
• Does anybody in your family have rheumatoid arthritis or another autoimmune disease, such as multiple sclerosis, Crohn's disease or type 1 diabetes?
• Have you had any recent infections or viruses that could create similar symptoms?
• What medicines, over-the-counter drugs or herbs have you taken recently? Some may cause side effects that could mimic RA symptoms.

• Take a detailed health history.
• Do a physical exam that will include testing your range of motion and grip strength.
• Order X-rays and blood tests.
• Depending on your history, physical exam, and symptoms, your physician may suggest you see a rheumatologist, a specialist in inflammatory diseases; a lung specialist, as this disease can affect lung function; or an ophthalmologist if you have eye symptoms.
• Prescribe drugs to reduce pain and inflammation, if these symptoms develop. These drugs are not cures — they simply damp down the inflammatory process to slow ongoing damage to your body.
• If you do develop RA, possibly prescribe disease-modifying drugs that can significantly affect the progression of the disease.
• Help you take preventive steps, such as quitting smoking and incorporating more antioxidants into your diet.
• If you develop the disease, advise you about self-care strategies. These include exercising, managing your weight, eating a healthy diet, learning pain management techniques such as meditation or guided imagery, applying hot and cold compresses, and using assistive devices (e.g., a cane, splint or brace) as needed.