Family history of rheumatoid arthritis: how much does it matter?

The NHS describes rheumatoid arthritis as a long-term condition that causes pain, swelling and stiffness in the joints, usually affecting the hands, feet and wrists. There may be periods where symptoms become worse, known as flare-ups or flares. With treatment it is possible to decrease the number of flares and minimise or prevent long-term damage.

It is an autoimmune disease, which means the immune system, which usually fights infection, attacks the cells that line the joints by mistake. The NHS explains this makes the joints swollen, stiff and painful, and that over time it can damage the joints, cartilage and nearby bone.

The NHS says there is some evidence that rheumatoid arthritis can run in families, although the risk of inheriting it is thought to be low because genes are only thought to play a small role in the condition. Its overview page lists having a family history of rheumatoid arthritis among the things that put you at increased risk.

That combination, a recognised but modest factor, is a fair summary. If your mother or sister has rheumatoid arthritis, you are somewhat more likely to develop it than someone without a relative, but the large majority of relatives never do, and many people with rheumatoid arthritis have no affected relative.

The NHS lists hormones as one possible factor. Rheumatoid arthritis is more common in women than men, which may be because of the effects of oestrogen, although it says this link has not been proven.

It also says some evidence suggests people who smoke have an increased risk of developing rheumatoid arthritis. Stopping smoking is therefore the main modifiable factor in the NHS list. Various theories have suggested an infection as a trigger, but the NHS says none of these has been proven.

The NHS says the main symptoms are joint pain, swelling and stiffness. They often develop gradually over several weeks, though some cases progress over a number of days, and they vary from person to person. The small joints of the hands and feet are often the first to be affected, and the condition typically affects joints on both sides of the body.

The pain is usually a throbbing and aching pain and is often worse in the mornings and after a period of inactivity. Stiffness in the morning often lasts longer than the 30 minutes the NHS describes as typical for osteoarthritis. Joints can become hot and tender, and some people have tiredness, a high temperature, sweating, a poor appetite and weight loss.

If you have a close relative with rheumatoid arthritis and you develop persistent swollen, stiff joints, mention the family history to your GP when you see them.

The NHS says to see a GP if you think you have symptoms of rheumatoid arthritis, so that they can try to identify the underlying cause, and that diagnosing it quickly is important. There is no cure, but early diagnosis and appropriate treatment enable many people to have periods of months or even years between flares and to lead full lives and continue regular employment.

The main options listed by the NHS are long-term medicine to relieve symptoms and slow the progress of the condition, supportive treatments such as physiotherapy and occupational therapy, and surgery to correct joint problems that develop.

The NHS says rheumatoid arthritis can lead to other conditions that cause additional symptoms and can sometimes be life threatening. They include carpal tunnel syndrome, inflammation of other areas such as the lungs, heart and eyes, and an increased risk of heart attack and stroke. Making sure rheumatoid arthritis is well controlled can help to reduce the risk of these complications.