--- title: "Rheumatoid Arthritis: Symptoms, Diagnosis and Treatment in Nepal" url: https://tulsimultispecialityclinic.com.np/blog/rheumatoid-arthritis-symptoms-treatment-nepal site: Tulsi Multi Speciality Clinic description: "Rheumatoid arthritis explained: early symptoms, morning stiffness, the blood tests and scans used to diagnose it, and the treatments that protect joints." lastModified: 2026-09-20T13:17:00.150Z type: Article author: "Dr. Krishna Adhikari, Consultant Rheumatologist" reviewer: "Dr. Krishna Adhikari, Consultant Rheumatologist" --- # Rheumatoid Arthritis: Symptoms, Diagnosis and Treatment in Nepal **Author:** [Dr. Krishna Adhikari, Consultant Rheumatologist](https://tulsimultispecialityclinic.com.np/doctors/dr-krishna-adhikari) (MBBS, MD (Internal Medicine), Fellowship in Clinical Rheumatology) **Medically reviewed by:** [Dr. Krishna Adhikari, Consultant Rheumatologist](https://tulsimultispecialityclinic.com.np/doctors/dr-krishna-adhikari) **Published:** 2026-09-20 **Last Updated:** 2026-09-20 **Category:** Health Tips **Reading Time:** 5 minutes Rheumatoid arthritis (RA) is a long-lasting autoimmune disease in which the immune system attacks the lining of a person's own joints. It usually starts in the small joints of the hands and feet, often on both sides of the body, with morning stiffness that lasts longer than 30 minutes and often more than an hour. It cannot be cured at present, but early treatment can control the disease and prevent joint damage, which is why getting a diagnosis quickly matters so much. ## What is rheumatoid arthritis? RA is the most common autoimmune type of arthritis. Instead of defending the body, the immune system sends antibodies to the lining of the joints and attacks the tissue surrounding them. That inflammation causes the pain and swelling, and over time it is what damages the joint. It is a different disease from osteoarthritis, which comes from joint tissues breaking down with use and age, even though both are called बाथ रोग in everyday Nepali. RA is also not limited to joints: it can cause problems in the heart, lungs, blood, nerves, eyes and skin. ## Symptoms of rheumatoid arthritis The main symptoms are joint pain, swelling and stiffness. Some patterns are especially suggestive: - The small joints of the hands and feet are often affected first. - It typically affects joints symmetrically — both sides at the same time and to the same extent. - Morning stiffness lasts longer than 30 minutes, often more than an hour, and improves with movement. In osteoarthritis it wears off within half an hour. - General symptoms are common: tiredness, a high temperature, sweating, poor appetite and weight loss. - Inflammation can show up as dry eyes, or chest pain if the heart or lungs are involved. Symptoms come and go. Periods when the condition gets worse are called flares. ## Who gets rheumatoid arthritis? About 75 per cent of people with RA are women, and the World Health Organization notes that women are affected two to three times more often than men. Symptoms usually start between the ages of 30 and 50, but RA can begin at any age. A family history raises the risk, although the chance of inheriting it is thought to be low, and there is evidence that smoking increases the risk of developing RA. NIAMS also lists obesity, gum disease and some lung diseases among risk factors. ## How rheumatoid arthritis is diagnosed There is no one test that settles it. Doctors diagnose RA by taking a medical history, performing a physical examination, ordering laboratory tests, and ordering imaging. Be ready to describe when your symptoms started and how they have changed — that history carries real weight. ### Blood tests **Rheumatoid factor (RF)** is an antibody many people with RA eventually have in their blood. **Anti-cyclic citrullinated peptide antibody (anti-CCP)** appears in many people with RA and can show up before symptoms develop, which helps doctors diagnose early. Neither test is perfect alone: some people with RA test negative. ### Imaging X-rays are used, but are often still normal in the early stages. Ultrasound and MRI can help diagnose rheumatoid arthritis earlier, because they show changes an X-ray misses. ## Treatment: DMARDs, biologics and what they are for What follows describes classes of treatment a doctor may prescribe — it is not advice to take anything. The goals are to relieve pain, decrease inflammation and swelling, and prevent, slow or stop damage to joints and organs. A **disease-modifying antirheumatic drug (DMARD)** is usually the first treatment prescribed. DMARDs slow or change how the disease progresses rather than only easing symptoms; common ones include methotrexate, leflunomide, hydroxychloroquine and sulfasalazine, and a combination of DMARD tablets is often used initially. If DMARDs alone do not control the inflammation, a rheumatologist may prescribe a **biologic** medicine, which is also a type of DMARD. **Janus kinase (JAK) inhibitors** are another class, which signal specific cells to stop inflammation. The target is remission or near remission. RA is a chronic condition with no cure at present, but there are many ways to treat and manage it. ## Why early treatment matters Diagnosing rheumatoid arthritis quickly is important, because early treatment can prevent it getting worse and reduce the risk of joint damage. The WHO puts it directly: early diagnosis and management can reduce symptoms, slow the disease and prevent disability. Joint damage already done cannot be undone, so months spent waiting to see whether the pain passes cannot be recovered. ## Living with rheumatoid arthritis Because RA is a long-term condition, you will be in regular contact with your healthcare team so they can check the disease is well controlled and the treatment is right for you. Regular exercise and a healthy diet are recommended, as for everyone. Exercise relieves stress, keeps joints mobile and strengthens supporting muscles; low-impact activities such as swimming, cycling and walking strain the joints less. Rest makes inflamed joints more comfortable, but without movement joints stiffen and muscles weaken, so the balance matters. If an activity leaves a joint warm and swollen or causes severe pain, stop and rest. ## When to see a rheumatologist Book an appointment if you have joint pain and swelling that has not settled, morning stiffness lasting more than 30 minutes, the same joints hurting on both sides, small joints of the hands or feet that are swollen and tender, or joint symptoms alongside fatigue, fever or weight loss. Do not wait for an abnormal blood test — the tests are part of the assessment, not the trigger for it. A rheumatologist can tell RA apart from osteoarthritis, gout and other rheumatic diseases, each managed differently. ## Rheumatology care in Kathmandu Valley Rheumatology care at Tulsi Multi Speciality Clinic is provided by Dr. Krishna Adhikari, consultant rheumatologist and Lecturer in Internal Medicine at Patan Academy of Health Sciences (Patan Hospital), NMC No. 13049. He consults Sunday to Friday from 4:00 PM at AVM Chowk, Manbhawan, Lalitpur-5, Kathmandu Valley. See our [rheumatology service](/services/rheumatology) and [Dr. Adhikari's profile](/doctors/dr-krishna-adhikari), [book an appointment](/book), or call +977-1-5914294. This article is general information, not a substitute for a consultation. ## Sources - [NHS — Rheumatoid arthritis](https://www.nhs.uk/conditions/rheumatoid-arthritis/) - [NHS — Rheumatoid arthritis: Symptoms](https://www.nhs.uk/conditions/rheumatoid-arthritis/symptoms/) - [NHS — Rheumatoid arthritis: Causes](https://www.nhs.uk/conditions/rheumatoid-arthritis/causes/) - [NHS — Rheumatoid arthritis: Treatment](https://www.nhs.uk/conditions/rheumatoid-arthritis/treatment/) - [NHS — Rheumatoid arthritis: Living with](https://www.nhs.uk/conditions/rheumatoid-arthritis/living-with/) - [NIAMS — Rheumatoid Arthritis](https://www.niams.nih.gov/health-topics/rheumatoid-arthritis) - [NIAMS — Rheumatoid Arthritis: Diagnosis, Treatment, and Steps to Take](https://www.niams.nih.gov/health-topics/rheumatoid-arthritis/diagnosis-treatment-and-steps-to-take) - [American College of Rheumatology — Rheumatoid Arthritis](https://rheumatology.org/patients/rheumatoid-arthritis) - [World Health Organization — Rheumatoid arthritis](https://www.who.int/news-room/fact-sheets/detail/rheumatoid-arthritis) --- *This article is for informational purposes only and does not replace professional medical advice. Consult a qualified healthcare provider for diagnosis and treatment.* *Tulsi Multi Speciality Clinic, AVM Chowk, Manbhawan, Lalitpur-5, Bagmati Province, Nepal. Phone: +977-1-5914294.*