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Version  |  Updated 18th September 2025
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New2RA: A Self-Help Guide for People Newly Diagnosed with Rheumatoid Arthritis

About Us

The National Rheumatoid Arthritis Society (NRAS) is the only patient-led charity in the UK focusing specifically on rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA), including adult JIA. We provide information and support services for those affected by RA and JIA, their families, friends, carers, and health professionals.

Connect with NRAS

Our freephone helpline can be contacted by phone on 0800 298 7650 or by email at helpline@nras.org.uk. Our trained helpline staff, supported by an advisory board of medical and healthcare professionals, are there to answer your questions on all aspects of living with RA and JIA.

New2RA Right Start

Ask your healthcare team to refer you to the New2RA Right Start service, where you can speak to friendly, empathetic, expert staff, get tailored, evidence-based support, and benefit from peer support. For more information, visit: www.nras.org.uk/resource/rightstart

NRAS and JIA Websites

Our websites offer a wealth of information about RA and JIA and their treatment, the latest research and developments, as well as lifestyle and supported self-management resources.

Our Booklets

NRAS produces a wide range of information booklets about RA and JIA. These can be downloaded or ordered through the website or by email at enquiries@nras.org.uk. If you don’t have access to the internet, just call us on 01628 823524.

Join Us

To find out how to support the work of the charity by becoming a Member of NRAS, visit www.nras.org.uk/join or call our Membership team on 01628 823524.

Credits

This booklet has been written with input at every stage from NRAS Members, with grateful thanks for their time, frankness, and constructive comments. Thank you also to all the health professionals who have contributed to this booklet.

Editors: Clare Jacklin, Victoria Butler, Ailsa Bosworth

Design and print: MB Creative

Contents

What to Expect from This Booklet

We’ve designed this booklet specifically for you: someone who has been diagnosed with RA within the last couple of years, and who wants to learn more about RA and what this means for you. You probably have many questions about your condition and how it will affect you. We hope we can help to answer some of them, such as:

  • What is RA?
  • How did I get it?
  • How will it be treated?
  • Will I get better?
  • Who will be involved in my care?
  • What can I do to help myself?
  • What might the future hold for me?

Dealing with an RA diagnosis can be scary and confusing. You may not yet be sure what you want (or need) to know, or feel ready to ask about it. So please don’t feel you have to read everything at once, if you don’t feel ready to. But we hope that, at the very least, this booklet will reassure you that there is a lot of support out there, and if you do have any questions, you’ll know where to go to find some answers.

I can remember the day I was diagnosed with RA so well. My son was just over a month old. At first I was relieved it wasn’t something more sinister, as my symptoms had come on so suddenly. One day I was fine, the next I woke up feeling like a truck had reversed over me several times. Everything hurt so much that I couldn’t move, and just the weight of my duvet on top of me felt unbearable. I had no idea what was going on, and I was terrified. As I left the hospital after diagnosis I felt utterly bewildered. I had so many questions. Where had this come from? I was only 31 years old – wasn’t arthritis an old person’s disease? Why me? Had I done something wrong? What was going to happen to me? Would I ever be me again?

I had practical worries too. How was I going to look after my children? Could I do the housework? Would I ever be able to go back to work after my maternity leave? Luckily, I found NRAS online. With the support of my rheumatologist and armed with the information NRAS provided, I started treatment, and it wasn’t long before I began to feel like me again. Life is different, but it goes on. And do you know what? In some ways, my life is actually better, as being diagnosed with RA has made me re-evaluate my priorities. I am back at work, but part time, and now I make time for myself and for my family. I eat well, exercise and pace myself. My RA is well-controlled and life is good.

— Julie, Aged 40, who has lived with RA for 9 years

What is Rheumatoid Arthritis?

RA is the most common form of inflammatory arthritis. It affects over 450,000 adults in the UK. Three times as many women as men are affected, and it can strike at any age. It not only affects joints, it can also affect other organs such as the heart, lungs, kidneys, and even the eyes.

RA is very different from osteoarthritis (OA), which is usually caused by wear and tear to the joints, often linked with ageing or sports/occupational joint damage. While rheumatoid arthritis is an autoimmune condition, meaning it occurs when your immune system mistakenly attacks your own body.

Symptoms of Rheumatoid Arthritis

  • Joint pain and swelling
  • Fatigue
  • Flu-like symptoms
  • Inflammation
  • Redness
  • Stiffness lasting more than 30 minutes
  • Anaemia
  • Depression
  • Irritability

How and Why Did I Get RA?

The short answer is: nobody knows. There is a great deal of research being carried out to try to identify the causes of RA. What we do know is that it’s not your fault, and there’s probably not much you could have done to prevent it. We also know that some people are more likely to develop RA because they have a genetic predisposition to the condition. That doesn’t necessarily mean that you are expected to have a family member with RA, or that you should be concerned that someone else in your family might develop the condition.

There are genes in your family that make it more likely to develop rheumatoid arthritis (RA). In fact, the chances of the child of someone with RA also developing the disease is only around 1-3%! However, genes aren’t the whole story. Some people have no family history of RA or other autoimmune diseases and still develop the condition. There is evidence that, regardless of your genes, certain environmental triggers can “switch on” your immune system to make it start ‘misbehaving’ and attacking your body, instead of attacking foreign invaders like viruses.

So far, researchers have found that stress seems to play a key role, as can smoking and changes in hormone levels due to childbirth or menopause. For some, RA may be triggered by an infection or virus.

How RA is Diagnosed

Your GP may suspect a diagnosis of RA based upon your symptoms, plus the presence of swelling and pain when they examine your joints. Blood tests are routinely done to help confirm their suspicions of RA, and include a measure of inflammation (an ‘ESR’ or ‘CRP’ test) as well as tests of your immune system (e.g. ‘Rheumatoid Factor’ and ‘Anti-CCP’ test).

My RA started with an acute attack just six weeks after the birth of my fourth child. My first symptom was excruciating pain. It was a very difficult time, as I had a newborn and three other young children to look after but, with the help of my wonderful husband, family, and friends, I managed to stay positive. Being told you have RA can be a depressing diagnosis, especially at first. It doesn’t help that arthritis is often associated with being old, or that the pain is generally invisible to others. But things have got a lot better since I was diagnosed.

Today, there are some amazing treatments available, with many more options than in the past. My advice to others who are newly-diagnosed is: don’t be fearful. Try not to read too much on the internet and always stick to trusted sources like the NRAS website. I am now in my late 50s and doing very well. I’m very much looking forward to the birth of my first grandchild. I plan to be a very involved granny and not let my RA hold me back from enjoying this new phase of my life.

— Jane, Aged 58, diagnosed at age 36 in 1995

Only a rheumatologist or a GP with a special interest in rheumatology can give a firm diagnosis of RA. This is because RA is a complex condition that presents in different ways in different people and sometimes the symptoms can be similar to, or mistaken for, quite a number of other conditions. Getting a referral to a rheumatology specialist in a timely manner is essential.

6 Stages of the RA Patient Journey

  1. Recognising symptoms
  2. First visit to GP
  3. Specialist referral
  4. Tests, treatments, and information
  5. Ongoing care
  6. Long-term management

For more information on this and other topics, visit www.nras.org.uk/smile to learn more about ‘Smile’, our free self-management e-learning courses.

Who Will Be Involved in My RA Care?

Once you have a diagnosis, several different health professionals – known as a multidisciplinary team (MDT) – will be involved in working with you to help get your RA under control and your life back on track. Who is included in the MDT will vary from hospital to hospital, but can include:

  • Consultant Rheumatologist: A doctor who specialises in the care of people with rheumatoid arthritis and other rheumatological conditions. It is their task to diagnose you and to help you decide which treatments are most suitable for you. They will also help introduce you to the wider multidisciplinary team, as well as communicating with your GP about your progress.
  • Rheumatology Specialist Nurse or Nurse Practitioner: A nurse who will give you advice and support about managing your RA, and will monitor your drug treatment. In many clinics, consultants share patient care with a nurse specialist. Some nurses are also qualified to administer steroid injections as part of flare management as well as trained to prescribe medicines. Most rheumatology departments have a nurse-led telephone advice line that you can contact between appointments.
  • Rheumatology Specialist Physiotherapist: Helps people affected by arthritis to improve their movement using special exercises and therapy, and by giving education and advice. Your physiotherapist will be involved in working with you on improving your fitness, flexibility, and day-to-day function.
  • Occupational Therapist: Works with you to help you find new or better ways to carry out everyday activities if your RA is making some things difficult. They can give you advice about equipment that will help take the strain off your painful joints.
  • Podiatrist (or Chiropodist): Can help with specialist advice and treatments if your RA causes you pain and/or problems with your feet and/or ankles. They may assist by fitting and providing insoles (orthoses) and footwear.
  • Pharmacist: As someone with RA, you will probably come into contact with several different types of pharmacists. A community pharmacist will fulfil your prescriptions and may also offer you an annual Medicine Use Review (MUR). A hospital-based pharmacist will specialise in the biologic/biosimilar medications that your consultant may prescribe.
  • General Practitioner (GP): Usually the first port of call when initial symptoms occur. A GP will refer you to a rheumatology service if they suspect inflammatory arthritis. Following diagnosis, they will help with work issues if fit notes are required, prescribe some medications, and offer support.
  • GP with a Special Interest in Rheumatology (GPwSI): Works in the community, often in an interface musculoskeletal (MSK) service.

For more information on meeting the team and other topics, visit www.nras.org.uk/smile to learn more about ‘Smile’, our free self-management e-learning courses.

GPwSIs take referrals from primary care colleagues/GPs and will diagnose and treat a number of MSK conditions such as frozen shoulder, carpal tunnel syndrome, ligament strain, etc. These days, a large proportion of rheumatology care is delivered in the community by GPwSIs working as part of the multidisciplinary team.

Your GP practice may also have the following:

  • Clinical pharmacist: Can help with reviewing patients’ medication and helping with adherence. They can prescribe for long-term conditions and deal with medication for patients recently discharged from hospital.
  • Advanced Nurse Practitioner (ANPs): Registered nurses who have done extra training to be able to examine, assess, diagnose, and treat patients. Like GPs, they can prescribe medication and make referrals to secondary care.
  • Social prescriber: Connecting patients with relevant organisations and services in their community to meet the practical, social, and emotional needs that affect their health and wellbeing.

Other professionals, who may not be part of your regular multidisciplinary team, but who are also available to help include:

  • A talking therapist: e.g., a counsellor. Dealing with a diagnosis of RA can be difficult, and some people feel anxious or experience periods of low mood or feel depressed. A clinical/health/counselling psychologist specialising in helping with physical health conditions can support you in adjusting to your condition and help you if you suffer from low mood and/or anxiety. They often have practical ideas for helping you find self-management strategies that work for you and your family.
  • A dietitian: An expert in human nutrition and the regulation of diet. Some people with RA may find it helpful to see a dietitian if they struggle to maintain a healthy weight and diet. Many conditions including RA are exacerbated by obesity and some foods can be triggers for inflammation. A dietitian can advise you on how to alter your diet based on your medical condition and individual requirements.
"I have reflected on that day I was diagnosed… I attended the hospital alone, thinking it was just another appointment… I felt that my consultant behaved as though I understood what was wrong with me and she was just confirming it. My wish is that following the diagnosis that immediately there would be a counselling session…" — Chris, Aged 46, diagnosed in 2014

Remember, YOU are at the centre of your multidisciplinary team:

  • Specialist nurse
  • Consultant rheumatologist
  • Talking therapies*
  • Pharmacist
  • Podiatrist
  • Occupational therapist
  • Dietitian
  • Physiotherapist

*It can be difficult to access talking therapies through your rheumatology team or GP in a time frame that works for you but it is worth asking.

How will my RA be treated?

Treatment and therapy vary from person to person, depending on the severity of symptoms. Often it’s a matter of time, as well as trial and error, before the right treatment can be found for you. Try not to get disheartened if the first drug you try doesn’t work; there are other medicines to try. Eventually, there will be a tailored treatment that works for you.

RA is not one disease which affects everybody in the same way – there are different sub-types. Blood tests which look for antibodies found more commonly in the blood of people with RA will identify which sub-type you have. The blood tests which are used are called ‘rheumatoid factor’ (RF) and ‘anti-CCP antibodies’ (ACPA). You can have both antibodies in your blood, neither of them or be positive for one but not the other! Those who have RF are described as ‘seropositive’ and those who do not have RF are described as being ‘seronegative’. Whether or not you are positive for anti-CCP autoantibodies as well adds to the clinical information which will help clinicians to determine treatment and dosage.

For more information, see our article: www.nras.org.uk/resource/seropositive-and-seronegative.

Unfortunately, these tests are not perfect, and false positive or false negative results are possible, making things more complicated and requiring the expertise of rheumatologists to make a firm diagnosis. For more information on blood tests for the diagnosis and treatment of RA, see our Blood Matters booklet.

How should a treatment help you?

  • An effective treatment should reduce inflammation and its side effects: pain, swelling, stiffness, and fatigue.
  • It should protect your body from the risk of damage to joints and bones caused by uncontrolled inflammation.
  • It should protect other organs in your body that might be affected by uncontrolled inflammation, such as the heart, lungs, and eyes.
  • It should allow you to maintain the ability to lead a normal life, with minimal impact on your relationships, family, home, work, and leisure time.

Managing pain

Pain is an extremely personal and individual experience, with a plethora of effects on both physical and mental health. It involves not only the nerves at the site of the pain but also the nerve pathways leading to the brain, and special pain pathways within the brain itself. Put simply, pain is a complex issue. If you’re in pain for any length of time, whatever the underlying cause, it can make you feel low or depressed, and interfere with your sleep. The stresses associated with RA-related job issues or relationship or family problems don’t help either. Feeling stressed and anxious impacts on how we cope with pain, sometimes making it feel worse.

The best way to ease the pain of RA is by effective and continuing control of the disease process, using the various medicines available. Taking simple over-the-counter (OTC) painkillers and combined pain remedies can bring immediate relief from pain. You may also find OTC or prescription non-steroidal anti-inflammatories (NSAIDs) - or in some situations, steroid preparations – helpful, as they give relief by reducing swelling and inflammation.

Table 1 – Pain and Anti-Inflammatory Drugs

Type Examples Purpose
Analgesics Paracetamol, Co-Dydramol (Paracetamol and Dihydrocodeine), Co-Codamol (Paracetamol and Codeine Phosphate), Tramadol (strong painkiller and mild opioid) To help control pain also known as painkillers
Non-steroidal anti-inflammatory drugs (NSAIDs) Ibuprofen, Meloxicam, Diclofenac, Naproxen* To ease pain and stiffness by reducing inflammation

For more detailed information on all the various medications currently available, you can request a free copy of the NRAS Medicines Booklet.

All paper used in this publication is FSC (Forest Stewardship Certified) and sourced from sustainable woodlands.

For more information, visit the National Rheumatoid Arthritis Society at www.nras.org.uk.

Rheumatoid Arthritis Treatments

Reducing Inflammation

Non-steroidal anti-inflammatory drugs (NSAIDs) reduce inflammation but do not prevent future damage. Corticosteroids are another option:

  • Prednisolone: Reduces inflammation, relieving pain. Usually prescribed as tablets and can be given during a severe episode of RA or when diagnosed to control pain and inflammation until disease-modifying drugs take effect.
  • Methylprednisolone: Can be injected into muscle or joints for similar reasons as prednisolone.
  • Triamcinolone-acetonide and Triamcinolone-hexacetonide: Can be injected into or around inflamed joints.

The following NSAIDs, celecoxib and etoricoxib, called COX 2s (cyclo-oxygenase-2) inhibitors, are used occasionally, usually when standard NSAIDs are not appropriate, with the knowledge that they can impact the cardiovascular system.

Disease Modifying Anti-Rheumatic Drugs (DMARDs)

DMARDs work by dampening the immune system’s response. They do not take effect immediately and may take up to 12 weeks to work properly. They can be prescribed individually or in combination. A stepped approach may be used to allow the body to adjust to the medication and gradually build up to the optimum dosage.

Starting a DMARD early in the course of RA can improve long-term outcomes. Up to 60% of people find their disease can be well managed using standard DMARDs. For more aggressive and complex disease, other treatments may be necessary.

Standard DMARDs

DMARD Name What You Need to Know
Methotrexate (MTX)

Introduced in 1947, MTX slows down the growth of rapidly dividing cells. It is used in lower doses for inflammatory arthritis and is regarded as the “gold standard.” It should be used early in RA treatment and may reduce the risk of cardiovascular disease. Side effects can include nausea, which may be reduced by switching from tablets to injections. Folic Acid supplements are recommended to mitigate side effects like digestive issues, mouth ulcers, and hair loss.
Sulfasalazine (SSZ) Tablets taken daily, often as part of a combination therapy, with dosage gradually increased over three weeks.
Leflunomide (LEF) Tablets taken daily, often as part of a combination therapy.
Hydroxychloroquine (HCQ) Tablets taken daily, either in combination therapy or as monotherapy for mild disease. Can affect the eyes, so regular ophthalmology assessments are recommended.
Ciclosporin Rarely used now, sometimes as an add-on treatment.
Azathioprine Rarely used now due to more effective treatments.

Advanced Therapies

For those whose disease does not respond to conventional DMARDs, advanced therapies like biologics, biosimilars, and JAK inhibitors may be used.

Biologic Therapies

Biologics target specific immune response pathways. They are large molecule drugs that require injection or infusion.

Biosimilar Medicines

Biosimilars work similarly to biologics and are newer alternatives.

JAK Inhibitors

These are small molecule drugs taken orally that interrupt the inflammatory process from inside the cells.

For more information, refer to the NRAS Medicines in Rheumatoid Arthritis booklet.

Patient Experience

"I didn’t realise that it’s common to have to try several different treatments before finding one that works for you. When the first few didn’t work for me, I felt like my life was over, and thought I was going to end up in a wheelchair. But I did find the right treatment for me and now I am in work, fully productive and the disease is well managed."

— Andrew, Aged 57, diagnosed in 2002

Further Information

For more details on medications and treatments, consult the NRAS website or contact their helpline at 0800 298 7650.

Healthcare Product Regulatory Agency (MHRA)

This scheme collates and reviews reports of suspected adverse reactions for all licensed and unlicensed drugs. Visit yellowcard.mhra.gov.uk for more information.

Measuring the Long-term Safety of Biologic Therapies

Over recent decades, biologic therapies for rheumatoid arthritis (RA) have become a mainstay of treatment. But how safe are they? To answer that question, a UK-wide register of people receiving biologic therapies was established in 2001. The British Society for Rheumatology Biologics Register for Rheumatoid Arthritis (BSRBR-RA) was set up to assess the long-term risk of serious side effects from biologic therapies.

This population study into the health of those with inflammatory arthritis is a unique collaboration between the BSR, The University of Manchester, and the pharmaceutical industry. Data from this study has provided doctors and patients with reassurance regarding the longer-term safety of these drugs.

The register has also proved to be a valuable resource for policymakers such as the National Institute for Health and Care Excellence (NICE), and some believe that this has led to greater patient access to biologic drugs. You can use the Yellow Card app to report any side effects quickly and easily, even if you’re on the move.

Over the intervening years, over 30,000 people in the UK have contributed to the register, which is hosted by The University of Manchester. In recent years, the BSRBR-RA has started to recruit patients who are starting biosimilars for the treatment of their RA. Although biosimilars have been prescribed for other conditions in the UK since the 1990s, they have only been approved to treat RA since 2015, increasing the number of treatments available on the NHS. For more information, visit NHS Prescriptions and Pharmacies.

Your Prescriptions

If you live in Northern Ireland, Scotland, or Wales, you’ll get free prescriptions for all your medicines. In England, however, you may have to pay unless you have an exemption certificate. To find out whether you are entitled to free prescriptions, go to: NHS Free Prescriptions.

You won’t be charged for any medication that is dispensed to you directly, without you having to fill a prescription; for example, if you are in hospital as an in-patient, attend an NHS walk-in centre, or are administered medication by your GP or hospital team in person (such as injections into a joint).

For regular prescriptions issued by the GP, especially if you have to obtain more than 12 prescribed items in a year, you can save money by getting a Pre-Payment Certificate. These can be paid annually or monthly. For more information, go to: NHS Pre-Payment Certificate.

How Will I Know if My Treatment is Working?

As mentioned earlier, it can take several weeks for your disease to start to respond to the medication you’re prescribed. In the meantime, you may also be given extra pain relief and steroids to “bridge” the therapy. Once you’re established on a particular treatment, you will be monitored to make sure the regime is working.

Blood Tests Overview

  • Haemoglobin: To find out if you are anaemic.
  • White cell count: The number of white cells in your body. White blood cells are involved in fighting infections.
  • Liver function tests (LFTs): To find out how well the liver is working.
  • Renal function test (U&E): To find out how well the kidneys are working.
  • ESR (erythrocyte sedimentation rate): To assess the level of inflammation as an indicator of disease activity.
  • CRP (C-reactive protein): To assess the level of inflammation.
  • Cholesterol: Raised cholesterol levels are associated with a higher risk of heart disease.

Other Ways of Monitoring Disease Activity

DAS 28 stands for Disease Activity Score. It assesses your joints, blood test results – C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) – and also your own view of how you have been feeling over the past week. The reason it’s called DAS 28 is because it assesses 28 specific joints for tenderness and/or swelling.

DAS Score Suggests
Less than 2.6 RA is in remission
2.6 to 3.2 A low level of disease activity
More than 3.2 Active disease that may require change in medication
More than 5.1 Very active disease that requires careful monitoring and adjustment to medication

The University of Manchester has been working on developing useful tools for remote monitoring patients with RA. There is a simple, easy-to-follow video available to demonstrate how to examine your own joints. This is part of a wider study called ‘REMORA’, REmote MOnitoring of Rheumatoid Arthritis. The study aims to develop, test, and evaluate a system for tracking daily symptoms in people living with RA, where data are collected using a smartphone app and integrated into NHS electronic patient records. However, anyone can access the demonstration video on YouTube at: YouTube Video and the chart and table for tracking your self-examinations can be downloaded from the patient resources on the study’s webpage.

Remora

X-rays

X-rays show if there are changes to the bones and their positions, but they are not as good at revealing problems with surrounding tissues or swelling. That’s why you won’t have many of them. You might have an occasional chest X-ray to look at your lungs if, for example, you have new symptoms or are about to start a treatment (e.g., methotrexate) and the team needs to see how your lungs look before commencing.

Rheumatoid Arthritis (RA)

RA is a generalized disorder which can affect virtually any organ of the body due to the inflammatory process. Although most patients are aware of its effects on the joints, fewer may recognize its potential for causing lung disease, hence the requirement to check the lungs.

Ultrasound

Ultrasound images are much better than X-rays at revealing inflammation in certain joints. That’s why ultrasound is increasingly being used as a tool in the diagnostic process, particularly in the early stages of RA, to detect inflammation that may not be visible as swelling or redness. Ultrasound can also detect early damage to the bones, such as erosions (the eating away of the surface of the bone) caused by the inflamed synovial membrane between the joints. If left unchecked and untreated, this is how RA causes long-term disability and deformity.

Health Assessment Questionnaire (HAQ)

The HAQ is a questionnaire that asks how easily you feel you can complete a range of tasks, to determine how well you are functioning physically. Questions include how easily you find dressing and personal grooming, preparing food or opening packages, walking certain distances or climbing stairs, etc. Sometimes you may be asked to complete this yourself in the clinic waiting room or sometimes you will complete it with your specialist nurse. There are other questionnaires in use by rheumatology teams within the NHS. It is important to complete these, if asked, as this data helps health professionals to understand more about how you are feeling and responding to treatment.

Managing Pain, Flares, and Fatigue

What is a Flare?

A “flare” is defined as a worsening of the disease process, which is experienced in a similar way to when your symptoms first started. You might think that your disease seems to be under control and then, suddenly, your joints become inflamed and painful, and you might also feel unwell and/or fatigued. The cause and duration of flares vary. Some people say that stress is a trigger for their flares. Sometimes flares occur after infections, such as viruses. But there might not be any obvious reason. Doctors believe flares can be related to natural (but poorly understood) fluctuations in the immunological processes that drive inflammation. They can be relatively short-lived, or so severe you can hardly get out of bed. A flare might be confined to one or two specific joints, or it could affect your whole body. One of the hardest things to cope with when you have RA is the unpredictability of flares. They can be frustrating, bewildering, and painful. You may get better at identifying the early signs of a flare. Sometimes, you can tell you’re going to have one because you notice symptoms getting worse over a few days. Fatigue can also be a warning sign – feeling like you’re hitting a ‘dead stop’ may mean your disease is becoming more active, and you need to respond to that. But you may get no early warning signs at all. RA flares really don’t play fair and can strike at the most inconvenient times.

Coping with Flares

Sometimes, simple self-management techniques and a few days’ rest are enough, and you won’t need additional treatment. But if your symptoms are gradually getting worse, you may need to see one of your healthcare team to discuss treatment options. If you are having regular flares it may be time to review your RA medicines. It could be that your dosage needs to be changed or that a change of medication might be needed. Some good general strategies for coping with a flare include:

  • Get some rest and relaxation early on.
  • Use cool packs on hot swollen joints. If you don’t have a cool pack, a bag of frozen peas can be equally effective. Protect your skin by wrapping them in a tea towel or similar.
  • Protect your joints, e.g., carry items on your forearms rather than holding them with your hands.
  • Wear comfortable, well-fitting shoes. If your feet are one of the main problems, ask to see a podiatrist.
  • Do gentle exercises, to help relieve the stiffness that makes pain worse.
  • Take your pain medication regularly and at the right dose.
  • Use hot baths or showers to relieve early morning stiffness and pain.
  • Let people around you know that you’re not feeling well, and allow them to help you.

If you’re having a flare, your General Practitioner (GP) may be able to help and will liaise with your hospital healthcare team, if necessary.

Managing Pain

Learning how to manage pain involves employing a range of different strategies. While drugs are important, non-drug treatments such as using heat and cold, relaxation, and distraction techniques can also make a big difference. It’s about finding what works for you. It helps to keep as active as you can, so you maintain the full range of movement and strength in your joints, and to reduce stiffness. Exercise also looks after your heart and can make you feel better about yourself by releasing the body’s natural painkillers, endorphins. For more information about exercises that you can do at home see: www.nras.org.uk/exercise

Managing Fatigue

Living with RA, you’ll know that fatigue isn’t just tiredness. It’s much more than that. It can feel like wading through mud or running into a brick wall. Fatigue is a very common symptom, and there is a great deal you can do to help prevent and reduce your fatigue. Above all, it’s important that your RA is well controlled. If you’re feeling more fatigued than usual and it’s getting hard to manage, don’t ignore it! Talk to your rheumatology team, and ask for help rather than trying to struggle on alone until your next appointment. Don’t beat yourself up just because you can’t do it right now. Tomorrow is another day! There are many different techniques and tips that can help you cope with fatigue. You may need to experiment until you find the ones that work best for you. As fatigue and pain can be connected, the advice on managing pain in this booklet and other NRAS publications such as Medicines in Rheumatoid Arthritis may also help to reduce fatigue. These are some of the fatigue-busting tips that people with RA say they have found helpful:

  • Make sure you take plenty of rest and give yourself time for relaxation.
  • Pace your activities, and plan ahead for what you want and need to do.
  • Follow a healthy diet and make sure you drink enough fluids.
  • Find easy-to-use gadgets, from electric tin-openers to long-handled back brushes in the bath, all of which make everyday activities less taxing. An occupational therapist can help and make suggestions.
  • Ask other people with RA for their tips, for example, via our online forum, NRAS HealthUnlocked, which can be accessed through the NRAS website. Take a look at the NRAS Fatigue Matters booklet.

For more information on managing pain and flares and other topics, visit www.nras.org.uk/smile to learn more about ‘Smile’, our free self-management e-learning courses.

Adherence to Medication

Ensure you take your medicines as prescribed. Adherence – the technical term for ‘sticking with your drug regimen’ – that is taking your medicines as prescribed – is often easier said than done, and you’re far from alone if you find it difficult. Research shows that, for chronic disease in general, patients take their treatments only half of the time and, for patients with RA, that figure varies between 30% and 80%. There are many reasons for this: people may forget; they may fear side effects or experience side effects which are unpleasant; or they might just feel better so think they don’t need to take their medicine any more. And sometimes, people simply get fed up having to think constantly about their RA, especially if they have to take daily medication in addition to adopting lifestyle changes like diet or exercise. Adhering to a regimen of any kind takes psychological effort and commitment.

Stamina. These days, people are increasingly involved in their own disease management and in decisions about their care, but that doesn’t mean adherence is any less important. Drugs only work properly if they’re taken exactly as prescribed. If you struggle to take your medications, or don’t understand why you need to take them even when you begin to feel better, it is worth being open and honest with your doctor, specialist nurse, or pharmacist. They won’t judge you, but they will be able to explain exactly how your medicines work and the risks you take by not continuing to follow the therapy as prescribed. They should also be able to give you advice on how to stick to your prescribed regimen.

My RA began in my thumbs. The rheumatologist talked about medication, but I thought this seemed too much for “only” sore thumbs and I didn’t like taking drugs, so I said I would try fish oil instead. I wish now that I’d started to tackle the RA with medication at that time, as it might have reduced the painful effects that later developed.

— Robin, Aged 55

The evidence is unequivocal: the success of RA therapy hinges on adherence. Patients who don’t take their treatment run the risk of flares of disease (worsening of symptoms), as well as continuing pain and stiffness, joint damage, and disability.

Dr Cathy Swales, Director of Clinical Studies, University of Oxford Medical School

I use my phone to send me a reminder. I remember when to take my drugs because M is for Monday – that’s Methotrexate day – and F, for Friday, means Folic Acid day. Feeling not in control makes you feel worse. Taking control by keeping records and notes doesn’t, in itself, make a big difference, but it makes you feel like you’re in charge.

Self-Management Techniques

SMILE-RA

SMILE-RA is a unique e-learning programme, free to register, and helps people with RA to learn about all aspects of their disease, its treatments, and how to live well with it. Being able to self-manage your disease effectively between rheumatology appointments is critical to getting the best outcomes for you, especially in a changing healthcare landscape where you may see your team less often than pre-pandemic. In modular format, you can choose the modules of most interest to you at any particular time. Your family can watch it with you, which helps them better understand how to support you.

In a survey, 88% of users found it easy to use, and 72% stated that SMILE-RA has increased their understanding of the importance of self-management. The programme has helped 2,300+ people at the time of publication of this resource and is a great resource for those living with or caring for someone with RA. Each module is on a particular theme or subject and most take between 20 – 30 mins to complete. There is an accessible and intuitive interface making it easy to use and navigate. After registering and completing the Foundation module, which includes baseline evaluation questions, you can direct your learning experience and revisit modules to refresh your knowledge. For more information and to register for SMILE, go to: www.nras.org.uk/SMILE

SMILE-RA is an extremely helpful and worthwhile tool - easy to navigate, user-friendly, and with a wealth of important information for those newly diagnosed.

— Feedback from SMILE user

Heat Therapy

Heat, whether dry or moist, can help if you have a painful muscle or a sore joint. If you’re applying dry heat – such as a hot water bottle, electric heat pad or jelly pad, make sure you protect your skin with a towel. Helpful moist heat techniques include:

  • Taking a hot shower or bath
  • Placing the affected limb in a basin or bowl of hot water
  • Applying a damp towel that’s been heated in a microwave

Cold Therapy

Cooling an inflamed (red hot, swollen) joint can also provide relief. You can use almost any clean, cold item. Try:

  • Dipping your hands or feet in a bowl of cold water with ice cubes
  • Using a bag of frozen broad beans as a mouldable ice pack (wrap it in a towel to avoid ice burn)
  • Using a jelly pack or a damp towel that’s been kept in the fridge

TENS

Some people find that a TENS machine (Transcutaneous Electrical Nerve Stimulators) is effective for pain relief. The NICE Guidelines on RA suggest that you ask your physiotherapist about TENS before trying it. TENS works by delivering small electrical pulses to the body through electrodes placed on the skin. It is thought to interrupt pain signals being sent to the brain.

Relaxation/Meditation

Relaxation is not just ‘taking it easy’. It means learning how to let go of physical muscle tension and emotional stress, relaxing both your body and mind. When you’re in pain for a long time, you can become tense without realising it. You can become mentally and emotionally tense, with the result that you find yourself trapped in a ‘cycle of pain’. Learning relaxation techniques can help to break this cycle and reduce pain. It takes practice, but once you’ve learned a technique, you can use it anywhere. There is a lot of information available on relaxation, mindfulness (a particular technique to help you relax), and meditation. There are many YouTube videos and apps, such as Headspace to help you get started.

I’ve found that, in addition to taking my RA meds, making dietary changes has really helped me. I have mostly cut out wheat, gluten, dairy, and sugary foods and drinks, which have helped me to lose quite a bit of weight. I also undergo a lot of intensive physiotherapy at least twice a week, which helps to keep my joints mobile and my joint pain to a minimum. Doing yoga and some simple exercises in the mornings and evenings also helps to reduce the stiffness of my joints.

— Anoushka, Aged 28, diagnosed in 2012

Get a Good Night’s Sleep

If your sleep pattern is disturbed, this is likely to increase your pain and leave you tired and lacking in motivation. Establishing good sleeping habits (sometimes called ‘sleep hygiene’) can help. The way to do this involves:

  • Establishing fixed times for going to bed and waking up
  • Creating a relaxing bedtime routine
  • Only going to bed when you feel tired
  • Maintaining a comfortable sleeping environment that’s not too hot, cold, noisy, or bright
  • Choosing not to nap during the day
  • Not eating a heavy meal late at night
  • Avoiding screen time before bed
  • Avoiding caffeine, nicotine, and alcohol late at night

Talk to your GP or specialist nurse if you continue to suffer from poor sleep, as they will be able to help. For more information on sleep, visit: www.nras.org.uk/sleep

Diet

Just like the medicines and the disease itself, the foods and diet that may help your symptoms vary from person to person. Some foods come up more often as either improving or worsening RA symptoms. A Mediterranean diet, for example, is commonly considered helpful. Keeping a food diary is a great idea to help identify what works best for you. More information on diet can be found on the NRAS website: www.nras.org.uk/diet

Exercise

There is a lot of evidence now showing that physical activity is safe and has many benefits for people with RA. We know now that physical activity improves RA symptoms and lowers the risk for developing heart disease. So, for people with RA, physical activity is important in managing their condition and maintaining a healthy lifestyle. Engaging in physical activity (such as walking or swimming) and/or regular movement exercises that can improve your range of motion can enhance your ability to manage day-to-day life. There are many places where you can find information on how to be active. A good place to start is the NRAS website; www.nras.org.uk/exercise and the SMILE module on the importance of exercise; www.nras.org.uk/smile

Everyone is different: What may work for one person with RA may not suit another. A physiotherapist will be able to offer you advice and design an exercise programme personalised to you. Don’t underestimate the importance of doing an activity you enjoy – walking, dancing, swimming, etc. as you are much more likely to continue doing it! Also, exercising with someone else (a family member or friend) can be more enjoyable and help with motivation.

Think ‘I Can’, not ‘I Can’t’

Some people find that ‘positive thinking’ helps them to cope better. But this approach may not suit everyone. If you are feeling down about your RA you shouldn’t feel bad or blame yourself. If you do want to give it a go, the trick is to...

Try making small changes to the way you think by focusing on the things you can do, rather than those you can’t. For example, instead of lying awake in bed thinking, ‘I’ll never get to sleep’, you could try telling yourself: ‘At least I’m resting my body’.

Diversion and Distraction

Getting immersed in an activity that interests you can help you to stop focusing on your pain, which can reduce the level of pain you feel. This is called diversion. You can also use distraction techniques to take your mind off your pain. For example, if going upstairs causes you difficulty, try naming a different country with each step you take. You’ll find yourself concentrating on the activity, rather than how much it hurts to climb.

St John’s Wort is a good example of a commonly taken complementary therapy which is not as benign as it may seem, as it is known to interact with a very large number of medications. However difficult your symptoms, don’t forget to plan activities that make you happy, whether you do them on your own or with family and friends.

— Ralph, Aged 51

Complementary Therapies

If you are considering any complementary or alternative therapy, discuss it with your rheumatology team first to make sure that it will not interact with your usual medication. Always remember that ‘natural’ doesn’t necessarily mean ‘harmless’. Some alternative remedies have side effects and can interact in harmful ways with medication. Even if you choose to take complementary therapies, it’s not advisable to take them instead of the treatments prescribed to you by your healthcare team.

I scoured the internet looking for alternatives. There are plenty of sites that tell you to eat X and you will be “cured”. Don’t fall for it. There is no scientific evidence that alternative or complementary therapies have any effect on the disease process or progression in RA. However, some complementary therapies can help to relieve symptoms in some people.

— Andrew, Aged 57

For example, grapefruit may seem to be entirely healthy, but it has been shown to interfere with many medications, in some cases increasing the amount of medication in your blood.

I tried some well-known supplements, but they did not make any difference.

— Ralph, Aged 51

I have used acupuncture in the past to manage my pain. I found it really beneficial.

— Lucy, Aged 29

Giving Up Smoking

Giving up smoking is good general advice for everyone, but for people with RA it is particularly important. There is clear evidence that smoking can make your symptoms far worse and medications considerably less effective. One of the environmental factors to developing RA is smoking. This risk relates to both the number of cigarettes smoked per day and the number of years someone has smoked, but importantly even moderate intensity smoking (such as smoking 6 to 9 cigarettes a day) can cause significant risk and this risk remains for many years (up to 19 years) after stopping smoking.

Cigarette smoking is associated with the production of rheumatoid factor and with positive anti-CCP antibodies; these are both specific and sensitive antibodies associated with developing RA. Smoking is associated with more severe RA such as more active disease, more joint damage (which can lead to deformity and loss of function), or disease outside the joints, such as nodules and inflammation of the blood vessels. Evidence shows those who smoke require more treatment with DMARDs, suggesting that smoking weakens the effectiveness of DMARDs and/or makes the disease more active.

Indeed, the British Society for Rheumatology Biologics Register for RA (BSRBR-RA) which collects data on patients who are on biologic, biosimilar and novel therapy medications (JAKs) showed that, when analysing data on 3000 patients, smokers were less likely to respond to some biologic therapies. Studies suggest that rates of RA remission may also be lower in smokers compared to nonsmokers. Additionally, patients with RA are at an increased risk of heart disease and strokes. Smoking only compounds this risk, putting people with RA at an even greater risk of heart disease.

These are all good reasons to seek help in stopping smoking as it isn’t easy to do on your own. Your GP or practice nurse may be able to refer you to local services to help you quit smoking, as may other members of your rheumatology team. Your local pharmacist should also have details. There’s also lots of support and advice available through the Smokefree website at www.nhs.uk/smokefree.

Talk About It

Your RA symptoms may be invisible, especially in the early stages. People with RA don’t look sick, which makes it hard for colleagues, friends and family to understand what you’re feeling. That’s why it’s important to talk about it. You may need to explain – both at work and at home - what RA is, how it affects you and what you need to better manage your RA. Opening up or finding the words to explain can be hard, but the NRAS Helpline Team can help you with this. As well as providing information about every aspect of RA, we can put you in touch with a trained Volunteer who understands what you’re going through and can talk to you on the phone. Sharing their experience with you can help get things in perspective and give you some real practical tips and techniques to getting your RA under control.

Apni Jung

‘Apni Jung’ means ‘our fight’ in Hindi. It is also the name of the area on the NRAS website – Apni Jung: our fight against RA – which makes information about RA and its treatment available in Hindi. Apni Jung offers a range of materials in Hindi, including videos, downloadable podcasts and pages of written information. Some of the information is also available in Punjabi and Urdu. This includes a video for Hindi speakers that looks at what is involved in moving from standard treatment with a disease-modifying anti-rheumatic drug (DMARD) to a biologic drug. nras.org.uk/2018/04/26/apni-jung. The video includes contributions, all in Hindi, from one of our young volunteers, a consultant rheumatologist and a researcher. www.nras.org.uk/apnijung

You can contact the NRAS helpline team on 0800 298 7650 or by email helpline@nras.org.uk

RheumaBuddy App

RheumaBuddy is an app NRAS have worked on in collaboration with the Danish company Daman. The app is free and enables users to record, manage and discuss their symptoms with their healthcare professionals. Similarly, it can be used as a resource by the parent of a child with JIA to understand their child’s arthritis, and record levels of pain and photographs of flare-ups.

RheumaBuddy offers an easy way to record symptoms such as pain, fatigue, low mood and stiffness, while also helping to identify things that can trigger a flare. With this insight, the app can help you to prevent or minimise future flares and provide you with a bank of personal data to share with a doctor, rheumatologist or other healthcare professional. This can be particularly helpful when there may be several months or longer between appointments (for patients with stable disease), making it hard to recall periods when pain, fatigue or other symptoms or side effects have been difficult to manage. For more information or to download the app, visit www.nras.org.uk/rheumabuddy.

NRAS New2RA RightStart Service

NRAS run a service for newly diagnosed patients, known as RightStart. The aim of this service is to support people newly diagnosed with RA to understand their diagnosis and how it may affect them. Getting the right, supportive start can help people to make adjustments to behaviour, lifestyle and health beliefs and understand why self-management is important and how to make those important first steps to managing their disease effectively.

Referral (by a health professional) is particularly effective at the beginning of someone’s journey with RA and we are pleased to offer the NRAS New2RA Right Start Service.

  1. Referral to Right Start: Referral to the Right Start Service begins with an online referral from a health professional at www.nras.org.uk/rightstart.
  2. NRAS Helpline call: On receipt of the online referral, a member of the NRAS team will get in touch with the person and arrange a call with our trained helpline team. We will try to contact the person being referred up to 3 times.
  3. Information tailored to individual needs: Following the above call, the helpline team will send further information to the individual, tailored to their conversation and that person’s individual needs and interests.
  4. Peer support volunteer: During the helpline call, if the person chooses, we can match them to a trained peer support volunteer.
  5. Follow-up call: Should you want it, a follow-up call can also be arranged with the helpline team, around 6 weeks after the initial call, to see if we can be of further assistance.

National Rheumatoid Arthritis Society

What Does the Future Hold for Me?

Impact on Work/Career

While RA can be challenging, it’s important to remember that most people with the condition can, and do, carry on working. You may need to make some changes or adjustments over time. For some, part-time work may be an option, or you may be able to work shorter hours or even alternate days. Adaptations and adjustments to working conditions and equipment can also make an enormous difference. There is support available to help you stay in work. NRAS can help with information about every aspect of working with RA, from how to talk to your employers/colleagues, to your legal rights. For more information about work and RA, order or download our work booklets, one for you and one to give to your employer, on the NRAS website.

Planning for a Family

If you are a woman of childbearing age, or a man who could father a child, it’s important that you ensure you take adequate contraceptive precautions while on RA medications. There are certain drugs that it is advisable not to take while trying to conceive or during pregnancy and while breastfeeding. They may require time to clear from your system before it’s safe to start trying to conceive. If you think you may wish to start a family in the future, discuss this with your rheumatology nurse or consultant.

"RA has impacted my life but has not defined it. By adapting and finding different ways of doing things, I have been able to have a family, a career and lead a very full life."
Amanda, Aged 40

Impact on Family

Remember those who love you are also living with your RA, so keep them in the loop as to what is happening with your disease and include them in your RA journey.

"As a newly diagnosed person, it’s important to take each day as it comes and to listen to your body and its needs. Too many times I have pushed on through excruciating pain and later regretted it."
Lucy, Aged 29

"I also wish I’d believed my doctors and my family more when they told me that I would be able to live a normal life again. You have to trust the people around you who care for you that things will get better. Doctors won’t stop until the right drug is found for you, so you can live a happy, fulfilling life."
Sasha, Aged 22

"Dad doesn’t go to the doctor often; he’d rather live with the pain. So you’re worrying all the time. I’d phone every evening to see if he was any better, and mum would say no. If you’d speak to him, he’d say ‘I’m fine’ but he wasn’t."
Maria, Adult daughter of parent with RA

10 Healthcare Essentials for those living with RA

Every person diagnosed with RA deserves and should expect a minimum level of healthcare. According to guidance from the NHS, NICE (National Institute for Health and Care Excellence), SMC (Scottish Medicines Consortium) and the British Society for Rheumatology, these are the 10 essential checks and services you are entitled to, or may benefit from knowing about. If you don’t think you are getting all the care you need, take this checklist to your rheumatology healthcare team and discuss it with them.

  1. Check your DAS (Disease Activity Score)
    NICE guidelines recommend that a DAS assessment should be carried out at least twice a year, but you should expect to have your DAS measured at every consultation, especially when newly diagnosed.
  2. Regular blood monitoring
    Depending on the drug treatment prescribed, frequency of blood tests required may vary, but will commonly include ESR, CRP (inflammatory markers), liver function tests, FBC (Full Blood Count) and blood chemistry (monitoring effects on the kidney and liver). Ask your consultant or specialist if you are unsure about the frequency or relevance of blood monitoring. It’s also helpful to know whether you are Rheumatoid Factor positive or negative and Anti-CCP positive or negative as this may influence drug choices at some point in your treatment pathway.
  3. Get support to quit smoking if you are a smoker
    Having RA puts people at increased risk of heart disease, and smoking further increases this risk. Evidence shows that RA treatment and therapy is less effective in people who continue to smoke.
  4. Annual Holistic Review
    People living with RA should be offered an annual holistic review which not only assesses disease progression but also gives you the opportunity to talk about your individual needs, any risk of conditions over and above your RA, and discuss the impact RA is having on your family and working life as well as your own emotional and mental health.
  5. Access to the multidisciplinary team
    To help manage your RA, you should have the opportunity to see specialist professionals including a rheumatologist, specialist nurse, physiotherapist, occupational therapist, podiatrist, dietician, and psychologist if required. Use every meeting with a member of the team as an educational opportunity and don’t be afraid to ask any questions you may have. Keep asking questions until you are satisfied you understand.
  6. Learn how to self-manage
    To help you understand and manage your RA, its treatment, drugs, and symptoms, you should be offered, and have the opportunity to access self-management education, be given good quality approved information and have an individual care plan.
  7. Access to a specialist nurse-led helpline
    You should have access to a nurse-led helpline when you need it, for instance, when experiencing side effects to medications or for help if you flare.
  8. Clear signposting to patient organisations
    Ask your rheumatology healthcare professionals about patient organisations that can offer comprehensive services including a helpline, peer to peer support, information booklets, online forums, educational opportunities and resources to help you self-manage.
  9. Exercise
    Ask your physiotherapist about an individual exercise programme designed for you. Exercise is essential and plays a key role in controlling the symptoms of RA, including fatigue and pain. It’s also important to maintain a generally healthy lifestyle, including a healthy diet and appropriate weight.
  10. Pregnancy
    Get information and specialist care if you are planning to have a baby. Your RA will need to be more tightly controlled and monitored during family planning for both prospective mothers and fathers. You should expect care and support from specialist healthcare professionals at every stage, from preconception to postnatal care.

In addition, the following are highly recommended for people living with RA:

  • Have your blood fats (cholesterol) measured annually.
  • Have your blood pressure measured and recorded at least once a year and set a personal target that is right for you.
  • Have your eyes screened, particularly if you have gritty eyes, which may be a sign of secondary Sjogren’s syndrome. This can be a common side effect of RA and some medications.
  • Ask your rheumatology team about any opportunities to participate in research. Ideally, all patients should have opportunities to take part in research, whether it be related to drugs or observational studies on subjects such as fatigue or exercise.

Finally…

As we stated at the beginning of this booklet, being diagnosed with RA can be really scary. You may feel that everything will come to an end, or that your life is no longer going in the direction you wanted it to. It can be hard to go from seeing yourself as a well person to accepting that you have a medical condition. These feelings are perfectly natural. There is nothing wrong with acknowledging them. If you need to have a good old cry, then do so. Or if you feel really angry and want to scream and shout, do it. Don’t bottle it all up but once you’ve done that reach out for the help that is there for you.

"I wish NRAS had existed when I first learnt about my rheumatoid arthritis. It is a great support network and a useful source of information – unlike some of the ‘fake information’ you get from a general web search. While nobody can predict the future, please feel reassured that being diagnosed with RA now is not the devastating news it once was. The future can be very positive."

Bright Future for RA Management

Knowledge of Rheumatoid Arthritis (RA) and its treatment has improved significantly, with more people achieving remission every day. With extensive research underway, the outlook is promising, and we hope for a cure in the near future. Meanwhile, much can be done to manage the disease, allowing for a full and active life.

We hope this booklet has reassured you and answered some of your questions.

Lorraine, Aged 47

National Rheumatoid Arthritis Society (NRAS) Publications

  • Living Better with RA: A self-help guide for people with established disease, including Juvenile Idiopathic Arthritis.
  • Fatigue Matters: Advice and resources to help manage fatigue for people with RA.
  • Medicines in Rheumatoid Arthritis: Understanding the use and function of medicines in managing RA.
  • Blood Matters: A guide to blood tests used in managing RA and Juvenile Idiopathic Arthritis.
  • I Want to Work: Advice to help people with RA stay in their jobs.
  • An Employer’s Guide to Rheumatoid Arthritis: Support for employers to assist employees living with RA.
  • Am I Likely to Develop RA? A guide for relatives of those living with RA.
  • JIA Explained: Information for parents and carers of children with Juvenile Idiopathic Arthritis.

For more NRAS publications, visit www.nras.org.uk/publications.

Contact Information

Helpline: 0800 298 7650
General: 01628 823 524
Email: helpline@nras.org.uk
Website: www.nras.org.uk
Address: Ground Floor, 4 Switchback Office Park, Gardner Road, Maidenhead, Berkshire SL6 7RJ

Join NRAS

For information about becoming a member of NRAS, visit www.nras.org.uk/become-a-member. Membership benefits include:

  • NRAS magazine twice a year
  • Monthly email updates
  • Invitations to free meetings and events

For further questions, contact us at 01628 823 524.

NRAS Lottery: Join the NRAS Lottery to support our work. Find out more at www.nras.org.uk.

Environmental Commitment: NRAS is committed to minimizing its environmental impact. All paper used is FSC certified and sourced from sustainable woodlands.

Registered Charity Numbers: 1134859 & SC039721. NRAS is a private company limited by guarantee, registered in England and Wales No 7127101.

Society

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Last modified 18th September 2025 08:47:42 am