Young Adults Living With RA

Medically Reviewed by David Zelman, MD on March 14, 2023
5 min read

Rheumatoid arthritis (RA) is more likely to appear in middle age, but young adults can get RA, too. As many as 8 in 100,000 people aged 18 to 34 get RA.

RA may be more severe if you get it as a young adult.

You may be more likely to have inflammation in the small joints of your hands and feet, and have bony erosions, than people who get RA later in life. You’re also more likely to have rheumatoid nodules. These are small, hard lumps under the skin around your joints, usually on your fingers.

Finally, you’re more likely to have seropositive RA, which means your immune system releases higher levels of certain proteins (your doctor might call them antibodies), like rheumatoid factor, into your blood. About 70% of people with RA have a positive result on this blood test.

But there is some good news, too. Young adults with RA are more likely to get aggressive treatment to get their disease under control. This can help prevent joint damage and disability. As a result, you may have better outcomes from treatment than older people. This could also be because younger folks have fewer of the health problems that come with aging.

Older adults with RA often have more side effects from biologics, a class of drugs that can lower inflammation and prevent joint damage. Read more about biologics and what to expect.

It may be a shock when your doctor tells you that you have RA. You may be worried that you won’t be able to stay in your job, stay active, or clean your house. You may fear that your body will change or that you won’t be able to have an enjoyable, full life.

But you can treat and manage your RA. Newer, more aggressive treatments help more people stay active and control their pain. These advances mean you could have a better quality of life with RA than many people diagnosed before you.

Your doctor will tell you to exercise. Do it. Exercise is good for your joints if you have arthritis. No matter what activity you do, it can give you more energy, strengthen your muscles and bones, and improve your quality of life. If you’re worried about doing any activity with RA, talk to your doctor or physical therapist first.

You can also stay on your career track. If RA symptoms make some of your work duties difficult, you have a legal right to ask your employer to make reasonable changes. You can ask for an ergonomic desk. You can ask for flexible work hours or a relaxed dress code.

Some activities are not a good idea if you have RA. Don’t smoke. Even social smoking can make your inflammation worse. Your RA can become more severe when you smoke. You’re less likely to go into remission. If you smoke, quit or get help to quit. Skip alcohol, too. It can affect the way your meds work. Get more tips on living with RA.

Young adults with RA can date and get married just like people who don’t have arthritis.

When it comes to intimacy, make plans with your partner so your RA doesn’t ruin the moment: Take a warm shower before sex to ease joint stiffness.

  • Take pain meds in advance so you can enjoy sex without joint aches.
  • If RA causes fatigue or joint pain in the mornings, plan to have sex in the evenings.
  • Focus on what makes you feel good, not what you don’t like about your body.

Learn more about how to manage RA and your relationships.

Plan ahead for pregnancy if you can. Tell your rheumatologist when you’d like to start a family, even if that’s in a few years. If your treatment plan keeps your RA well controlled, you’re more likely to be able to conceive and have a healthy, safe pregnancy.

Some RA medications, like leflunomide and methotrexate, can cause serious birth defects if they’re passed to an unborn baby by either its mother and father. Others may lower sperm count in men with RA. Talk with your doctor about when to stop these drugs so they can clear out of your system before you try to conceive a baby.

Almost half of all pregnancies in the U.S. are unplanned. If you don’t want to have a baby right now for any reason, use birth control every time you have sex. Talk with your rheumatologist about safe, effective options to prevent pregnancy.

There are RA treatments that you can take while you’re pregnant or breastfeeding so you keep your RA under control. That’s important, because high disease activity during pregnancy could cause your baby to have a low birth weight. Your rheumatologist will prescribe safe, effective treatments to help you control your RA during these times. Find out more information on family planning with RA.

If you’re stressed out or worried about your RA diagnosis, tell your doctor. They can help you get mental health therapy to help you live with your disease, or even prescribe medication for depression if you need it.

Other tips for living with RA:

  • Don’t try to do too much. Get enough rest when RA makes you feel worn out.
  • Ping your friends and talk it out when RA makes you feel upset or worried.
  • Check out online or local RA support groups to share your feelings with others who are going through the same thing.
  • Make time for yourself. If you’re beat, skip out on some social activities. Take a walk, listen to some tunes, or just hang out at home. Give yourself a break.

Get tips on how to fight depression that comes with RA.

Show Sources

SOURCES:

Johns Hopkins Arthritis Center: “Rheumatoid Arthritis Signs and Symptoms.”

Arthritis & Rheumatism: Is the Incidence of Rheumatoid Arthritis Rising?

Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders: “Pattern of Young and Old Onset Rheumatoid Arthritis (YORA and EORA) Among a Group of Egyptian Patients with Rheumatoid Arthritis.”

National Rheumatoid Arthritis Society: “Rheumatoid Arthritis & Pregnancy,” “Rheumatoid nodules.”

Rheumatology: “Are there differences between young- and older-onset early inflammatory arthritis and do these impact outcomes? An analysis from the CATCH cohort.”

Mayo Clinic: “Does smoking increase my risk of rheumatoid arthritis?” “Exercise helps ease arthritis pain and stiffness,” “Rheumatoid arthritis,” “Rheumatoid factor.”

Medscape: “Rheumatoid Factor.”

Seminars in Arthritis and Rheumatism: “Efficacy and safety of biological agents in the older rheumatoid arthritis patients compared to Young: A systematic review and meta-analysis.”

SimpleTasks.org: “The Mental and Emotional Toll of Rheumatic Diseases.”

Arthritis Care & Research: “Change of psychological distress and physical disability in patients with rheumatoid arthritis over the last two decades.”

Arthritis Foundation: “Alcohol and Arthritis,” “Rheumatoid Arthritis in the Workplace.”

American College of Rheumatology: “Sex and Arthritis.”

CDC: “Unintended Pregnancy Prevention.”

Open Access Rheumatology: “Management of rheumatoid arthritis during pregnancy: challenges and solutions.”

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