Rheumatoid Arthritis

Common Questions & Answers
Rheumatoid arthritis isn’t currently curable. But treatments can help manage symptoms, improve quality of life, support movement, and slow disease progression. Speak to a doctor about which treatments and lifestyle changes may help your arthritis symptoms.
Early symptoms often affect the same joint on both sides of the body and include mild pain, swelling, stiffness, tenderness, and warmth in the joints – particularly in smaller joints like fingers and toes. Fatigue is also common early on.
Triggers for flare-ups can vary but may include stress, infections, changes in weather, diet changes, or overexertion. Not all flares have a known trigger. Avoiding known triggers can help you reduce your risk of flare-ups.
Some people find it helpful to limit processed foods, sugary drinks, and foods high in saturated fat. The Mediterranean diet may be beneficial for RA because of its focus on nutritious whole foods.
RA diagnosis typically involves a physical exam, blood tests for RA like rheumatoid factor and anti-CCP, and imaging tests like X-rays or MRIs. RA can be challenging to diagnose, and no single test confirms it.

Beth Biggee, MD
Medical Reviewer
Beth Biggee, MD, is medical director and an integrative rheumatologist at?Rheumission, a virtual integrative rheumatology practice for people residing in California and Pennsylvania. This first-of-its-kind company offers whole person autoimmune care by a team of integrative rheumatologists, lifestyle medicine practitioners, autoimmune dietitians, psychologists, and care coordinators.
Dr. Biggee also works as a healthcare wellness consultant for Synergy Wellness Center in Hudson, Massachusetts. Teamed with Synergy, she provides in-person lifestyle medicine and holistic consults, and contributes to employee workplace wellness programs. She has over 20 years of experience in rheumatology and holds board certifications in rheumatology and integrative and lifestyle medicine.?Dr. Biggee brings a human-centered approach to wellness rather than focusing solely on diseases.
Dr. Biggee graduated cum laude with a bachelor's degree from Canisius College, and graduated magna cum laude and as valedictorian from SUNY Health Science Center at Syracuse Medical School. She completed her internship and residency in internal medicine at Yale New Haven Hospital, completed her fellowship in rheumatology at Tufts–New England Medical Center, and completed training in integrative rheumatology at the University of Arizona Andrew Weil Center for Integrative Medicine. Following her training, she attained board certification in rheumatology and internal medicine through the American Board of Internal Medicine, attained board certification in integrative medicine through the American Board of Physician Specialties, and attained accreditation as a certified lifestyle medicine physician through the American College of Lifestyle Medicine. She is certified in Helms auricular acupuncture and is currently completing coursework for the Aloha Ayurveda integrative medicine course for physicians.
In prior roles, Dr. Biggee taught as an assistant clinical professor of medicine at Mary Imogene Bassett Hospital (an affiliate of Columbia University). She was also clinical associate of medicine at Tufts University School of Medicine and instructed "introduction to clinical medicine" for medical students at Tufts. She was preceptor for the Lawrence General Hospital Family Medicine Residency.
Dr. Biggee has published in Annals of Rheumatic Diseases, Arthritis in Rheumatism, Current Opinions in Rheumatology, Journal for Musculoskeletal Medicine, Medicine and Health?Rhode Island, and Field Guide to Internal Medicine.

Atul Khasnis, MD
Medical Reviewer
Atul Khasnis, MD, is a board-certified rheumatologist and lifestyle medicine specialist. He is the director of the Georgia Rheumatology Clinic in Tyrone. As a practicing rheumatologist, he cares for adults?with systemic autoimmune diseases (such as lupus, rheumatoid arthritis, vasculitis, and myositis) and various kinds of arthritis.
After completing medical school and residency in India and coming to the United States, he did an additional residency in internal medicine at Michigan State University and a rheumatology fellowship at the Cleveland Clinic. He also completed a fellowship in vasculitis (offered by the Vasculitis Clinical Research Consortium), a master's in clinical research at Case Western Reserve University, and a two-year research fellowship in cardiac electrophysiology.?
Dr. Khasnis has written and coauthored several book chapters, journal articles, and abstracts, and participated as a faculty-presenter in continuing medical education activities. He is the membership chair for the Georgia Society of Rheumatology.
Khasnis loves reading and travel, and has a passion for photography.

Beth Biggee, MD
Medical Reviewer
Beth Biggee, MD, is medical director and an integrative rheumatologist at?Rheumission, a virtual integrative rheumatology practice for people residing in California and Pennsylvania. This first-of-its-kind company offers whole person autoimmune care by a team of integrative rheumatologists, lifestyle medicine practitioners, autoimmune dietitians, psychologists, and care coordinators.
Dr. Biggee also works as a healthcare wellness consultant for Synergy Wellness Center in Hudson, Massachusetts. Teamed with Synergy, she provides in-person lifestyle medicine and holistic consults, and contributes to employee workplace wellness programs. She has over 20 years of experience in rheumatology and holds board certifications in rheumatology and integrative and lifestyle medicine.?Dr. Biggee brings a human-centered approach to wellness rather than focusing solely on diseases.
Dr. Biggee graduated cum laude with a bachelor's degree from Canisius College, and graduated magna cum laude and as valedictorian from SUNY Health Science Center at Syracuse Medical School. She completed her internship and residency in internal medicine at Yale New Haven Hospital, completed her fellowship in rheumatology at Tufts–New England Medical Center, and completed training in integrative rheumatology at the University of Arizona Andrew Weil Center for Integrative Medicine. Following her training, she attained board certification in rheumatology and internal medicine through the American Board of Internal Medicine, attained board certification in integrative medicine through the American Board of Physician Specialties, and attained accreditation as a certified lifestyle medicine physician through the American College of Lifestyle Medicine. She is certified in Helms auricular acupuncture and is currently completing coursework for the Aloha Ayurveda integrative medicine course for physicians.
In prior roles, Dr. Biggee taught as an assistant clinical professor of medicine at Mary Imogene Bassett Hospital (an affiliate of Columbia University). She was also clinical associate of medicine at Tufts University School of Medicine and instructed "introduction to clinical medicine" for medical students at Tufts. She was preceptor for the Lawrence General Hospital Family Medicine Residency.
Dr. Biggee has published in Annals of Rheumatic Diseases, Arthritis in Rheumatism, Current Opinions in Rheumatology, Journal for Musculoskeletal Medicine, Medicine and Health?Rhode Island, and Field Guide to Internal Medicine.
Rosalyn Carson-DeWitt, MD
Medical Reviewer
Rosalyn Carson-DeWitt, MD combines an undergraduate English degree from Kalamazoo College and a medical degree from Michigan State University in her work as a medical writer, editor, and consultant. Dr. Carson-DeWitt served as editor in chief for two multivolume Macmillan encyclopedias: The Encyclopedia of Drugs, Alcohol, and Addictive Behavior and Drugs, Alcohol, and Tobacco: Learning About Addictive Behavior; she also collaborated on the 18th edition of the Merck Manual of Diagnosis and Therapy. She has written thousands of articles, in print and online, for health care providers and consumers, including Family Health International, Columbia University, the Mayo Clinic, and GlaxoSmithKline. She is committed to providing accessible information for both medical professionals and consumers.

David Alboukrek, MD
Medical Reviewer
David Alboukrek, MD, is board-certified in internal medicine and rheumatology. He is an affiliate clinical professor at Florida Atlantic University's Charles E. Schmidt College of Medicine, where he has been a preceptor for first and second year medical students, and participates in clinical activities such as elective rotations with the third and fourth year medical students and second and third year internal medicine residents.?He is currently chairperson of the Medical Staff Excellence Committee (peer review) at Boca Raton Regional Hospital, where he previously served as chief of medicine from 2011 to 2013.?He maintains privileges at Boca Raton Regional Hospital and Delray Medical Center.
Dr. Alboukrek was born in Mexico City and grew up in Guatemala, where he attended medical school. He went on to complete a family medicine residency program in Guatemala City before moving to the United States. He did a one-year fellowship in child psychiatry at the Children's Hospital in Philadelphia, followed by a residency in internal medicine at Berkshire Medical Center in Pittsfield, Massachusetts. He then completed a fellowship in rheumatology at the University of Texas Health Science Center in San Antonio, Texas. Before moving to Boca Raton in 1995, he was in practice with Berkshire Orthopedic Associates in Massachusetts.
Alboukrek has been a member of multiple medical societies in the USA and abroad. He is a fellow of the American College of Rheumatology. He is a member of the Florida Medical Association, Florida Society of Rheumatology, and the Palm Beach County Medical Society. He has had active roles in the Osteoporosis Diagnostic and Treatment Center of South Florida and the RASF–Clinical Research Center, and has provided care to indigent patients at the Whelton Virshup Creaky Joints Arthritis Clinic for many years.
When not at work he is most likely playing pickleball or ping pong somewhere.

Sian Yik Lim, MD
Medical Reviewer
Lim has authored several book chapters, including one titled “What is Osteoporosis” in the book Facing Osteoporosis: A Guide for Patients and their Families. He was also an editor for?Pharmacological Interventions for Osteoporosis, a textbook involving collaboration from a team of bone experts from Malaysia, Australia, and the United States.

Dania Masseoud, MD
Medical Reviewer
Dania Masseoud, MD, founded Atlanta Rheumatology Consultants in 2007, where she focuses on the whole patient and strives to achieve a successful quality of life for her patients.
She attended Agnes Scott College for her undergraduate degree, earning a bachelor's degree in chemistry and biochemistry. She attended Emory University for medical school, residency, and fellowship, then served on staff at Emory Clinic for two years. She is board-certified in both rheumatology and internal medicine.
Dr. Masseoud is a board member of the Georgia chapter of the National Arab American Medical Association and previously served as its president. In addition, she is involved with other medical and humanitarian organizations.

Reyna Franco, RDN
Medical Reviewer
Reyna Franco, RDN, is a New York City–based dietitian-nutritionist, certified specialist in sports dietetics, and certified personal trainer. She is a diplomate of the American College of Lifestyle Medicine and has a master's degree in nutrition and exercise physiology from Columbia University.
In her private practice, she provides medical nutrition therapy for weight management, sports nutrition, diabetes, cardiac disease, renal disease, gastrointestinal disorders, cancer, food allergies, eating disorders, and childhood nutrition. To serve her diverse patients, she demonstrates cultural sensitivity and knowledge of customary food practices. She applies the tenets of lifestyle medicine to reduce the risk of chronic disease and improve health outcomes for her patients.
Franco is also a corporate wellness consultant who conducts wellness counseling and seminars for organizations of every size.?She taught sports nutrition to medical students at the Albert Einstein College of Medicine, taught life cycle nutrition and nutrition counseling to undergraduate students at LaGuardia Community College, and precepts nutrition students and interns. She created the sports nutrition rotation for the New York Distance Dietetic Internship program.
She is the chair of the American College of Lifestyle Medicine's?Registered Dietitian-Nutritionist Member Interest Group. She is also the treasurer and secretary of the New York State Academy of Nutrition and Dietetics, having previously served in many other leadership roles for the organization, including as past president, awards committee chair, and grant committee chair, among others. She is active in the local Greater New York Dietetic Association and Long Island Academy of Nutrition and Dietetics, too.

Alexa Meara, MD
Medical Reviewer
Alexa Meara, MD, is an assistant professor of immunology and rheumatology at The Ohio State University.?She maintains a multidisciplinary vasculitis clinic and supervises a longitudinal registry of lupus nephritis and vasculitis patients. Her clinical research is in improving patient–physician communication. She is involved in the medical school and the Lead-Serve-Inspire (LSI) curriculum and serves on the medical school admissions committee; she also teaches multiple aspects of the Part One curriculum. Her interests in medical-education research include remediation and work with struggling learners.
Dr. Meara received her medical degree from Georgetown University School of Medicine in Washington, DC.? She completed her internal medicine training at East Carolina University (ECU) at Vidant Medical Center in Greenville, North Carolina, then spent two more years at ECU, first as chief resident in internal medicine, then as the associate training program director for internal medicine. She pursued further training in rheumatology at The Ohio State University in Columbus, completing a four-year clinical and research fellowship?there in 2015.?

Samir Dalvi, MD
Medical Reviewer
Samir Dalvi, MD, is a board-certified rheumatologist. He has over 14 years of experience in caring for patients with rheumatologic diseases, including osteoarthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lupus, and gout.

Yuying Luo, MD
Medical Reviewer
Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City.?She aims to deliver evidence-based, patient-centered, and holistic care for her patients.
Her clinical and research focus includes patients with disorders of gut-brain interaction such as irritable bowel syndrome and functional dyspepsia; patients with lower gastrointestinal motility (constipation) disorders and defecatory and anorectal disorders (such as dyssynergic defecation); and women’s gastrointestinal health.
She graduated from Harvard with a bachelor's degree in molecular and cellular biology and received her MD from the NYU Grossman School of Medicine. She completed her residency in internal medicine at the Icahn School of Medicine at Mount Sinai, where she was also chief resident. She completed her gastroenterology fellowship at Mount Sinai Hospital and was also chief fellow.
- Rheumatoid arthritis: Symptoms and Causes. Mayo Clinic. September 29, 2023.
- Rheumatoid Arthritis. Arthritis Foundation.
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