Rheumatoid arthritis (RA) is a disease that mainly affects joints, and is a result of the body's immune system which targets and attacks joint linings. While RA may affect other tissues and organs, joints bear the blunt. Rheumatoid arthritis is not the same as osteoarthritis, a condition that also affects joints but results from wear and tear. The causes of rheumatoid arthritis are not known for sure. However, doctors believe that genetics and the environment are involved. If RA is left untreated, the damages to the joints may be worsened, leading to loss of shape, alignment and functionality of the joint.

What Causes Rheumatoid Arthritis?

1. Genes

Research has shown that a person with a genetic marker named HLA shared epitope, is five times more likely to develop rheumatoid arthritis than a person who doesn't have the marker. HLA site within human genes is responsible for immune responses. RA is also associated with other genes, including STAT4 which is involved in regulating and activating the immune system; TRAF1 and C5 which have a part to play in chronic inflammation; and PTPN22, a gene that is associated with the onset and progression of RA. However, research has established that not everyone suffering from RA has these genes, nor do all people with these genes develop rheumatoid arthritis.

2. Hormones and Environmental Factors

While studies are ongoing to find out what causes rheumatoid arthritis, observations have indicated that some factors may trigger the onset of RA in people whose genetic makeup make them more prone to its development. These factors include:

• Infection causing bacteria and viruses
• Obesity
• Female hormones–women constitute 70 percent of people with RA
• The body's response to stress, physical and emotional trauma

Several studies indicate that some environmental factors may contribute to an individual's risk to develop rheumatoid arthritis as well. These factors include

• Air pollution
• Exposure to cigarette smoke
• Exposure to insecticides
• Occupational exposure to chemicals such as mineral oil and silica

What Can Trigger Rheumatoid Arthritis Flares?

It is not known what causes rheumatoid arthritis flares, however, you need to be aware of the following contributing factors:

1. Stress

Studies of people with rheumatoid arthritis have indicated that RA flares come during times of increased stress. 16 studies reviewed in 2010 show that stress can definitely trigger RA flares.

2. Infection

Because RA medications depress the immune system, they leave the body exposed to various infections and with a weakened immunity, even minor infections such as the common cold can become serious. One study conducted in 2012 with 584 rheumatoid arthritis patients found that about 50 percent of the subjects suffered from several infections, requiring intravenous antibiotics or hospitalization.

3. Foods

Many RA patients and doctors are in agreement that some food items can trigger RA flares. However, the specific foods cannot be enumerated because they are not the same for everybody. While some people may suffer from food allergies, others may have sensitivity to chemicals in the food. Keep a diet journal to track the foods you eat throughout the day to find the exact food that may cause RA flare.

4. Fatigue

Overexertion by people who have rheumatoid arthritis can lead to increased fatigue, inflammation and even trigger RA flare. Studies have shown that fatigue can arise due to physical or psychological reasons. Chemicals known as cytokines increase inflammation and fatigue in people who have RA. To curb these chemicals and reduce fatigue, new medications known as biologics have been developed.

5. Pregnancy

Pregnancy presents a time of RA remission as the immune system becomes less active during pregnancy. A review of several studies carried out in 2011, concerning RA and pregnancy found that 75 percent of women with RA have RA remission during pregnancy. However, within the first year following pregnancy, 90 percent of women with RA have flares. Pregnancy or the end of pregnancy has therefore been found to trigger RA flare.

Possible Complications of Rheumatoid Arthritis

While what causes rheumatoid arthritis is not known, you have a higher risk of developing the following complications if you suffer from RA:

• Osteoporosis: Rheumatoid arthritis and some of the medications used to treat RA may increase the risk of osteoporosis. The patient's bones may be weakened and tend to get fracture easily. 
• Rheumatoid Nodules: RA can lead to the formation of rheumatoid nodules. These collections of tissue can form small bumps located around the elbows, and other joints that are affected by RA. 
• Dry Eyes and Mouth: RA victims may develop a disorder known as Sjogren's syndrome, a condition in which the eyes and mouth have low moisture.
• Infections: The RA disease and several medications used to treat it depress the immune system, leading to a higher risk of infection. 
• Carpal Tunnel Syndrome: When rheumatoid arthritis affects the wrists, most of the nerves serving the hands and fingers are affected by the inflammation.
• Heart Problems: Rheumatoid arthritis can lead to an increased risk of inflammation of the heart's enclosing sac, as well as blocked and hardened arteries.
• Lung Disease: Rheumatoid arthritis can cause inflammation and scarring within the lungs, leading to breathing problems.
• Lymphoma: Rheumatoid arthritis raises the risk of blood cancers, lymphoma, and other problems of the lymph system.

Can You Prevent Rheumatoid Arthritis?

While what causes rheumatoid arthritis remains a mystery, research has identified certain genetic markers which indicate that some groups of people are more likely to get RA. Other factors such as bad habits can also trigger RA. There are ways to reduce your chance of developing RA:

• Shed excess weight. This is even more important if you are under the age of 55. Obese people have a higher chance of developing rheumatoid arthritis.
• Brush your teeth. New research suggests that RA is linked to periodontal (gum) disease. Having regular dental checkups and brushing your teeth regularly might save you from RA.
• Consult your doctor. While a visit to your doctor will not stop you from getting RA, it can ensure that you get treatment sooner. This will reduce the effects of RA and its damage to your joints. If you notice any RA symptoms, consult your doctor as soon as possible.