Hidradenitis suppurativa (HS) and rheumatoid arthritis (RA) are long-term conditions that affect different parts of the body. Many people may not realize that these two illnesses can be related.

Several members of myHSteam have asked if others are also living with rheumatoid arthritis or another type of inflammatory arthritis. One member asked, “Has anyone experienced RA as a comorbidity of HS?” She added, “My doctor is expecting RA.”

Research suggests that people with HS are more likely to develop rheumatoid arthritis. This makes it important for people with HS to understand the symptoms of rheumatoid arthritis. Read more to learn about rheumatoid arthritis and the connection between rheumatoid arthritis and HS.

Rheumatoid Arthritis: An Overview

Rheumatoid arthritis is a chronic autoimmune condition. It is one of the many health conditions (comorbidities) that can occur alongside HS. In rheumatoid arthritis, the immune system, which usually fights off germs, mistakenly attacks the body’s own tissues, especially the lining of the joints. This causes inflammation of the joints and can lead to joint damage over time. Rheumatoid arthritis can make it difficult to move and perform everyday activities, like opening a jar or walking.

Rheumatoid arthritis can affect anyone, but its prevalence is higher in women than men. It usually starts between the ages of 30 and 50, but young people and older adults can get it, too. While there’s no cure for rheumatoid arthritis, treatments are available that can help manage the symptoms and improve quality of life.

Symptoms of Rheumatoid Arthritis

Signs and symptoms of rheumatoid arthritis can include:

• Joint pain, swelling, and stiffness
• Decreased flexibility of the joints
• Fatigue
• Weakness
• Fever
• Weight loss

Pain, swelling, and stiffness can occur in any joint but most often affect the small joints in the wrists, hands, and feet. Joint stiffness is usually worse in the morning or after periods of rest. It may last an hour or more but generally improves with movement.

In addition to small joints, rheumatoid arthritis can also affect larger joints or other organs, like the eyes or lungs. Symptoms of rheumatoid arthritis tend to come and go. When symptoms return or worsen, it’s called a flare. When symptoms improve or go away for a while, it’s called remission.

Causes of Rheumatoid Arthritis

The exact cause of rheumatoid arthritis isn’t known, but it’s believed to result from a mix of genetic factors (traits passed down from parents) and environmental factors. If someone in your family has rheumatoid arthritis, you may be more likely to develop it, because certain genes can increase your risk. However, having these genes doesn’t guarantee you will get rheumatoid arthritis. Environmental factors, like smoking, can also increase the risk of rheumatoid arthritis and worsen symptoms. Sex is another risk factor. Women are two to three times more likely to develop rheumatoid arthritis than men.

Diagnosing Rheumatoid Arthritis

To be diagnosed with rheumatoid arthritis, you will need to see a rheumatologist. A rheumatologist is a doctor who specializes in diagnosing and treating conditions such as arthritis and autoimmune disorders. They will review your health history, do a physical exam, and order blood tests and scans (such as X-rays or MRIs). If you are diagnosed with rheumatoid arthritis, they will start you on treatment to reduce inflammation, relieve symptoms like pain or swelling, and prevent long-term damage to your joints.

When To Seek Help for Rheumatoid Arthritis

If you have joint pain, swelling, or stiffness that doesn’t go away, talk to a rheumatologist about rheumatoid arthritis. They can run tests to check for rheumatoid arthritis and other conditions that might cause similar symptoms. Getting the right diagnosis early is critical, as early treatment can help prevent worsening symptoms and joint damage, ultimately improving your quality of life.

What Is the Relationship Between HS and Rheumatoid Arthritis?

Inflammatory arthritis is a group of conditions involving inflammation of the joints. Rheumatoid arthritis is one type of inflammatory arthritis. A recent study found that people with hidradenitis suppurativa have a greater chance of developing inflammatory arthritis than people without HS. The study also found that people with HS are nearly two times more likely to develop rheumatoid arthritis than people without HS.

Another study found that people with a history of rheumatoid arthritis are also at a higher risk of developing HS later in life. Among people with HS, people over 30 have an increased risk of developing rheumatoid arthritis.

The exact reasons why HS and rheumatoid arthritis may be linked are not fully understood, and very few studies have explored their relationship. However, the inflammation processes that happen in both diseases may explain the overlap between the two. Other possible reasons people experience HS and rheumatoid arthritis together include genetic factors, immune system problems, unusual levels of certain proteins in the body, and environmental influences.

Risk Factors for HS and Rheumatoid Arthritis

Although researchers are still trying to understand the association between HS and rheumatoid arthritis, the risk factors shared by the two conditions can help us understand why someone might have both. One major risk factor is cigarette smoking. Both conditions are more likely to occur in people who smoke, suggesting that nicotine may play a role in their development.

Another risk factor is that it more commonly affects females. Both HS and rheumatoid arthritis are more common in women, which suggests that estrogen may play a role in predisposing individuals to these conditions.

Managing and Treating HS and Rheumatoid Arthritis Together

Managing both HS and rheumatoid arthritis can be challenging, but it’s possible with the right approach. Treatment for each condition often involves medication to control the immune system and reduce inflammation. For rheumatoid arthritis, common treatments include disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate or biologics. DMARDs are medications that help slow down or stop damage caused by rheumatoid arthritis. They work by calming the immune system so it doesn’t attack the joints as much, which can reduce pain, swelling, and long-term joint damage.

Some treatments for rheumatoid arthritis and HS overlap. For example, the biologic adalimumab (Humira) is approved by the U.S. Food and Drug Administration (FDA) to treat both conditions. Another biologic, secukinumab (Cosentyx), is FDA-approved for HS and other types of inflammatory arthritis, including ankylosing spondylitis and psoriatic arthritis. Other treatment options for HS may include antibiotics and anti-inflammatory medications.

If you have HS and rheumatoid arthritis, it’s important to work closely with your health care team, including your dermatologist, to find the best treatment plan for both conditions. They can help you manage symptoms and adjust treatments as needed to keep both conditions under control. Remember, managing these conditions is a team effort, and you can lead a healthy and active life with the right support.

Talk With Others Who Understand

On myHSteam, the social network for people with HS and their loved ones, more than 44,000 members come together to ask questions, give advice, and share their stories with others who understand life with HS.

Are you living with hidradenitis suppurativa? Do you have concerns about rheumatoid arthritis? Share your experience in the comments below, or start a conversation by posting on your Activities page.