The history of rheumatoid arthritis (RA) goes back hundreds of years. Scientists are not sure how long humans have been experiencing it, but doctors first described the condition around 1800 and named it RA in 1890.

French physicians studied the condition that would become known as RA in the 19th century, learning more about it and trying early treatments, such as cold therapy and hot water baths.

In 1948, glucocorticoid treatment emerged, which reduced symptoms. Later, disease-modifying antirheumatic drugs (DMARDs) became available. These drugs slow the progression of RA.

Keep reading to learn more about RA history, including its discovery, early treatment, research, and origins.

Old photo of physiotherapists lowering a person with RA into a pool to do exercises.Share on Pinterest
Physiotherapists lower a patient with rheumatoid arthritis into a thermal pool so that they can begin exercises. © Hulton-Deutsch Collection/CORBIS/Corbis via Getty Images

The first written description of RA is from the year 1800. It came from French physician Augustin Jacob Landré-Beauvais, who wrote about his treatment of a few patients with severe joint pain.

He noticed the symptoms differed from other known conditions, such as osteoarthritis and gout. Unlike gout, this type of joint pain tended to affect people who were poor and occurred more often in females than males.

Landré-Beauvais believed this condition was one that medical literature had not described before. He called it “primary asthenic gout.” While his classification of the disease as a form of gout was inaccurate, his research spurred further study of the illness.

In the mid to late 1800s, the English physician Alfred Garrod separated gout from other arthritic conditions. This happened when he found high levels of uric acid in the urine of people with gout but not in those with other types of arthritis.

In 1859, Alfred Garrod wrote a treatise that differentiated arthritis from gout and described RA as a separate condition, which he called “rheumatic gout.”

One of Alfred Garrod’s sons, Archibald Garrod, was among the doctors who continued to research RA. In 1890, he wrote a treatise on the condition but gave it a different name: rheumatoid arthritis.

Garrod believed this name more accurately portrayed the condition’s effects. It describes joint inflammation (arthritis) that resembles rheumatism (rheumatoid), an old medical term for joint pain and swelling.

Previously, doctors believed joint swelling occurred due to a buildup of “rheum,” or watery discharge, in the joints. This is where the words “rheumatoid” and “rheumatology” come from.

According to the historical evidence, some of the past treatments people used for RA included:

  • Cold water therapy: This entails taking cold showers or ice baths. Some people still use this approach to relieve symptoms, using ice packs or pads on painful joints. Research from 2017 found that whole-body cold water therapy may reduce pain from inflammatory arthritis, but more studies are necessary.
  • Hot water baths: This refers to taking a long bath in hot water. An older 2015 review investigating the value of hot baths and mineral baths did not find evidence that it is effective.
  • Counter irritants: This involves the use of a cream that produces surface irritation on the skin, which produces warmth and reduces underlying pain, according to an older 2010 study.
  • Bloodletting: This entails removing blood from a person through various means, such as taking it from a vein or using leeches. People have practiced bloodletting for at least 3,000 years, but in Western medicine, doctors no longer use it.
  • Willow bark: Some ancient cultures used willow bark to relieve pain and inflammation. Willow bark contains compounds that are similar to modern-day aspirin, but despite anecdotal evidence that willow bark helps, few studies have explored its effects on RA.

Since the discovery of RA as a distinct condition, research has led to the development of a number of evidence-based treatments for the condition, including:

  • Glucocorticoids: In 1948, a rheumatologist discovered that glucocorticoids, such as prednisone (Rayos), can help relieve RA symptoms and lower inflammation.
  • Antimalarial drugs: In 1957, a doctor used chloroquine (Aralen) to treat joint inflammation. Today, doctors widely use hydroxychloroquine (Plaquenil) to treat many rheumatic conditions because of its effectiveness.
  • DMARDs: These drugs can slow the progression of RA. The Food and Drug Administration (FDA) approved the first drug in this class, methotrexate (Otrexup), for RA in 1988.
  • Biologic agents: Biologic disease-modifying agents, which are also DMARDs — such as infliximab (Remicade) — can inhibit a substance called tumor necrosis factor (TNF). TNF causes inflammation and is high in people with RA. These medications came on the market in 1998.
  • Janus kinase (JAK) inhibitors: Doctors may prescribe one of these medications for someone who cannot take methotrexate alone. The first one, tofacitinib (Xeljanz), came on the market in 2012.

There are differing theories about how long humans have been experiencing RA.

One theory is that the condition dates back to ancient times. Archibald Garrold was a proponent of this theory and described ancient skeletal remains from Pompeii and Egypt that he believed showed signs of damage from RA.

Some scientists who believe RA was present in ancient times argue that there is evidence of its existence dating back to at least 3,000 B.C.E. The ancient Greek physician Hippocrates also described a condition that resembles RA in 400 B.C.E., but at that time, doctors did not distinguish between the different types.

Another theory is that RA is a modern disease, only developing due to modern lifestyles and diets. An older 2016 research article notes that it is possible both theories may be true.

The authors explain that people may have had RA in ancient times, but due to a lower life expectancy, they may not have lived long enough to manifest all the symptoms. RA symptoms typically begin between the ages of 30 and 65 years.

A 2017 study examined the incidence and prevalence of RA from 1990–2014 in the United Kingdom. According to this data, RA is not becoming more common. In fact, the authors found a decrease in the incidence and prevalence of RA in recent years.

Not much earlier data exists, though, so scientists do not know if rates of RA have increased over the centuries.

Rheumatoid arthritis history shows that treatment has come a long way since physicians first described the condition in the 19th century. The use of glucocorticoids has helped relieve symptoms, and the advent of DMARDs has helped slow the progression in many cases.

RA remains a challenging condition to live with, but due to these advances, the outlook for people with the condition has improved. There is also ongoing research that may improve RA treatment in the future, such as the development of nanoparticles, which can carry existing drugs to specific tissues in the body.

Another area of future study may involve individualized targeted therapies, which are tailored to each person. This may yield better results with fewer side effects, similar to some cancer treatments.