The Educated Patient Podcast: Understanding Rheumatoid Arthritis

In recognition of World Arthritis Day, the third episode of The Educated Patient Podcast features host Mike DeMarco in conversation with Saloni Mitchell, M.D., assistant professor of Medicine in the Division of Rheumatology at Mount Sinai West/Morningside Hospital. Together, they discuss rheumatoid arthritis (RA) — what it is, how it develops and how patients can best manage it.

Mitchell shares that her path to rheumatology began during medical school, when she saw firsthand how rheumatologists build long-term relationships with patients and help them live better with chronic diseases once thought to be disabling. Today, she practices primarily in Manhattan, where she focuses on patient care and education.

She explains that not all arthritis is the same. While osteoarthritis — caused by wear and tear — makes up about 90% of cases, rheumatoid arthritis falls into the “inflammatory” category, in which the immune system mistakenly attacks the joints. Other forms of inflammatory arthritis include psoriatic arthritis and lupus-related arthritis. Mitchell notes that RA arises from a complex interplay between genetic and environmental factors, such as stress, infections or smoking. Women are more often affected, in part due to hormonal and genetic factors.

Early, aggressive treatment is critical, she emphasizes, because it helps prevent joint damage and improves long-term outcomes, including overall health and cardiovascular risk. Building a care team that includes a rheumatologist, primary care doctor and physical or occupational therapist can make a big difference.

Lifestyle habits — such as healthy eating, sleep, and exercise — also play important roles. While these alone can’t prevent RA, Mitchell encourages patients to adopt an anti-inflammatory, Mediterranean-style diet rich in fruits, vegetables, olive oil and lean protein, and to stay active with low-impact exercises such as yoga or swimming.

The conversation also explores new developments, from GLP-1 medications, which may reduce inflammation, to the growing role of artificial intelligence in diagnosing disease and improving patient care. Mitchell envisions a future of personalized medicine, where doctors can tailor RA treatment based on an individual’s biology rather than trial and error.

Her final message for patients: learn as much as you can about your treatment, communicate openly with your care team, and don’t hesitate to seek a second opinion. Managing RA is a partnership — and staying informed and engaged is the best way to take control of your health.