As Rheumatoid Arthritis progresses, the body changes. Some changes you can see and feel, while others you cannot. Each stage of Rheumatoid Arthritis comes with different treatment goals.
Stage 1 of Rheumatoid Arthritis
Stage 1 is early-stage Rheumatoid Arthritis. Many people feel joint pain, stiffness, or swelling. During stage 1, there’s inflammation inside the joint. The tissue in the joint swells up. There’s no damage to the bones, but the joint lining, called the synovium, is inflamed.
Stage 2 of Rheumatoid Arthritis
Stage 2 is moderate-stage Rheumatoid Arthritis. In this stage, the synovium’s inflammation causes damage to the joint cartilage. Cartilage is the tissue that covers the end of bones at the site of joints.
When cartilage is damaged, people may experience pain and loss of mobility. The range of motion in the joints may become limited.
Stage 3 of Rheumatoid Arthritis
Once Rheumatoid Arthritis has progressed to stage 3, it’s considered severe. At this point, the damage extends not only to the cartilage but also to the bones themselves. Since the cushion between bones is worn away, they’ll rub together.
There may be more pain and swelling. Some people may experience muscle weakness and more mobility loss. The bone can be damaged (erosion), and some deformities may occur.
Stage 4 of Rheumatoid Arthritis
At stage 4, there’s no longer inflammation in the joint. This is end-stage Rheumatoid Arthritis when joints no longer work.
In end-stage Rheumatoid Arthritis, people may still experience pain, swelling, stiffness, and mobility loss. There may be reduced muscle strength. The joints may become destroyed, and the bones become fused together (ankylosis).
Progression through all four stages can take many years, and some people don’t progress through all stages within their lifetime.
Some people have periods of no Rheumatoid arthritis activity. In some cases, this may mean that Rheumatoid Arthritis has gone into remission.
Signs Rheumatoid Arthritis is progressing
Most people with Rheumatoid Arthritis experience a gradual worsening of symptoms. There may be periods of relief, where Rheumatoid Arthritis is more manageable. At other times, Rheumatoid Arthritis symptoms may flare up and be more intense.
How your condition progresses depends on many factors, including:
Family history of Rheumatoid Arthritis
Age at diagnosis
Stage of Rheumatoid Arthritis at diagnosis
Any disease triggers that are specific to you
The presence of certain antibodies in your blood
By considering these factors, your doctor can help you better understand how your condition is progressing.
However, keep in mind that it’s impossible to predict exactly how Rheumatoid Arthritis will progress over time in any individual person. Even if you have family members with Rheumatoid Arthritis, your condition may progress differently from theirs.
Another common pattern occurs when people experience strong attacks in the early stages of Rheumatoid Arthritis, followed by periods with minimal disease activity.
Less than 10% of people with Rheumatoid Arthritis fall into spontaneous remission within the first 6 months of the onset of their symptoms. Remission from Rheumatoid arthritis has a precise medical definition.
In general, it means that Rheumatoid Arthritis disease activity stops. Patients who do not demonstrate the disease markers anti-cyclic citrullinated peptide (anti-CCP) antibody and rheumatoid factor have a greater chance of achieving remission.
How does your treatment change as Rheumatoid Arthritis progresses?
When it comes to treating Rheumatoid Arthritis, your doctor will consider different medication options and recommend a treatment plan for you.
The treatment plan will depend on:
The stage of Rheumatoid Arthritis
The severity of your symptoms and degree of inflammation
How long you’ve been living with Rheumatoid Arthritis
Different types of common medication for Rheumatoid Arthritis perform different roles. Some examples include:
NSAIDs and steroids reduce inflammation.
Disease-modifying antirheumatic drugs (DMARDs) help save joint tissue by slowing the increase in Rheumatoid Arthritis progression by suppressing your body’s immune and inflammatory responses.
Biologic drugs work specifically on the immune system to change the body’s inflammatory response.
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