How Ra Symptoms Progress Over Time
Everyone is different, but there are a few common patterns in the way RA plays out over the years:
- Long remissions. When you’re in one of these periods, your pain and stiffness go away or get much better, but you aren’t cured. In a few people with RA — about 5% to 10% — the disease starts suddenly, and then they have no symptoms for many years, even decades.
- Symptoms that come and go. This happens to about 15% of people with rheumatoid arthritis. You may have periods of few or no problems that can last months between flare-ups.
- Progressive rheumatoid arthritis. Most people in this situation need a long-term treatment plan and a coordinated medical team to manage the condition and slow or stop it from getting worse.
How Is Ra Diagnosed
Doctors that specialize in diagnosing RA and other types of arthritis are called rheumatologists. If your primary care provider suspects you might have RA or another type of arthritis, he or she may refer you to a rheumatologist for testing.
A rheumatologist will diagnose RA based on several tests. These include blood tests, imaging tests such as X-rays and MRIs and a physical examination.
Blood tests search for a protein called rheumatoid factor and antibodies called anticitrullinated protein antibodies . Other tests such as the erythrocyte sedimentation rate test and C-reactive protein test can find high levels of inflammation present in people with RA.
These tests also help doctors distinguish RA from other types of arthritis such as gout, osteoarthritis, lupus and psoriatic arthritis.
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Small Joint Inflammation: Symptoms In The Fingers Wrists Toes And Ankles
For more than half of RA patients, the first symptoms will occur in one or more of the small joints of the fingers , the wrists, the toes , or the ankles. Symptoms can begin slowly and subtly over a period of weeks or months, worsening over time.
In the majority of patients, this swelling and pain is symmetrical, meaning the same joints are affected on both sides of the body.
But this is not always the case. Its important not to wait to treat until the disease becomes symmetric. Early diagnosis and treatment are key to prevent joint damage even if only one joint on one side of the body is affected, notes Rebecca Manno, MD, a rheumatologist and adjunct assistant professor of medicine at the Johns Hopkins University School of Medicine in Baltimore.
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Overview Of Rheumatoid Arthritis
Rheumatoid arthritis is a chronic inflammatory disease that mostly affects joints. RA causes pain, swelling, stiffness, and loss of function in joints. It is an autoimmune disorder because the immune system attacks the healthy joint tissues. Normally, the immune system helps protect the body from infection and disease.
Additional features of rheumatoid arthritis can include the following.
- It affects the lining of the joints, which damages the tissue that covers the ends of the bones in a joint.
- RA occurs in a symmetrical pattern, meaning that if one knee or hand has the condition, the other hand or knee does, too.
- It affects the joints in the wrist, hands, feet, spine, knees, and jaw.
- RA may cause fatigue, occasional fevers, and a loss of appetite.
- RA may cause medical problems outside of the joints, in areas such as the heart, lungs, blood, nerves, eyes, and skin.
Fortunately, current treatments can help people with the disease to lead productive lives.
Does Rheumatoid Arthritis Come On Suddenly
Asked by: Bruce Erdman
In a few people with RA — about 5% to 10% — the disease starts suddenly, and then they have no symptoms for many years, even decades. Symptoms that come and go. This happens to about 15% of people with rheumatoid arthritis. You may have periods of few or no problems that can last months between flare-ups.
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Can I Live A Normal Life With Rheumatoid Arthritis
Many people can live a healthy, active life with RA. It is difficult to predict the exact impact that RA will have on a persons life expectancy because the course of the disease differs significantly between people. In general, it is possible for RA to reduce life expectancy by around 10 to 15 years.
How Quickly Can Ra Really Come On
Pls help me, my dr thinks I have RA following a high Rheumatoid factor reading, symptoms including swollen hand joints and awful foot pain in both feet causing limping, an urgent rheumatology referral has been made.. But over the last week only one of my shoulders has started to hurt, then today it’s like my shoulder symptoms exploded! Suddenly I cannot lift my arm above my waist, majorly restricted movement. My prescribed codeine isn’t touching the pain… Is this RA, can it really hit that quickly? I haven’t injured my shoulder at all. Thanks
1 like, 37 replies
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Sudden arthritis is not a real medical condition, but the symptoms of arthritis namely, joint pain and swelling can develop very abruptly in some people, according to the Centers for Disease Control and Prevention .
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Arthritis can also come and go, so you could feel tip-top one day and wake up feeling sore and achy the next.
Heres more on why arthritis might seem to come on all of a sudden, including when you should call a doctor about your symptoms.
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Stage : Antibodies Develop And Swelling Worsens
In many cases, RA progresses to the second stage without being diagnosed. In the second stage the body makes the antibodies and the joints start swelling up, Dr. Bhatt says. It can affect other organ systems and cause inflammation there: the lungs, the eyes, a skin rash, and it can even affect the heart. Lumps on the elbows called rheumatoid nodules may also develop.
When it comes to imaging results, the second stage is more confirmative for the diagnosis, Dr. Bhatt says. It has kind of a moth-eaten, chipped off appearance on the X-rays. Ultrasound can also be done, and the most sensitive is an MRI, which would pick up if there are any problems even if the X-ray is normal.
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How Quickly Does Rheumatoid Arthritis Come On
The symptoms of rheumatoid arthritis often develop gradually over several weeks, but some cases can progress quickly over a number of days. The symptoms vary from person to person. They may come and go, or change over time. You may experience flares when your condition deteriorates and your symptoms become worse.
What Are Medical Treatments For Rheumatoid Arthritis
Rheumatoid arthritis is a progressive inflammatory disease. This means that unless the inflammation is stopped or slowed, the condition will continue to worsen with joint destruction in most people. Although rheumatoid arthritis does occasionally go into remission without treatment, this is rare. Starting treatment as soon as possible after diagnosis of rheumatoid arthritis is strongly recommended. The best medical care combines medication and nondrug approaches.
Nondrug approaches include the following:
Drug approaches include a variety of medications used alone or in combinations.
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How Common Are Ra Flare Ups In The Back
Rheumatoid arthritis is a complex condition that can affect many joints. Since RA is inflammation of a joints synovial membrane, any joints with such a membrane are fair game, including the facet joints in the spine.
RA flare ups can affect any synovial joint, including the facet joints in your spine.
Dr. Mukai explains that although other joints are more commonly affected, the spine is not immune to RA flare ups. The most common place in the spine affected by RA is the upper neck near the base of the skull. The C1-2 joint at the top of the neck can become inflamed and in severe cases can become unstable or form a pannus that sticks out the back of the spine and can start compressing the spinal cord or even the brain.
Symptoms By Body Part
The most commonly affected areas during the onset of RA are the small joints in your hands and feet. This is where you may first feel stiffness and an ache.
Its also possible for RA inflammation to affect your knees and hips. Because the disease presents differently in different people, it can go on to affect almost any joint.
Your organs are another area that can be disrupted by RA inflammation:
- Your heart muscle can become damaged.
- Your lungs can become scarred.
- Blood vessel damage can lead to subsequent skin and nerve issues.
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How Rheumatoid Arthritis Is Treated
There is no cure for rheumatoid arthritis, but early diagnosis and appropriate treatment enables many people with rheumatoid arthritis to have periods of months or even years between flares and to be able to lead full lives and continue regular employment.
The main treatment options include:
- medication that is taken in the long-term to relieve symptoms and slow the progress of the condition
- supportive treatments, such as physiotherapy and occupational therapy, to help keep you mobile and find ways around any problems you have with daily activities
- surgery to correct any joint problems that develop
Read more about treating rheumatoid arthritis.
Complications Of Rheumatoid Arthritis
- Cardiopulmonary disease resulting from RA can take different forms. Your breathing may be affected either with pleurisy or intrapulmonary nodules . Pericarditis and atherosclerosis can both cause chest pain. Atherosclerosis is the leading cause of death in RA so be sure to tell your doctor if you experience any chest pain symptoms.
- Sjögrens syndrome develops in 10-15 percent of RA patients. Sjögren’s is characterized by dry eyes and/or a dry mouth.
- Peripheral neuropathy or nerve damage is an occasional complication of the nervous system in RA patients. It is typically a mild numbing feeling in the lower extremities like your legs and feet that can cause poor coordination. Other neuropathies can occur because RA causes joint tissue swelling that compresses the nerve tissue. Carpal tunnel symptoms can often be relieved by a cortisone shot to the wrist. If this is not successful, surgery may be required to open the tunnel and relieve pressure on the nerve.
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Causes Of Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune condition, which means it is caused by the bodys immune system attacking itself. However, it is not yet known what triggers this.
Normally, your immune system makes antibodies that attack bacteria and viruses, helping fight infection. But if you have rheumatoid arthritis, your immune system mistakenly sends antibodies to the lining of your joints, where they attack the tissue surrounding the joint.
This causes the thin layer of cells covering your joints to become sore and inflamed.
This inflammation in turn causes chemicals to be released that thicken the synovium and damage nearby:
- National Rheumatoid Arthritis Society : Possible causes and risk factors
Does Stress Affect Rheumatoid Arthritis
Patients commonly report that stress, either physical or emotional, was present or severe when their RA began. This is true in other autoimmune disorders as well. Since the mind-body connection is very real, most doctors agree that there is a link between stress and disease onset or flares.
Because there are clear interactions between the nervous, immune and endocrine systems, the impact of stress on disease presentation and severity is explainable in physiologic terms. Obviously, life is stressful. Thus, how to employ stress reduction in a therapeutic regimen is up to the individual patient, in concert with the physician. Many patients have found benefits from mindfulness programs that facilitate learning tools to reduce the impact of stress.
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Early Detection And Diagnosis
As with most diseases, early detection and diagnosis are crucial for being able to treat symptoms, manage pain, and slow progression. An early diagnosis of RA can help you and your team of physicians and specialists put together an individualized treatment plan so that you can continue living a high quality of life.
Early on, you will want to discuss your case with a rheumatologist or RA specialist who can provide you with the treatment you need to delay the diseases progression. Generally, early diagnosis treatment is aggressive and targeted to properly manage the disease and prevent it from progressing.
If your RA was diagnosed in the early stage when symptoms first appeared, your chances of achieving longer periods of remission typically increase drastically. Thats not to say you wont experience flare-ups. Early diagnosis simply helps manage the disease and cannot guarantee the complete elimination of symptoms.
Whats The Age Of Onset For Rheumatoid Arthritis
RA usually starts to develop between the ages of 30 and 60. But anyone can develop rheumatoid arthritis. In children and young adults usually between the ages of 16 and 40 its called young-onset rheumatoid arthritis . In people who develop symptoms after they turn 60, its called later-onset rheumatoid arthritis .
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Stage : Symptoms Are Visible
In this latter, more severe stage, blood tests and imaging are less relevant for diagnosis because you can actually see the effects of the disease. The joints start becoming bent and deformed, the fingers become crooked, Dr. Bhatt says. These misshapen joints can press on the nerves and can cause nerve pain as well, he says. In the older days we used to see more deformed joints when we did not have much treatment, but now we are seeing less and less, Dr. Bhatt says.
What Happens In Rheumatoid Arthritis
Doctors do not know why the immune system attacks joint tissues. However, they do know that when a series of events occurs, rheumatoid arthritis can develop. This series of events includes:
- A combination of genes and exposure to environmental factors starts the development of RA.
- The immune system may be activated years before symptoms appear.
- The start of the autoimmune process may happen in other areas of the body, but the impact of the immune malfunction settles in the joints.
- Immune cells cause inflammation in the inner lining of the joint, called the synovium.
- This inflammation becomes chronic, and the synovium thickens due to an increase of cells, production of proteins, and other factors in the joint, which can lead to pain, redness, and warmth.
- As RA progresses, the thickened and inflamed synovium pushes further into the joint and destroys the cartilage and bone within the joint.
- As the joint capsule stretches, the forces cause changes within the joint structure.
- The surrounding muscles, ligaments, and tendons that support and stabilize the joint become weak over time and do not work as well. This can lead to more pain and joint damage, and problems using the affected joint.
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Some People Experience Fatigue And Other Flu
Up to a third of patients have more systemic symptoms before or along with joint pain and inflammation. This can include fatigue, muscle pain, mood changes, and low-grade fever. As the digital arthritis community CreakyJoints puts it, “Some patients describe the symptoms of RA as being ‘flu-like’ that general yucky feeling you get when you are on the verge of getting sick.”
Although these symptoms can be an early sign of RA, because they overlap with other illnesses, RA usually isn’t the first thing the doctor considers, especially without joint pain.
Other symptoms many don’t realize can also indicate RA include rashes, easily bruising, itchy and dry eyes, and sharp chest pain brought on my irritation of the costosternal joints, which connect the ribs to the breastbone.
Measures To Reduce Bone Loss
Inflammatory conditions such as rheumatoid arthritis can cause bone loss, which can lead to osteoporosis. The use of prednisone further increases the risk of bone loss, especially in postmenopausal women.
You can do the following to help minimize the bone loss associated with steroid therapy:
- Use the lowest possible dose of glucocorticoids for the shortest possible time, when possible, to minimize bone loss.
- Get an adequate amount of calcium and vitamin D, either in the diet or by taking supplements.
- Use medications that can reduce bone loss, including that which is caused by glucocorticoids.
- Control rheumatoid arthritis itself with appropriate medications prescribed by your doctor.
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How Is Rheumatoid Arthritis Diagnosed
Your healthcare provider may refer you to a physician who specializes in arthritis . Rheumatologists diagnose people with rheumatoid arthritis based on a combination of several factors. Theyll do a physical exam and ask you about your medical history and symptoms. Your rheumatologist will order blood tests and imaging tests.
The blood tests look for inflammation and blood proteins that are signs of rheumatoid arthritis. These may include:
- Erythrocyte sedimentation rate or sed rate confirms inflammation in your joints.
- C-reactive protein .
- About 80% of people with RA test positive for rheumatoid factor .
- About 60% to 70% of people living with rheumatoid arthritis have antibodies to cyclic citrullinated peptides .
Your rheumatologist may order imaging tests to look for signs that your joints are wearing away. Rheumatoid arthritis can cause the ends of the bones within your joints to wear down. The imaging tests may include:
In some cases, your provider may watch how you do over time before making a definitive diagnosis of rheumatoid arthritis.