Wednesday, July 17, 2024

What Are The Four Stages Of Rheumatoid Arthritis

Does Rheumatoid Arthritis Cause Fatigue

Rheumatoid Arthritis (RA) Signs & Symptoms (& Associated Complications)

Everyones experience of rheumatoid arthritis is a little different. But many people with RA say that fatigue is among the worst symptoms of the disease.

Living with chronic pain can be exhausting. And fatigue can make it more difficult to manage your pain. Its important to pay attention to your body and take breaks before you get too tired.

What are rheumatoid arthritis flare symptoms?

The symptoms of a rheumatoid arthritis flare arent much different from the symptoms of rheumatoid arthritis. But people with RA have ups and downs. A flare is a time when you have significant symptoms after feeling better for a while. With treatment, youll likely have periods of time when you feel better. Then, stress, changes in weather, certain foods or infections trigger a period of increased disease activity.

Although you cant prevent flares altogether, there are steps you can take to help you manage them. It might help to write your symptoms down every day in a journal, along with whats going on in your life. Share this journal with your rheumatologist, who may help you identify triggers. Then you can work to manage those triggers.

What About Juvenile Ra

It’s important to note that juvenile idiopathic arthritis , an umbrella diagnosis for several types of arthritis that affect kids and teens, is not the same as adult rheumatoid arthritis in most cases. In fact, JIA used to be called juvenile RA, but the name was changed to firmly make this distinction.

Only one type of JIA, polyarticular arthritis positive for IgM rheumatoid factor, is believed to be the same disease as adult RA.

Among the differences between JIA and RA is how they progress. And while RA is a lifelong, progressive condition without exception, some kids can “outgrow” some forms of JIA.

Given this, information you read about adult RA cannot be considered applicable to all children with JIA. It’s important that you speak with your child’s healthcare providers to learn more about what their JIA diagnosis could mean for them.

Ra Progression Isnt Inevitable

Thanks to the newer treatments available and more on the horizon RA doesnt have to mean a life of eventual disability or even limited mobility. Its not an inevitable thing nowadays, says Dr. Bhatt. People can have a normal life.

But patients do have to be sure to follow their treatment plan and doctors recommendations. Routine follow-up with a rheumatologist who performs joint exams, follows levels of systemic inflammation in the blood and can assess function is the best way to ensure RA is being controlled and is not progressing, Dr. Lally says.

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Stage : The Early Stage

Early stage rheumatoid arthritis often causes joint stiffness, swelling and pain, as well as fatigue. The key to alleviating these symptoms and preventing damage to the joints is to address inflammation as quickly as possible.

Your healthcare provider may prescribe steroids along with a disease-modifying antirheumatic drug for this purpose. DMARDs can help prevent irreversible damage from happening to your joints, as well as slow down the advancement of rheumatoid arthritis. Methotrexate, a drug originally created to treat cancer, is the DMARD most often used to treat rheumatoid arthritis.

If you are a smoker with this disease, it is important that you kick the habit, as it can interfere with treatment.

Weight loss can also help with, as excess weight places stress on the joints. Choosing certain foods that may help reduce inflammation such as some Mediterranean diet staples like fish, whole grains and fresh fruits and vegetables can also help.

What Are The 4 Stages Of Rheumatoid Arthritis

progression of rheumatoid arthritis ra and osteoarthritis oa in

Rheumatoid Arthritis, or RA, is a painful condition that affects the joints. With an autoimmune disease, such as RA, the bodys immune system attacks healthy cells. In this case, it attacks cells at the joints and causes inflammation.

There are four stages of rheumatoid arthritis. At first, inflammation leads to joint swelling, stiffness, and pain. As the disease progresses, it damages the joint tissues until there is no tissue left. But with modern treatment options, the progression into later stages is avoidable.

What are the 4 stages of rheumatoid arthritis and how is it diagnosed? Well cover these questions below so you can catch RA early.

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Symptoms And Early Signs

Typically, the first sign of rheumatoid arthritis is stiffness, followed by pain and tenderness in the joints. These symptoms can worsen slowly over weeks or months. Most often, symptoms start in smaller joints such as fingers and toes, and then move to other joints.

The number of joints affected varies, but RA most often attacks five or more joints. It may start as swelling that comes and goes, lasting for a few days or weeks at a time, but it gradually gets worse.

Symptoms may also worsen and occur in intense attacks called flares when triggered by stress, suddenly stopping medications or too much activity, according to National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Common RA symptoms include:

What Causes It And Who Is More At Risk

Rheumatoid arthritis is an autoimmune condition, meaning your immune system isnt working as it should. Normally, your immune system would only send antibodies to kill bacteria and viruses in order to fight an infection. However, when you have rheumatoid arthritis, your immune system attacks the surrounding tissue in your joints. This results in a thin layer of cells, known as synovium, coating your joints, causing them to become sore, inflamed and release chemicals that harm nearby bones, cartilage, tendons and ligaments. If your rheumatoid arthritis goes untreated, these chemicals gradually wear away the joint, causing it to lose its shape and alignment, and eventually, it can destroy the joint completely. Its not yet known what triggers your immune system to attack joint tissue. But some theories have been suggested like an infection being a trigger but none of these have been proven. You may be at an increased risk of developing rheumatoid arthritis depending on: Genetics: Theres a small amount of evidence that suggests rheumatoid arthritis runs in families, but the risk factors are low as genes are unlikely to play a significant part. Hormones: The condition is more common in women than it is in men, possibly due to the effects of the hormone oestrogen, but this connection hasnt been proven. Smoking: Theres some evidence that suggests smokers have a higher risk of developing rheumatoid arthritis.

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Is Surgery An Option For Rheumatoid Arthritis

Yes, in the later stages of rheumatoid arthritis progression, surgery is also an option. The goal of surgery is to improve daily function. Additionally, it helps to reduce pain and repair damage. Surgery may involve removing the synovium or repairing tendons. Although joints can also be fused or replaced entirely.

Have you been diagnosed with RA? We may be able to help. Call for more information.

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Stage : The End Game And The Full Deterioration Of Join Movement

What are the 4 stages of rheumatoid arthritis?

Known as end-stage rheumatoid arthritis, stage four is the most advanced stage of the disease known to modern medicine.

Stage four rheumatoid arthritis under an X-ray is likely to show severe cartilage and bone damage, as well as possible, severe joint deformity and muscle degeneration.

Even at this stage of the disease, remission can still happen and medical professionals have no way to explain how or why this happens.

It is still unlikely, and therefore it is important to continue seeking proper medical care to try and control the disease.

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Does Rheumatoid Arthritis Qualify For Long

The Social Security Administration considers rheumatoid arthritis a qualifying disability, provided it is advanced enough to meet their eligibility requirements.

There may come a time when your RA is so severe that it becomes debilitating and you can no longer work in the office. Studies show that 35 percent of people left their jobs 10 years after their RA diagnosis.

While deciding to stop working might be your toughest decision yet, the stress of staying at your job despite being unable to work due to your condition could make you prone to depression.

Because of your rheumatoid arthritis, you may qualify for long-term disability benefits, but only if you fall under certain terms and conditions.

What Is The Safest Drug For Rheumatoid Arthritis

The safest drug for rheumatoid arthritis is one that gives you the most benefit with the least amount of negative side effects. This varies depending on your health history and the severity of your RA symptoms. Your healthcare provider will work with you to develop a treatment program. The drugs your healthcare provider prescribes will match the seriousness of your condition.

Its important to meet with your healthcare provider regularly. Theyll watch for any side effects and change your treatment, if necessary. Your healthcare provider may order tests to determine how effective your treatment is and if you have any side effects.

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Signs Of Rheumatoid Arthritis Progression

RA has no cure, and it gets worse over time, but it is a very individual disease. How fast RA progresses and how it affects you will be different from others with RA. The progression of the disease varies so much between individual patients, says Dr. Chu. In some people, symptoms rapidly get worse over the course of a few weeks in others, it can take several months. And in people with rheumatoid arthritis who are diagnosed early and begin treatment right away, the progression of symptoms may be so gradual you hardly notice it. These are some common indications that the disease is progressing:

  • Flares are occurring more frequently

  • Flares are lasting longer

  • Joints pain and swelling is increasing

  • Joint pain and swelling is spreading to new areas of the body

  • Nodules are forming

  • Blood tests indicate higher level of CRP

  • The disease is no longer responding to your medication

How RA plays out for you will depend on some other variables, including your sex: Women with rheumatoid arthritis tend to have more severe disease, as do people who tested positive for RA antibodies, says Dr. Chu. Smokers also are likely to do poorly. Smoking increases inflammation and makes treating RA more difficult. If you smoke, your treatment will be less responsive, thats for sure. We emphasize that all the time to our patients, says Dr. Chu.

Ra Stage I: Synovitis

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The beginning stage of Rheumatoid arthritis is Synovitis or synovial inflammation. At this early RA stage, slight symptoms will appear. These symptoms are a pain in fingers, hands, knees, and ankles. The beginning of this stage is associated with the attack of the bodys immune system on the synovial membrane. Due to that reason, the synovial membrane is also get affected in this stage.

The synovial membrane envelops the synovial fluid present in between the joints. It has a significant role in keeping joints free from damage or any injury. As it regulates the synthesis of synovial fluid, which is present inside the joint cavity. This fluid provides nourishment and protection to the joint cartilage by keeping your joints lubricated.

Due to the inflammation and swelling in the synovial membrane, you will feel slight pain and stiffness in joints. But these symptoms are very mild and confusing thats why you cant even imagine that the pain is because of synovitis. So, never ignore even slight pain and inflammation in joints or muscle regions.

At this stage, only the joint lining gets affected, and bones are free from damage or inflammation. Hence, it would be good to treat RA at this stage.

Synovitis Treatment

Once you are diagnosed with synovitis then oral drugs and injections are the best way to treat synovitis. The medication for synovitis includes anti-inflammatory drugs especially DMADs and also steroid injections.

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How Is Rheumatoid Arthritis Treated

Joint damage generally occurs within the first two years of diagnosis, so its important to see your provider if you notice symptoms. Treating rheumatoid arthritis in this window of opportunity can help prevent long-term consequences.

Treatments for rheumatoid arthritis include lifestyle changes, therapies, medicine and surgery. Your provider considers your age, health, medical history and how bad your symptoms are when deciding on a treatment.

Symptoms Of Rheumatoid Arthritis

  • The affected joint feels warm to touch pain and inflammation may be present as well.
  • Pain and stiffness seem increased after waking up in the morning and after long periods of rest.
  • Weakness and fever may be experiencedas well as lack of hunger.
  • The symptoms manifest in the smaller joints like fingers and toes first. After a while, the bigger joints like elbows, ankles, wrists, etc. also get affected.
  • However, some patients may not manifest the above-mentioned symptoms and have skin, eyes, other internal organs like heart, lungs, kidneys, etc. affected instead.

The severity of symptoms varies from patient to patient. So too does the duration. There maybe times when the symptoms are very painful followed by periods of no pain at all .

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What Types Of Lifestyle Changes Can Help With Rheumatoid Arthritis

Having a lifelong illness like rheumatoid arthritis may make you feel like you dont have much control over your quality of life. While there are aspects of RA that you cant control, there are things you can do to help you feel the best that you can.

Such lifestyle changes include:


When your joints are inflamed, the risk of injury to your joints and nearby soft tissue structures is high. This is why you need to rest your inflamed joints. But its still important for you to exercise. Maintaining a good range of motion in your joints and good fitness overall are important in coping with RA.


Pain and stiffness can slow you down. Some people with rheumatoid arthritis become inactive. But inactivity can lead to a loss of joint motion and loss of muscle strength. These, in turn, decrease joint stability and increase pain and fatigue.

Regular exercise can help prevent and reverse these effects. You might want to start by seeing a physical or occupational therapist for advice about how to exercise safely. Beneficial workouts include:

  • Range-of-motion exercises to preserve and restore joint motion.
  • Exercises to increase strength.
  • Exercises to increase endurance .

Unusual Symptoms Of Rheumatoid Arthritis

Rheumatoid Arthritis (RA) Part 1: Introduction

Most people experience the usual stiffness and swelling, but there are some unusual symptoms of rheumatoid arthritis. These include a skin rash, eye pain, and difficulty breathing. These symptoms are signs of inflammation elsewhere in the body. People may also get rheumatoid nodules, which are lumps on the elbows.

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Stage : The Damage Has Moved From The Cartilage To The Bone And The Condition Has Become Severe

In her article Treating Severe Rheumatoid Arthritis: How Treatment Options Change in Stage 3 Disease , journalist Carol Eustice explains that depending on the degree of severity, the inflammation might also begin to affect other organs throughout the body, which can include:

  • Pericarditis affects the area around the heart
  • Vasculitis affects the blood vessels
  • Pleuritis affects lung tissue

In addition to the increased chance of inflammation around vital organs, stage three rheumatoid arthritis can also see the development of joint deformities in the affected areas.

These deformities often appear as solid nodules that physically affect the appearance of an individuals hands, feet, legs, or other joints the disease may be affecting.

The Stages Of Rheumatoid Arthritis

  • Stage 1: In the early stage of rheumatoid arthritis, its common to have inflammation, pain, and stiffness in just a few joints in the body. Typically, this reaction comes after doing a strenuous activity.
  • Stage 2: In this stage of rheumatoid arthritis, the cartilage in the joints is decreasing and inflammation is increasing. In this stage of the disease, patients begin to experience problems with mobility.
  • Stage 3: This stage is considered severe rheumatoid arthritis. In this stage, not only is the cartilage deteriorating, but also the bones at the joints are wearing away. This causes a lot of pain and decreases mobility and muscle strength in multiple parts of the body.
  • Stage 4: In this stage of the disease, mobility becomes extremely limited, and joints stop functioning the way they are supposed to. Pain, inflammation, and loss of mobility are severe symptoms in this stage.

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What Are The Four Stages Of Rheumatoid Arthritis

  • Stage 1: In early stage rheumatoid arthritis, the tissue around your joint is inflamed. You may have some pain and stiffness. If your provider ordered X-rays, they wouldnt see destructive changes in your bones.
  • Stage 2: The inflammation has begun to damage the cartilage in your joints. You might notice stiffness and a decreased range of motion.
  • Stage 3: The inflammation is so severe that it damages your bones. Youll have more pain, stiffness and even less range of motion than in stage 2, and you may start to see physical changes.
  • Stage 4: In this stage, the inflammation stops but your joints keep getting worse. Youll have severe pain, swelling, stiffness and loss of mobility.

Stages Of Rheumatoid Arthritis

Stages of Rheumatoid Arthritis

There are four stages. Each has its own treatment options.

Stage 1:

  • In the early stages, your joint lining, or synovium, becomes inflamed. The bones arenât damaged yet. But the tissue around them often swells, making your joint stiff and painful.

Stage 2:

  • In this moderate stage, inflammation damages your cartilage, the cushiony stuff that protects the ends of your bones.
  • The joint will be stiff, and you wonât be able to move it as far as you used to. The doctor will say youâve lost range of motion.

Stage 3:

  • This is the severe stage. Inflammation is wearing away cartilage and causes erosion of bones near your joints. The joints may become unstable. You might start to notice deformities as the bones move around. Youâll have pain, swelling, and loss of motion.

Stage 4:

  • In end stage RA, inflammation stops, but the damage continues. The joint might stop working. Youâll still have pain, swelling, stiffness, and lack of motion. Your muscles may be weak, too. It could be time for joint replacement surgery.

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