Being aware of these symptoms can help you gauge the severity and progression of your rheumatoid arthritis.
Rheumatoid arthritis (RA) is a joint disease characterized by inflammation and pain. The condition is also 3 times more likely to impact women, according to research. One of the trickiest things about treating rheumatoid arthritis is that this autoimmune disease doesn't progress the same way in everyone who has it. Some people will be able to manage their symptoms entirely, while others will see their disease grow worse.
Despite all the research that’s been done, who may develop severe rheumatoid arthritis and joint damage and whose joint damage will slow over time still remain somewhat of a medical mystery. “I don’t know when I see someone over the first two or three visits how serious it will be,” says John J. Cush, MD, a former professor of internal medicine and rheumatology at UT Southwestern Medical Center in Dallas and chair of several leadership committees for the National Arthritis Foundation and the American College of Rheumatology.
Here are five important signs that could indicate your rheumatoid arthritis is progressing. It’s important to be aware of them and discuss with your doctor.
1. The Number of Swollen, Painful Joints You Have Is Increasing
The more joints that are painful and swollen, the more severe the disease may be, says Dr. Cush. Joint pain and swelling are characteristic signs and symptoms of rheumatoid arthritis. Rheumatologists consider this a very important way to measure disease severity.
Your doctor should examine joints in your hands, feet, shoulders, hips, elbows, and other spots to see how many are causing problems. The traditional morning stiffness and joint swelling that are characteristic symptoms of RA should be discussed with a rheumatologist as soon as possible, says Vinicius Domingues, MD, a rheumatologist in Daytona Beach, Florida, and a medical advisor to CreakyJoints, a support, education, advocacy, and research organization for people living with arthritis and rheumatic disease. “Those are signs of active rheumatoid arthritis, and when it presents like that, it gives doctors an opportunity to be aggressive in early treatment or to switch to another class of drugs if symptoms are worsening.”
2. You’re Having More Flares
Frequent flares, which are periods of increased disease activity where your symptoms feel worse, are another indicator of more active and severe disease for a patient with RA, says Jason Liebowitz, MD, an assistant professor of medicine in the division of rheumatology at Columbia University Vagelos College of Physicians and Surgeons in New York City.
“Flares can occur when the disease is not being adequately treated,” says Dr. Liebowitz. “This may be in cases where medication has not yet been started or when the medication prescribed for that patient is not effective for their type of disease.” If you’re experiencing joint pain, fatigue, or fever more often than you normally do, talk to your rheumatologist about ways to help you get your flares under better control.
3. Your Symptoms Are Symmetrical
Symmetrical symptoms, such as having the same swollen joints on both sides of the body, are also classic symptoms of rheumatoid arthritis, Cush says. According to CreakyJoints, in the early stages of RA, only a few joints may be affected, but as the disease progresses, the pain felt in a joint on one side of the body will often be mirrored in the same joint on the other side of your body.
“Rheumatoid arthritis most commonly involves peripheral joints such as the wrists, knuckles, fingers, ankles, and toe joints,” says Liebowitz. “Other joints can be involved, but if those joints are painful, swollen, and coupled with symmetric morning stiffness lasting longer periods of time, this often may indicate active RA.”
4. You’re Losing Range of Motion
If you’re finding it harder and harder to bend or straighten your neck, fingers, wrists, or elbows, it’s likely a sign that your RA is advancing. As the disease becomes more severe, it can lead to irreversible joint damage and deformities that impact your ability to perform daily functions with ease.
But RA isn’t always the cause of this problem. “Range of motion may be affected by many factors,” says Liebowitz. According to Mount Sinai Hospital, brain, nerve, or muscle disorders such as cerebral palsy and muscular dystrophy can also cause motion limitation. But there’s little question that both RA and osteoarthritis can have a major impact, too, Liebowitz says.
Fortunately, moving around more frequently may help. “Exercise is often helpful in supporting healthy bones and muscles in general and may be reasonable for many people with arthritis,” says Liebowitz. Talk to your rheumatologist about the types of exercise that are right for you. People with arthritis who exercise regularly sleep better and have more energy, improved daily function, and less pain, according to the American College of Rheumatology (ACR).
5. Your Fingers Feel Numb
Unmanaged inflammation in the wrist joints can compress the nerves, which can lead to weakness, tingling, and numbness in the hands and fingers in people who have RA. But much like another warning sign that your disease may be progressing — range of motion — numbness in the fingers isn’t always caused by RA.
“Numbness in the fingers may be from many causes, such as carpal tunnel syndrome,” says Liebowitz. Both arthritis and carpal tunnel syndrome can affect the wrists, hands, and fingers, says the ACR. “These issues may occur in the absence of RA,” Liebowitz adds, “but bilateral carpal tunnel syndrome should raise suspicion for the disease.”
Effective Treatments for RA Are Available
Even if your RA may be progressing, the good news is that treatments are better than ever. “There are phenomenal therapies for RA, and most patients will have a completely normal life, provided they take their medications,” says Dr. Domingues.
Editorial Sources and Fact-Checking:
- Hunter TM et al. Prevalence of Rheumatoid Arthritis in the United States Adult Population in Healthcare Claims Databases. Rheumatology International. April 28, 2017.
- 11 Red-Flag Signs Your Rheumatoid Arthritis May Be Getting Worse. CreakyJoints. September 2021.
- Limited Range of Motion. Mount Sinai.
- Exercise & Arthritis. American College of Rheumatology. April 2023.
- Carpal Tunnel Syndrome. American College of Rheumatology. February 2023.
Important Notice: This article was originally published at www.everydayhealth.com by Cathy Garrard where all credits are due. Medically reviewed by Samir Dalvi, MD
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