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RA Prognosis and Life Expectancy: What to Expect

Keep this in mind

Rheumatoid arthritis (RA) is a chronic inflammatory disease in which the immune system mistakenly attacks the joints. The most common symptoms are pain, swelling, and inflammation of the joints. Eventually, the joints can become deformed.

In the United States, about 1.5 million people have RA. The onset of RA is highest among people in their sixties. The rate is almost three times higher in women than in men.

Your outlook depends on many factors, including whether or not you test positive for rheumatoid factor (RF) or anticyclic citrullinated peptides (anti-CCPs). Other factors that affect your outlook include your age at time of diagnosis, overall health, and whether or not you develop complications.

Treatment is often able to limit or reduce joint damage and improve your quality of life. Making the right lifestyle choices and adhering to your treatment plan can make a big difference in your outlook.

Read more: How is rheumatoid arthritis diagnosed? »

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Quality of life

What will my quality of life be like?

RA can affect joints throughout the body, causing damage to your cartilage, tendons, and ligaments. In time, RA can also affect your bones and other organs. People who have RA are more likely to develop a disability than those who don’t. This may interfere with your daily life.

If you test positive for RF or anti-CCPs, you may experience more severe symptoms of RA.

Early treatment can minimize pain and disability resulting from RA. If you experience new or worsening symptoms, talk to your doctor immediately.

Besides medication, there are some self-care methods to help improve your overall health.

Self-care tips
  • Get physical: Low-impact exercise is an important part of your RA treatment. A combination of aerobic, muscle strengthening, and flexibility exercises can help you feel stronger.
  • Rest: Get a good night’s sleep and rest tired joints during the day as needed.
  • Eat well: There’s no special diet for RA, but how you eat still matters. A balanced diet should include vegetables, fruits, whole grains, and lean protein. Avoid highly processed junk foods, which can lead to inflammation.
  • Experiment: Complementary therapies such as massage, acupuncture, and meditation may help your symptoms. You can also try heating pads and cold packs for pain as needed.
  • Tend to your emotional health: Consider joining a support group for others living with chronic illness.

Treatment

What kind of medical care will I need?

If you have RA, you should still see your primary care doctor as needed. You’ll also need to see a rheumatologist. Rheumatologists specialize in RA and other autoimmune, rheumatic, and musculoskeletal conditions. They may prescribe disease-modifying anti-rheumatic drugs, which can help reduce disease activity and prevent joint damage.

RA isn’t the same for everybody. Your rheumatologist will assess your condition, form a treatment plan, and advise you on how to best take care of yourself. They’ll also monitor your disease progression and adjust your medications as needed. In time, you may have additional needs such as physical therapy, occupational therapy, or other types of treatments.

Learn more: DMARDs and TNF-alpha inhibitors for RA treatment »

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Complications

Am I at risk for complications?

RA can lead to various complications. Nodules under the skin and joint deformities are some of the more common complications. Some people also develop problems with the cervical spine.

Other potential complications include:

  • anemia
  • eye inflammation
  • osteoporosis
  • diabetes

People with RA are also more prone to developing inflammation of the:

You should be aware of other possible serious complications from RA, including the following.

Heart disease

RA is an inflammatory disease. Because of this, it can damage your blood vessels and cause them to narrow. This increases your risk of heart disease, particularly ischemic heart disease.

If you have RA, you’re also more likely to be hospitalized due to myocardial infarction, angina, or congestive heart failure. These risks are higher if you test positive for RF, have severe disease activity, or go through menopause before age 45.

More research is needed to study heart disease in people with RA and how the disease and the drugs used to treat it may contribute to heart problems.

Assessing your individual risk for heart complications is difficult. This is one reason why it’s important to see your doctor regularly. You can lower your risk of heart disease by maintaining a heart-healthy diet and getting regular exercise.

Infections

People with autoimmune diseases such as RA are generally more susceptible to infections, including tuberculosis and gum infections. According to one study, infections may account for as many as 36 percent of deaths in people with RA. Researchers aren't sure if this is due to RA itself, if it’s a side effect of the drugs used to treat RA, or a combination of both.

For this reason, make sure all of your vaccinations are up to date. Report any signs of infection to your doctor right away.

Lung problems

Because it’s a chronic inflammatory disease, RA can affect many of your organs. As the disease progresses, RA increases your risk of lung problems, such as nodules or high blood pressure in the lungs.

You may also be at increased risk of developing a blockage in the small airways of the lungs. The most common lung problem in RA is interstitial lung disease. This can lead to pulmonary fibrosis, which causes scarring of the lungs.

Respiratory causes are the second major cause of death in people with RA. You can lower your risk of lung problems by not smoking.

Learn more: What you should know about rheumatoid arthritis (RA) and smoking »

Mental health

Can RA affect my mental and emotional health?

It’s possible that living with RA may affect your mental and emotional health. As many as 40 percent of people with RA experience symptoms of depression. The exact reasons for this aren’t known. Living with chronic illness, pain, and disability can lead to depression in some people. There may also be a link between depression and inflammation.

Depression can make you less likely to adhere to your treatment plan, which can make your RA worse. Depression also increases the likelihood of alcohol and drug abuse, and can harm your overall health. Symptoms of depression include:

  • feelings of sadness or hopelessness
  • feelings of anger or irritation, even over small things
  • loss of interest in hobbies
  • sleeping too much or sleeping too little
  • lack of energy
  • difficulty concentrating
  • noticeable weight gain or loss
  • repetitive negative thoughts

Depression can be treated with medication, as well as behavioral and talk therapy. If you’re experiencing symptoms of depression, talk to your doctor or mental health professional.

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Life expectancy

What about life expectancy?

While RA isn’t fatal, complications can shorten your lifespan by roughly 10 years. However, it’s important to note that disease progression varies greatly from person to person. People who test positive for RF and anti-CCPs tend to progress at a faster rate.

Treatment options for RA are advancing and new drugs may improve chances for remission. You can improve your outlook by adhering to your treatment plan and seeing your doctor regularly.

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Coping

Tips for coping with RA

In addition to following your doctor’s suggested treatment plan, there are other things you can do to manage your condition. You can:

Eat a balanced diet. A diet rich in vegetables, fruits, whole grains, and lean protein can increase your energy and boost your mood. Junk foods may aggravate inflammation and cause weight gain. More weight puts additional stress on your joints.

Listen to your body. If you do something physical and then have severe pain lasting an hour or more, it means you’ve probably overdone it. When you start feeling increased pain, stop the activity and rest.

Use assistive devices. There are a variety of devices specially designed to meet the needs of people with arthritis. These include kitchen utensils, household tools, and even writing implements with easy-grip features. Using these tools can improve your daily life.

Ask for help. Enlist the aid of family and friends for the most difficult tasks, such as heavy lifting, vacuuming, and scrubbing floors.

Move your body. Make sure you move a little each day. It will help with muscle strength and flexibility. Ask your doctor how much exercise and what kind is best for you. If possible, work with a personal trainer or physical therapist to formulate an exercise plan. Also, avoid staying in one position for too long. Get up from a seated position at least once every 30 minutes to stretch and move around. If you’re doing work involving a gripping action, try to release your grip every 10 to 15 minutes.

Pamper yourself. When your hands or feet start to ache, take a cool or warm soak for relief.

Be proactive. Don’t wait. Tell your doctor as soon as you notice significant changes in your symptoms.

Keep reading: 7 tips from people with RA about living well with rheumatoid arthritis »

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