RA is a progressive autoimmune disorder that triggers healthy cells to attack joints and surrounding tissues. You can manage symptoms naturally and with over-the-counter pain medications at first, but getting prompt medical treatment is crucial as the condition progresses.
Rheumatoid arthritis (RA) causes pain and swelling in the hands, feet, knees, and hips. Without treatment, it can damage your joints and seriously impact your mobility. It can also lead to various complications.
More than 50 million Americans have some form of arthritis, and about 1.3 million people have RA. It typically develops between the ages of 30 and 60, and women are more likely to be diagnosed with this chronic inflammatory disease.
There isn’t a cure for RA, but there are many treatment options to help manage symptoms and preserve quality of life. Your treatment plan will depend on the severity of your condition and how far it has progressed.
Keep reading to learn how mild, moderate, and severe RA differ in symptoms and treatment.
There isn’t one single diagnostic tool used to detect RA.
- personal or family history of related autoimmune diseases, such as lupus or psoriatic arthritis
- elevated inflammatory markers such as the erythrocyte sedimentation rate (ESR) and C-reactive proteins (CRP) in the blood
- high levels of cyclic citrullinated peptide (CCP) antibodies
- a positive rheumatoid factor blood test
- X-rays to pinpoint areas of joint damage and possible bone erosions
RA looks different at each stage. After a diagnosis is made, your doctor will develop a treatment plan to help manage symptoms and slow disease progression.
Mild RA is the least severe form of this condition. At this stage, you may experience:
- joint pain and swelling that comes and goes
- joint stiffness from time to time, especially in the morning
- Low-grade fever of about 99°F (37.2°C)
RA can be hard to detect at this stage because symptoms are so mild.
People often write these symptoms off as related to age or injury and don’t seek medical attention. If left untreated, RA can progress, so it’s important to see your doctor if you’re experiencing any unusual symptoms.
At this stage, an X-ray will
For RA, the Arthritis Foundation recommends “early, aggressive treatment.” The key is to stop the inflammation caused by RA. Not only will this reduce pain and joint stiffness, but it can also stop disease progression.
Once RA is diagnosed, your doctor may prescribe:
Corticosteroids may be necessary as a short-term treatment to reduce inflammation, though the 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis recommend reducing their use because of potential side effects.
For pain, your doctor may recommend an over-the-counter (OTC) nonsteroidal anti-inflammatory drug, such as ibuprofen (Advil) or naproxen (Aleve).
While you are still in the mild stage, certain lifestyle changes can help improve your condition and delay progression.
- eat right and quit smoking: A healthy lifestyle goes a long way in stalling arthritis. Adopt a healthy diet that includes plenty of fruits and vegetables. This
will helpimprove your overall well-being and control your weight.
- exercise: Aim for routines that can help build muscle around the joints but don’t cause damage. Walking, swimming, and other low-impact workouts are best. Avoid high-impact repetitive exercises, such as running, jumping, or any sports that involve kicking. Warm up before exercise to lubricate joints, and stretch at the end of your workout to avoid injury.
- use hot and cold treatments: Ask your doctor about using heating pads and ice packs as part of your regular self-care plan. Some people find applying ice helps reduce swelling, whereas applying heat helps relieve pain.
Moderate RA has many of the same characteristics as mild RA. You may find that your joint pain and stiffness have become more frequent. You may even “see” inflammation in certain joints, such as redness in your hands or knees.
The key difference is that, at this stage, these symptoms will affect your ability to perform everyday tasks. You may find it difficult to reach for things on the top shelf or have a hard time gripping smaller items in your hand.
You may also experience:
- skin rashes
- night sweats
- mild fever of about 101°F (38°C)
- unexplained weight loss
At this stage, an X-ray will
With moderate RA, the goal is to control pain and inflammation while improving mobility. The medications for moderate RA are the same as for mild RA.
If you were previously diagnosed with mild RA, your doctor may add it to your treatment plan. For example, if you were previously taking a DMARD, they may also recommend an injected biologic medication.
If you’re initially diagnosed with moderate RA, your doctor will prescribe one or more of the following:
If your symptoms are disrupting your sleep, you may also consider adding a sleep medication to your regimen. This can help you achieve better rest and relaxation.
Be sure to check with your doctor before taking any new OTC medications. They should confirm that your prescribed medications won’t interact with any OTC option that you’re considering.
With severe RA, joint pain and inflammation can be overwhelming at times. By this stage, most of your joints are experiencing swelling and pain.
You may have visible deformities, like malalignment, in some joints as a result of cartilage destruction and damage to the supporting ligaments. An X-ray will usually show all the earlier markers of the condition, but affected bones will be fused together
Unlike mild to moderate forms of RA, severe stages can be debilitating. Severe joint damage can cause noticeable mobility issues, and high levels of pain and discomfort.
It’s estimated that
Treating severe RA
In addition to the standard RA medications, your doctor may recommend physical and occupational therapies to improve mobility. This helps you complete everyday tasks and maintain your independence.
Joint replacement surgery may be recommended if other therapies fail. About 25% of people will undergo a total replacement of the joint
If left untreated, RA may lead to decreased mobility and joint deformity.
RA can also increase your risk for:
- Sjörgen’s, which can cause dry eyes and can lead to vision damage
- dry mouth, which can lead to dental damage
- carpal tunnel syndrome
- osteoporosis, a condition that weakens your bones
- rheumatoid nodules, firm bumps of tissue found around pressure points
- heart problems, such as hardened or blocked arteries
- lung disease resulting from inflammation or scarring in the lungs
- lymphoma, which is a group of blood cancers that develops in the lymph system
In addition, people living with RA have a
If you’re experiencing symptoms of RA, it’s important to see your doctor as soon as possible. Early diagnosis can help you get a handle on your symptoms and delay disease progression.
If at any point you notice a change in your systems, see your doctor. They may need to adjust your treatment plan.
Here, we’ve compiled answers to additional questions about RA and its stages.
How do you know if your rheumatoid arthritis is severe?
Stage 4 is severe RA, and in some cases, even stage 3. At these stages, a person
At what age does RA usually start?
In females, RA usually begins between the ages of 30 and 60. In males, it usually begins after the age of 45.
How do I know if it’s osteoarthritis or rheumatoid arthritis?
RA and osteoarthritis can cause similar symptoms, but they have different causes. RA is an autoimmune disease, whereas osteoarthritis has to do with physical damage to the joints. Since it can be difficult to tell the difference, seeing a doctor can help a person determine the cause of their joint symptoms and get the best treatment.
During the early stages, symptoms can be managed at home by keeping active, eating healthy, and engaging in social activities that help keep your mood positive.
Isolating yourself from social interaction will increase your risk of developing RA-related depression later. Research shows that the risk of developing depression is
As your symptoms progress, medication and physical therapy can help you maintain a healthy level of mobility. Staying active is key, as this can help you manage your condition and boost your overall well-being. Going for a walk, visiting a neighbor, or even hitting the gym for low-impact exercise are all good options.
The key to treating RA and preventing complications is to see your doctor at the first sign of joint pain and inflammation. If you’ve already been diagnosed with RA and your symptoms have worsened, you should immediately make a follow-up appointment. Your doctor can tweak your treatment plan as needed and provide personalized guidance.