What are the 4 stages of rheumatoid arthritis?
Rheumatoid arthritis (RA) has no cure. Over time, RA tends to get worse, which is called disease progression. RA progresses in stages. There are four stages of RA based on X-ray studies of your joints:
- In the first stage of RA, joint X-rays do not show any joint damage.
- In the second stage of RA, joint X-rays show evidence of thinning bones around the joint and some bone destruction underneath the cartilage of the joint. (Bones that form joints have a smooth covering of protective tissue called cartilage.)
- In the third stage of RA, there is evidence of both cartilage and bone destruction, and there is a change in the function and structure of the joint, called deformity.
- Stage four of RA has all the findings of stage three, but now the joint has started to lose the ability to move. Boney tissue or other tissue fills the joint space and freezes the joint, called ankylosis.
This staging is important for planning treatment and to see if treatment is slowing the progression of RA.
- RA can also be classified as early or established. If you have had RA symptoms for less than six months, you have early RA. After six months, it is called established RA.
- Another way to classify RA is by disease activity. Based on your symptoms and a physical exam, your doctor may describe disease activity as low, moderate or high.
These classifications all help your doctor decide on the best treatment for you.
Symptoms and treatment
The most common first symptoms of RA are swelling and stiffness of the small joints in your hands. These include the joints of your fingers and wrists. As RA progresses, so do your symptoms. RA is a disease that affects more than just your joints.
Symptoms may include:
- Aching pain in more than one joint on both sides of your body
- Stiffness, especially in the morning
- Tenderness
- Swelling of joints
- Weight loss
- Fever
- Fatigue
When treating RA, the goal is to slow down or stop disease progression. Drugs called disease-modifying anti-rheumatic drugs (DMARDs) are effective at slowing progression and relieving symptoms. They can be started as soon as RA is diagnosed.
Even with treatment, many people with RA have periods of flares when symptoms get worse, also called exacerbations. You will also have periods when symptoms are under control, called remissions. Although there is no cure, treatment can improve symptoms, slow progression and improve quality of life.
Progression of RA can also be slowed by making the right lifestyle decisions:
- Stopping smoking. Many studies show that smoking makes RA worse.
- Like other people, people with RA should try to get 30 minutes of exercise on at least five days of the week. There are special physical activity programs for RA for those who need support.
- Maintaining a healthy weight with a healthy diet and exercise reduces stress on your joints, which can improve RA symptoms.
Related questions
- How long does a rheumatoid arthritis flare-up last?
- What are the best foods to eat or avoid for RA?
- RA vs OA vs PsA: Which one is it?
References
- Chauhan K, Jandu JS, Goyal A, et al. Rheumatoid Arthritis. StatPearls [Internet]. 2020 Nov. 5. Available at: https://www.ncbi.nlm.nih.gov/books/NBK441999/. [Accessed May 25, 2021].
- Centers for Disease Control and Prevention (CDC). Rheumatoid Arthritis (RA). July 2020. Available at: https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html. [Accessed May 25, 2021].
Read next
What's a good prednisone taper schedule?
The best prednisone taper will depend upon how long you have been taking the medicine, your dose, and why you are being treated. If you've been treated with a high dose of prednisone, or taken it for more than a few weeks, you will need to slowly stop your medicine, usually over a period of days, weeks or months. Your healthcare provider will determine your prednisone tapering schedule. Continue reading
Prednisone: What are 12 Things You Should Know?
Prednisone has been on the market for more than 70 years but is still one of the most commonly prescribed anti-inflammatory or immunosuppressive medications. Prednisone is used to treat dozens of different conditions such as skin disorders, breathing disorders, allergies, arthritis, and ulcerative colitis. But did you know it also has some pretty serious side effects as well?
Continue reading
Can you take ibuprofen on an empty stomach?
Despite the common belief that you must take ibuprofen with food, you can safely take low-dose ibuprofen (up to 1200 mg daily in divided doses for 1 to 7 days) on an empty stomach, and this provides faster pain relief than taking ibuprofen with food. Food slows ibuprofen absorption time, although it doesn't affect the total amount absorbed. There is actually no scientific evidence that taking ibuprofen with food prevents stomach irritation. Over-the-counter ibuprofen doses have a low incidence of gastric problems anyway.
Continue readingSee also:
Related medical questions
- What does rheumatoid arthritis feel like?
- What are the first signs of rheumatoid arthritis?
- Osteoporosis FAQs: Your Top Questions Answered
- What causes osteoporosis?
- Meloxicam vs Ibuprofen: What's the difference?
- Aleve vs Ibuprofen: What's the difference?
- Can you take expired ibuprofen?
- Can you overdose on ibuprofen?
- Can You Take Tramadol with Acetaminophen, Ibuprofen, or Aspirin?
- Can you drink alcohol with ibuprofen?
- How do Celebrex and ibuprofen compare?
- Should I take meloxicam at night or in the morning?
- How long can you take Celebrex for?
- What are the new drugs for rheumatoid arthritis (RA)?
- Tylenol vs Advil: What's the difference?
- How long does ibuprofen take to work?
- Can ibuprofen cause constipation?
- All Eyes on Ibuprofen: What are 10 Things You Need to Know?
- Why should I take folic acid with methotrexate?
- Can antidepressants be used for arthritis pain?
- How will I feel after a Rituxan infusion?
- How do I know if methotrexate is working for rheumatoid arthritis?
- Does Celebrex act as a blood thinner or cause bleeding?
- Is meloxicam very similar to Celebrex?
Related support groups
- Rheumatoid Arthritis (337 questions, 1,334 members)