What Are the 4 Stages of Rheumatoid Arthritis?

Rheumatoid arthritis falls under the category of auto-immune diseases wherein the body’s immune mechanism attacks its own parts. The lining of the joints, known as the synovium, is what is affected by this particular condition. However, the condition progresses eventually to affect more than just the synovium – the joints and cartilages too get affected. The condition is painful and needs prompt 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 (remission).

Stages of Rheumatoid Arthritis

RA progresses through 4 stages.

Stage 1:

• In this stage, the joint lining or the synovium is affected.
• The patient will complain of pain and swelling in the affected joint; joint mobility too might be affected. The bone itself does not suffer damage at this stage.
• Early treatment is crucial and the treating doctor might start the patient on methotrexate. Methotrexate is a drug that works by modifying the immune mechanism.There are also other similar drugs the doctor might prescribe.
• Along with medication which includes pain killers, the patient may also start physiotherapy.
• In some cases, steroids may be prescribed.

Stage 2:

• The symptoms worsen and the duration of the symptoms is also longer.
• In this stage, the cartilage might get affected. This results in reduction in mobility.
• The doctor may add another class of drugs (to the ones the patient is already on) called biologic response modifiers.

Stage 3:

• This marks the beginning of the severe stage. The condition starts affecting the bones which begin to undergo changes.
• Visible deformation in the affected joint may be observed.
• The patient may experience loss of balance along with symptoms from the previous two stages.
• The doctor may introduce a class of drugs called Janus kinase inhibitors.

Stage 4:

• This is called end stage RA. Characterized by severe loss of mobility, in this stage the bones fuse together and the ability of the patient to perform tasks independently is affected.
• Patient can use assistive devices to make routine tasks easier.
• The doctor may suggest joint replacement surgery at this stage.
• Along with the medications given above, the doctor will also guide the patient on other factors which might affect treatment. These include quitting smoking, losing weight, and other applicable lifestyle changes.

Who Can Develop Rheumatoid Arthritis?

• Age: RA commonly affects individuals in the age group of 40-60.
• Gender: Women are more affected than men.
• Family History: Having a family member who has RA increases the risk factor.
• Excess Weight: Being overweight can also increase the risk of developing RA.
• Smoking raises the risk of RA by a considerable margin. People who develop RA are advised against smoking as the condition worsens with smoking and the response to medication also decreases.

Diagnosing RA

The doctor will do a thorough physical examination examining the joints and their range of motion. A combination of blood tests and imaging tests will be needed to confirm diagnosis. Rheumatoid Arthritis can affect different body parts simultaneously and hence it is necessary to make sure the doctor has a complete personal and medical history.

Learning to Manage RA

As already mentioned, flare-ups and remissions will happen with RA. A flare-up usually happens as a result of another infection or due to stress. However, if flare-ups are being experienced regularly, the doctor has to be informed as it may require a modification of treatment. Some ways to manage RA include:

• Perform exercises that do not strain the joints. It is always better to get the doctor’s opinion before starting any exercise routine. In case of pain after exercise, it is better to rest till the pain settles down.
• Heating pads applied to the joints will help relax the muscles around the joint. Icing the painful area will also help with pain relief.
• Practicing relaxation techniques like meditation will help deal with stress.

Reach Out for Help

• Being diagnosed with RA can be quite overwhelming. It may even lead to depression and anxiety. But the first thing to realize is that no one has to deal with it alone.
• Talking to family and friends is good for stress relief and helps with coming to terms with the condition.
• Medical help is always available and eventually patients will realize that the condition can be managed. This will however take time so it is important not to rush things or expect instant results.
• Different strategies work for different people and it is necessary to find what suits one best.
• Indulging in enjoyable activities will help with stress relief so it is necessary to set some time aside for that.
• Fatigue is also common and rest is important during these times.

RA can be managed and best results are obtained when treatment is started early. As medical sciences keep improving, the prognosis for RA is constantly getting better. With the right treatment, it is definitely possible for someone with RA to lead a fulfilling life.