Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a complex and progressive autoimmune condition that affects the joints and, in some cases, other organs. 

Approximately 1.3 million Americans experience rheumatoid arthritis symptoms, with women being more likely to develop the disease than men. [1] In Canada, RA affects about 1.2% of Canadians over the age of 16, with higher prevalence in women. [2] 

These rheumatoid arthritis statistics underscore the importance of early screening, especially in high-risk populations. Early recognition of rheumatoid arthritis symptoms is crucial to slow progression and avoid irreversible joint damage.

What Is Rheumatoid Arthritis?

Rheumatoid arthritis is a chronic inflammatory condition that primarily targets joints. Unlike osteoarthritis, which is caused by wear and tear, RA is systemic and autoimmune. The body’s immune system mistakenly attacks the synovium – the lining of the joints – leading to swelling, pain, and eventual joint erosion if left untreated. [3]

RA often begins in the small joints of the hands and feet. [4] Over time, it can affect larger joints such as knees, elbows, and shoulders. This systemic inflammation can also impact other tissues, including blood vessels, eyes, lungs, and skin. RA tends to progress in periods of flare-ups and remissions.

Is Rheumatoid Arthritis Genetic?

Yes, rheumatoid arthritis is genetic in part. Having a close relative with RA increases your risk. Specific genes like HLA-DRB1 and other immune-regulating genes contribute to susceptibility, but they do not determine onset alone. Environmental and lifestyle factors must also be present. [4]

Rheumatoid Arthritis Life Expectancy

Rheumatoid arthritis life expectancy may be reduced by 10 years if untreated. However, modern treatments allow many patients to live normal or near-normal lifespans. Risk factors such as uncontrolled inflammation, smoking, and cardiovascular disease play a larger role in prognosis than RA alone. [5]

Types of Rheumatoid Arthritis

RA is classified based on the presence or absence of specific antibodies in the blood. Understanding the types of rheumatoid arthritis helps inform treatment and prognosis.

Seropositive Rheumatoid Arthritis

Seropositive rheumatoid arthritis is the most common and typically more aggressive form. Patients test positive for rheumatoid factor (RF) or anti-cyclic citrullinated peptide (anti-CCP) antibodies. These markers often indicate more severe disease, increased joint damage over time, and a higher risk of extra-articular complications such as lung or cardiovascular involvement.

Seronegative Rheumatoid Arthritis

In seronegative rheumatoid arthritis, blood tests don’t detect RF or anti-CCP antibodies. Despite this, patients still exhibit symptoms of rheumatoid arthritis and may experience significant joint inflammation. Diagnosis is based on clinical signs and imaging. This form can be milder but still leads to joint damage if untreated. [6]

What Are the 4 Stages of Rheumatoid Arthritis?

RA progresses in these distinct phases:

1. Stage 1 (Early stage): Inflammation of the synovial membrane; early signs of rheumatoid arthritis like joint stiffness and pain appear.
2. Stage 2 (Moderate stage): Inflammation damages cartilage; rheumatoid arthritis hands and rheumatoid arthritis knee pain become more frequent.
3. Stage 3 (Severe stage): Bone erosion starts; deformities and loss of joint function occur.
4. Stage 4 (End stage): Joints may fuse or become non-functional; pain and mobility issues persist. [7]

Rheumatoid Arthritis Symptoms and Signs

RA produces both subjective symptoms and visible signs. Recognizing both can help facilitate early diagnosis.

Common Symptoms of Rheumatoid Arthritis

Rheumatoid arthritis symptoms can vary in intensity but generally include:

• Swollen, painful, and warm joints
• Prolonged morning stiffness (lasting over 30 minutes)
• Fatigue, low-grade fever, and unintended weight loss
• Decreased range of motion in affected joints
• Weak grip strength or difficulty holding objects
• Persistent rheumatoid arthritis elbow, knee, and ankle pain that worsens during flare-ups and may limit movement or cause limping
• In later stages, joint deformities and misalignment [8]

These rheumatoid arthritis early symptoms often begin in a symmetrical pattern, such as both wrists or both knees, and gradually worsen if untreated.

Visible Signs of Rheumatoid Arthritis

Signs of rheumatoid arthritis include observable changes that may signal disease progression:

• Swelling and tenderness in two or more joints
• Redness and warmth around affected areas
• Joint misalignment in chronic stages
• Reduced joint function and range of motion
• Firm lumps under the skin (rheumatoid nodules in the early stages) [9]
• Difficulty performing daily tasks (e.g., writing, lifting, walking)

These signs and symptoms of rheumatoid arthritis may spread to larger joints and affect mobility.

Unusual Symptoms of Rheumatoid Arthritis

Some unusual symptoms of rheumatoid arthritis can indicate systemic involvement:

• Skin manifestations such as rheumatoid arthritis rash or hives caused by immune-mediated inflammation or vasculitis
• Numbness or tingling from nerve compression (carpal tunnel syndrome)
• Dry eyes and mouth (secondary Sjogren’s syndrome)
• Shortness of breath from lung involvement [9]

Such manifestations suggest that RA is affecting tissues beyond the joints.

What Does Rheumatoid Arthritis Feel Like?

Many describe it as a deep, aching pain accompanied by joint stiffness and fatigue. The pain often worsens in the morning or after inactivity. During a rheumatoid arthritis flare, patients may feel exhausted, feverish, and unable to perform daily tasks due to joint discomfort.

How Long Does It Take for RA to Cause Permanent Damage?

RA can cause permanent damage within the first 1–2 years if untreated. Joint erosion, cartilage loss, and deformities can begin early, which is why early intervention with disease-modifying therapies is essential. [10]

When to See a Doctor

Seek medical attention if you experience persistent joint pain, swelling, or morning stiffness lasting longer than a few weeks. Timely referral to a rheumatologist can lead to early diagnosis and intervention, which are key to preventing joint damage and disability.

Moore MyoWorx neuromuscular specialists support patients with pain, muscle imbalances, fatigue, and functional limitations commonly seen in rheumatoid arthritis, especially when these symptoms persist even with medical therapy.

What Causes Rheumatoid Arthritis?

The causes of rheumatoid arthritis are multifactorial and not yet fully understood. RA develops when the immune system mistakenly attacks the synovial lining of the joints. Several internal and external factors contribute to this abnormal immune response:

• Genetic predisposition: Individuals with certain genes (e.g., HLA-DRB1) have an increased risk.
• Environmental triggers: Infections, pollution, or smoking may activate the immune system in those genetically predisposed.
• Hormonal changes: Particularly in women, hormonal fluctuations may influence immune activity.
• Immune dysregulation: The failure of the immune system to distinguish between self and non-self leads to chronic inflammation. [1]

This autoimmune cascade damages joints and may eventually affect other organ systems. These underlying rheumatoid arthritis causes continue to be researched.

Is Rheumatoid Arthritis Caused by Stress?

Chronic stress doesn’t directly cause RA but may worsen it. Stress affects immune regulation and can trigger symptoms of rheumatoid arthritis flare. [9]

Rheumatoid Arthritis Risk Factors

Understanding rheumatoid arthritis risk factors can help identify those more likely to develop the condition.

People with a family history of RA have a higher chance of developing it due to inherited genes. Smoking is a significant and preventable factor that not only increases the risk of RA but also makes it more severe. Obesity contributes to chronic inflammation, which may trigger or exacerbate joint symptoms. [19]

RA disproportionately affects women, making female sex another recognized factor. [9] The condition most commonly begins in middle age, defined as between 30 and 60 years old—this is the window when symptoms are most likely to develop. Environmental exposures, such as prolonged contact with silica or asbestos, may also increase risk in some individuals. [11]

Complications of Rheumatoid Arthritis

RA can lead to several long-term complications:

• Cardiovascular disease: RA-related inflammation accelerates heart disease.
• Lung conditions: Interstitial lung disease or pleuritis can occur.
• Osteoporosis: Especially in those on long-term corticosteroids.
• Eye disorders: Scleritis and dry eye syndrome.
• Infections: Immune suppression from RA or medications increases infection risk.
• Mental health: Anxiety and depression are common in chronic pain sufferers. [12]

Proactive management helps minimize these outcomes.

Most Common Cause of Death in Rheumatoid Arthritis

The most common cause of death in rheumatoid arthritis is cardiovascular disease. Chronic systemic inflammation increases the risk of heart attacks, stroke, and heart failure. Lymphoma, lung disease, and infections also contribute significantly to mortality in RA patients. [10]

Is RA a Disability?

Yes, RA is a disability when it significantly limits mobility or the ability to work. In advanced stages, joint damage and fatigue may qualify patients for disability benefits under national or workplace insurance systems. [2]

RA Outlook and Progression 

RA is a lifelong condition, but its progression and impact vary widely. With early diagnosis and appropriate treatment, many patients achieve remission or low disease activity. Disease-modifying therapies and lifestyle changes can preserve joint function and improve quality of life.

Without intervention, RA can lead to irreversible joint deformities, disability, and increased risk of cardiovascular or pulmonary complications.

The long-term outlook depends on factors like age at onset, disease severity, access to care, and adherence to treatment.

Moore MyoWorx provides advanced neuromuscular care that complements medical RA treatment. Our team helps patients manage chronic pain, fatigue, and movement dysfunction, which are all essential elements of long-term rheumatoid arthritis care. 

The earlier you act, the better your chances of preserving your mobility and well-being.