*हिंदी में पढ़ें: रूमेटाइड आर्थराइटिस (Rheumatoid Arthritis) के 4 चरणों को समझें
Rheumatoid arthritis (RA), much like other chronic conditions, progresses in stages. There is no fixed timeline for RA progression. However, if the condition is left untreated, symptoms may worsen over a period of time, progressing through stages.
In this blog, we are going to discuss the stages of rheumatoid arthritis, its symptoms and implications, and the management strategies to slow down disease progression. Controlling disease progression can help you lead an active life and delay the need for surgery longer.
To understand the stages of RA, let’s first understand what the condition really means. It is when the body’s immune system mistakenly attacks the synovium (the lining of joints). This leads to inflammation, joint pain, stiffness, and eventually deformity (if not treated in time). RA is popularly characterised by its episodic nature – the symptoms tend to come and go in episodes known as “flares” or “flare-ups”.
The condition initially affects only joints. However, if left untreated, it can adversely affect other body parts, including the eyes, skin, lungs, and even the heart. As rheumatoid arthritis progresses, the body changes. Each stage of RA comes with different management strategies.
Stages of Rheumatoid Arthritis (RA)
Stage 1
This is the first stage of rheumatoid arthritis. Many individuals report some stiffness in small joints like fingers, toes, feet, and hands, right after they wake up or after long periods of rest.
This stage may come with joint pain, barring the swelling that is commonly associated with RA. The swelling may start by affecting only one joint as opposed to the symmetrical pattern typical of RA.
Since the symptoms are not too obvious in this stage, individuals affected by the condition may not initially be aware of it. A series of imaging and laboratory tests is conducted for a proper diagnosis. Blood tests may not always indicate inflammation markers. Antibodies (ACPA/Anti-CCP, RF), typically identified to make a diagnosis, may also be present years before the symptoms even develop.
If you identify unusual stiffness and joint pain (along with other symptoms such as fatigue, recurring fever, etc.) in stage 1, you must visit a rheumatologist. Tackling the condition with appropriate management strategies in the initial stage itself can help you lead a much more active life. If your body responds well to treatment, you may be able to cut down the frequency of flare-ups and significantly delay progression.
Stage 2
This is the next stage of RA, also commonly known as the moderate stage. It is when your condition has progressed to this phase that antibodies may become more detectable, and your joints start swelling. The inflammation may also start to spread to other parts of the body, such as:
- Lungs
- Eyes
- Skin
- Heart
Additionally, you may also be noticing small bumps under your skin, typically near the elbows. These are known as rheumatoid nodules. At this stage, it becomes easier to make a proper diagnosis as cartilage damage symptoms show up on X-ray.
However, if an X-ray is normal even at this stage (despite persistent pain & stiffness), an MRI may be advised.
*Note: It is important to note that, in some cases, Rheumatoid Arthritis (RA) may progress to stage 2 before being identified or diagnosed.
Stage 3
Once rheumatoid arthritis progresses to stage 3, doctors classify the condition as ‘severe’. The symptoms become so apparent that blood tests or imaging scans may not even be required for a diagnosis.
The bones begin to experience erosion (damage) and the cartilage damage continues; slight changes in their appearance and formation may also occur. For instance, thickened knuckles and twisted fingers. These deformed joints can put more strain on the nerves and cause further pain.
Stage 4
This is the final stage of RA. In this stage, inflammation in the joints may reduce. The joints stop functioning completely, owing to the excessive damage. The damage progresses so much by this stage that the bones may fuse (ankylosis).
That being said, it is important to note that progression may differ for different individuals. Some people’s condition may progress fast, while for others, it may take years. Some people might not even progress through all the stages.
Studies[1] suggest that severe complications like fused bones or ankylosis generally affect only 0.3% to 1.5% of people with RA.
👉 Read more: Different Types of Rheumatoid Arthritis (RA) Explained
Signs of Rheumatoid Arthritis (RA) Progression
In case you’re wondering how to tell if your rheumatoid arthritis may be progressing, here are some signs to look out for:
- Persistent fatigue
- Increase in joint pain & stiffness
- Evident swelling
- Tender joints
- Symmetrical pain (in the same body parts on both sides of the body)
- Rheumatoid nodules
- Diminishing range of motion
- Tingling or numbness in fingers
- More frequent flare-ups
👉 Read more: Symptoms of Rheumatoid Arthritis
RA is a chronic autoimmune condition. However, its progression may not always look the same for every individual. This is why Sohana Hospital’s team of expert rheumatology doctors in Chandigarh works tirelessly, collaborating with multiple departments, to devise the most effective and personalised treatment plans, suited to each patient’s unique needs.
From cutting-edge diagnostic facilities to modern treatment options for an array of autoimmune diseases – our dedicated staff & doctors take care of you, no matter the stage of your condition. So if you or a loved one has been dealing with the above-mentioned symptoms, visit Sohana Hospital today, delay disease progression, and achieve a pain-free life.
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