Rheumatoid arthritis, commonly referred to as RA, is an autoimmune disease that is characterized by pain and swelling within the joints. Although the causes of rheumatoid arthritis are not fully understood, it is thought that something triggers the immune system to attack the joints. RA affects around 1% of the population and there is no known cure.
Every person’s experience with rheumatoid arthritis is different, but generally, the onset of rheumatoid arthritis is gradual and takes weeks to fully develop. A person may start experiencing the coming and going of stiffness in the hands and feet in the morning. Eventually, this will become a regular occurrence. Most people experience pain and swelling in one or two joints at first and over time more joints become involved. In a small number of people, the onset is sudden and involves numerous joints.
Rheumatoid Arthritis tends to be categorized as mild, moderate, or severe. Rheumatologists use many criteria such as a physical examination, lab tests, and x-rays to determine the severity of the disease. The goal of treatment is to keep mild RA from progressing into severe RA. The speed at which RA progresses from mild to severe varies from person to person, however, treatment can slow or even stop the progression of RA. This is a simplified explanation of what categorizes the severity of rheumatoid arthritis.
Mild
Someone with mild rheumatoid arthritis will have joint pain and inflammation of at least 3 joints, but will have no evidence of joint damage. Morning stiffness will last less than an hour and they will only suffer from slight fatigue. Lab tests will show no anemia and only a mild elevation of inflammation in the body. Mild RA is first treated with non-steroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen or naproxen. If these drugs do not give the person enough relief from symptoms, he or she may be prescribed a disease-modifying anti-rheumatic drug, or a DMARD, such as methotrexate or Arava. People with mild rheumatoid arthritis can continue with their daily activates with only minor interference from their symptoms.
Someone with moderate rheumatoid arthritis will have between 6 and 20 inflamed joints. A blood test will show elevated inflammation in the body and some anemia. A rheumatoid factor test will come back positive. X-rays will show inflammation in joints, but no damage. A person with moderate RA will need stronger medications to perform their daily activities. Moderate rheumatoid arthritis is typically treated with DMARDs or biologic drugs such as Enbrel or Humira.
Severe
Severe rheumatoid arthritis is characterized by significant joint pain and damage. A person with severe RA will have hours of morning stiffness, significant weight loss, and profound fatigue. Lab tests will show anemia and a high level on a rheumatoid factor test. Inflammation may have spread beyond the joints into other areas of the body. A person suffering from severe RA will extreme difficulty performing their daily activities. Many times, people with severe rheumatoid arthritis don’t respond well to traditional treatments and will need to try the newer biologic drugs like Orencia or Rituxan.
