There is no standard time frame for rheumatoid arthritis. Some folks will have symptoms for weeks or months before the illness ramps up. For others, it can flare up over a period of days. How fast does rheumatoid arthritis progress?
The Short Answer: RA Can Progress Early
RA usually begins slowly, with stiffness, swelling and pain in small joints in the hands and feet. But just because it's gradual, doesn't mean it's gentle. John Hopkins says that bone erosion and cartilage damage can be seen as early as two years into the illness, while the NHS reports RA damage can be irreparable if it is not well managed.
So, the answer is this: Rheumatoid arthritis can start in weeks or months, but destruction can begin early, if the inflammation continues.
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What Affects How Fast Rheumatoid Arthritis Progresses?
Early Treatment Matters Most
This is the most important. The NHS stresses quick diagnosis of rheumatoid arthritis is important as early treatment stops it progressing and helps prevent the arthritis damaging your joints. The recent EULAR guidelines also recommend starting DMARDs as soon as you're diagnosed, and the Arthritis Foundation guidelines continue to recommend methotrexate as the typical first line for many people with moderate and high RA disease activity.
Some Cases Are Naturally More Aggressive
RA is unpredictable. Johns Hopkins states the progression of rheumatoid arthritis cannot be predicted. Some may have short periods of remission, although more commonly, the disease is active and fluctuates over time.
Blood Tests And Scans Can Offer Clues
Some biochemical tests may indicate a high-risk pattern. People with positive rheumatoid factor and anti-CCP antibodies may have more severe RA and require more aggressive treatment. X-rays and MRI scans can also be used to monitor inflammation and joint damage.
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Signs RA May Be Progressing
When it's time, progression isn't just bad deformities. It can show up as:
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longer-lasting morning stiffness
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more joints that are painful or swollen
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more frequent flares
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weaker hand grip or increasing fatigue
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struggling to dress, cook, walk, or drive
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What To Do if You Think Your RA is Changing
Don't wait until your symptoms are "severe". If the joint pain, swelling or stiffness has persisted for six weeks or more or your symptoms are definitely getting worse, it is time for a review. Keeping diary of flares, morning stiffness and joints affected will assist your clinician in determining whether medication and/or monitoring and/or x-rays should change.
The Bottom Line
So, how fast does rheumatoid arthritis progress? The onset can be slow or rapid, or it can vary, but rest assured, RA activity can cause early joint damage. We all experience different timelines, but early treatment provides the greatest chance for slowing which joint damage occurs, minimising joint damage and maintaining quality of life. If there's one thing to take away from this, it's this: while playing RA, the rule is patience makes it seem faster.
