Rheumatoid Arthritis: What to Expect

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It's never possible to tell someone exactly what to expect when they're first diagnosed with rheumatoid arthritis (sometimes referred to as RA). As with many autoimmune diseases, the way people experience rheumatoid arthritis varies quite a lot from one person to another. For instance, some people only have mild symptoms, whereas others may find themselves debilitated by pain in multiple joints or from inflammation in unexpected parts of the body, such as the lining of the lungs.

Still, over time, researchers have learned more about the usual course of rheumatoid arthritis. Here are some important findings:

Three broad patterns of rheumatoid arthritis have been identified.

  • A lucky 10 percent of people experience prolonged remission -- when inflammation markers and symptoms disappear -- even without use of ongoing medications.

  • About 15 to 30 percent of those with rheumatoid arthritis will have an "intermittent" course, which means that the body will go through periods of disease activity but will also experience up to a year at a time of medication-free remission.

  • Most people experience "progressive" disease, in which their symptoms slowly get worse, unless they find the right combination of medications.

About 70 percent of permanent joint damage occurs in the first two years. This is why it's important to start treatment early, especially if the disease seems to be active. For those with active disease, early use of disease-modifying antirheumatic drugs (DMARDs) prevents or delays permanent damage to the joints.

After 20 years, more than half of people with rheumatoid arthritis will experience joint damage severe enough to affect day-to-day function.


Dr. Leslie Kernisan

Leslie Kernisan is a clinical instructor in the University of California, San Francisco, Division of Geriatrics, and maintains a popular blog and podcast at BetterHealthWhileAging. See full bio