Rheumatoid arthritis is a progressive disease, causing increased
joint destruction and restricted movement over time. But the time course
and total extent of this disability varies significantly between people and can
be controlled by treatment with medicine.
Quality of life with rheumatoid arthritis
Rheumatoid arthritis affects people in different ways, both in the
symptoms they experience and in the severity of joint changes. Ultimately,
rheumatoid arthritis most commonly leads to joint destruction and deformity if
the disease process is not altered. The bone and
cartilage are eroded, and the surface on which the
joint movement occurs is destroyed, often leading to loss of range of motion.
This process may occur over many years. But in certain people, it develops much
Treatment can slow or even stop this process. But some people with
rheumatoid arthritis have complete loss of function of a particular area,
especially the hands. In rare cases, when other organs besides the joints are
affected in rheumatoid arthritis, especially when inflammation of blood vessels
(vasculitis) is present, rheumatoid arthritis may be
People often ask whether rheumatoid arthritis can spontaneously go
into remission, and unfortunately, for the vast majority, the answer is no.
Very few people who have rheumatoid arthritis will experience complete remission
without treatment. Much more commonly, rheumatoid arthritis is a chronic, often
disabling condition when not treated early and continually.
It has been known for quite some time that the permanent destruction
of joints begins within the first 2 years of disease in the majority of people
who have rheumatoid arthritis. Untreated, this joint destruction leads to loss of
motion, persistent pain and stiffness, and deformity. Eventually, this process
often ends in "burnt-out" disease in which a person is left with deformed,
immobile joints, but little remaining inflammation. Several treatment systems
have produced good results in preventing new erosions. This has led many rheumatologists to believe that remission of rheumatoid arthritis can be
induced just as it is in some cancers.
Anne C. Poinier, MD - Internal Medicine
Nancy Ann Shadick, MD, MPH - Internal Medicine, Rheumatology
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