Jennifer Freeman, MD

Doctor of Medicine (M.D.) in 2008 from UT Health San Antonio, Surgeon at TRACC Dallas

Oct 27, 2018 4 min read

RA Progression: What are the Signs of Rheumatoid Arthritis Progression?

If you suspect you have rheumatoid arthritis (RA) or have been recently diagnosed with RA, you will likely have lots of questions and be feeling uncertain about what this disease means for your future. What is the normal RA progression? Will my symptoms get worse? How can I manage the disease? Do I have to have a surgery?

Progression of RA
These (and more) are all frequent questions asked by RA sufferers. The reality though is that each patient will experience a unique progression of this disease. RA progression depends on multiple unpredictable variables. Because it is still unclear exactly what triggers RA, it can be nearly impossible to predict an exact outcome.

Below is some general information about what to expect as well as the different stages of RA including the advanced condition known as progressive rheumatoid arthritis.

What to Expect

RA sets in motion many unpredictable symptoms that create a unique disease pattern in each patient. Here is an overview of potential outcomes that can occur while living with RA:

• Symptoms may come and go over the course of the disease
• Intensity and severity of symptoms may change over time
• Symptoms may get better
• Symptoms may worsen
• Pain can be managed and long remission periods can be achieved
• Flare-ups can become more frequent or more prolonged
• Symptoms can stay relatively consistent throughout the course of the disease

In some cases, joint inflammation may continue or worsen despite treatment. It may not necessarily lead to a full progressive state of RA, but it may become more difficult to maintain your mobility and range of motion.

RA Progression Factors

While it is impossible to know the exact progression of each patient, your physician can help you assess your specific case. The progression of your unique condition of RA will depend on many factors including (but not limited to) the following:

• Whether or not you have a family history of the disease
• The age at which you were diagnosed
• What the potential triggers of the disease are as discussed with your physician
• Whether you have the presence of rheumatoid factor or anti-CCP in your blood tests
• The stage at which your condition was diagnosed

Stages of RA

There are four distinct stages of RA progression, and each has their own treatment courses.

Stage 1: This is early stage RA. This stage involves the initial inflammation in the joint capsule and swelling of synovial tissue. The swelling causes the symptoms of joint pain, swelling, and stiffness.

Stage 2: In the moderate stage of RA, the inflammation of the synovial tissue becomes severe enough that it creates cartilage damage. In this stage, symptoms of loss of mobility and decreased joint range of motion become more frequent.

Stage 3: Once the disease has progressed to stage three, it is considered severe RA. Inflammation in the synovium is now destroying not only the cartilage of the joint but the bone as well. Potential symptoms of this stage include increased pain and swelling and a further decrease in mobility and even muscle strength. Physical deformities of the joint may start to develop as well.

Stage 4: In the end stage of RA, the inflammatory process ceases and joints stop functioning altogether. Pain, swelling, stiffness and loss of mobility are still the primary symptoms in this stage.

Early Detection and Diagnosis

As with most diseases, early detection and diagnosis are crucial for being able to treat symptoms, manage pain, and slow progression. An early diagnosis of RA can help you and your team of physicians and specialists put together an individualized treatment plan so that you can continue living a high quality of life.

Early on, you will want to discuss your case with a rheumatologist or RA specialist who can provide you with the treatment you need to delay the disease’s progression. Generally, early diagnosis treatment is aggressive and targeted to properly manage the disease and prevent it from progressing.

If your RA was diagnosed in the early stage when symptoms first appeared, your chances of achieving longer periods of remission typically increase drastically. That’s not to say you won’t experience flare-ups. Early diagnosis simply helps manage the disease and cannot guarantee the complete elimination of symptoms.

Progressive Rheumatoid Arthritis

Progressive rheumatoid arthritis is the condition that occurs when advancing through the disease stages. This advancing condition is characterized by more frequent bouts of inflammation and worsening chronic pain. Additional symptoms that never occurred before can also start to develop in patients who have progressive rheumatoid arthritis.

Progressive rheumatoid arthritis requires a deliberate treatment plan provided by a team of physicians and specialists. This plan should be tailored specifically to your individual symptoms and history of the disease.

Keep in mind that what works for some patients may not work for you. Your response to treatment is largely dependent on the potential factors that triggered your RA, including genetic background.

Symptoms of Progressive Rheumatoid Arthritis

Here are some general warning signs and symptoms that you may have developed progressive rheumatoid arthritis:

• The “active” state of the disease is becoming more frequent
• Flare-ups are occurring regularly and lasting for longer periods of time
• Your pain and swelling are becoming more intense, spreading throughout other areas of your body
• Your diagnosis occurred early on, and so the disease has had a long time to develop
• You are beginning to develop rheumatoid nodules that you didn’t have before
• Your blood tests show high levels of Rheumatoid Factor (RF) or anti-CCP

If you suspect that your rheumatoid arthritis has become progressive, consult your rheumatologist to determine the changes in your condition and discuss potential adjustments to your treatment plan.

When to Seek Treatment

The following are general guidelines of when to seek treatment for your RA progression:

• When you first suspect symptoms
• Regularly during the first few years of diagnosis
• If you suspect you are experiencing progressive rheumatoid arthritis
• If you feel your condition is worsening in any way or new symptoms appear


While it is difficult to prevent the disease itself due to its unknown causes, RA progression can be managed. The ultimate goal is to stop symptoms from worsening and to prevent the disease from advancing through its stages.

If you undergo individualized, targeted and aggressive treatment early in your disease process, you are more likely to delay and possibly prevent the progression of RA. Working closely with your physician to determine the specific stage of your condition will help to create a unique treatment plan for you for each stage.


View Sources Last Edited: October 27, 2018

Sources and Citations

Understanding RA Stages and Progression