Rheumatoid arthritis (RA) is a long-term inflammatory joint and autoimmune condition that may progress over time.¹ The goal of RA treatment is to slow or stop the disease from getting worse (disease progression).^1,2 While your symptoms like joint pain and fatigue may change daily, some signs such as joint damage can show that your disease is progressing.³

A change in your symptoms does not always mean that your RA is progressing. While living with RA, you may experience disease flares or periods when your symptoms and inflammation become more intense.³ Flares, or flare-ups, can last for several days or even months.³

It’s important to keep your health care providers and rheumatologist (the specialty of doctors who diagnose and treat rheumatic conditions such as RA) updated on all your symptoms.² Since RA is a condition that can progress, you should tell your doctors about changes in your symptoms. Keeping your doctor aware of your RA symptoms and how they affect your daily life will also help them understand if your treatments are working. It may be helpful to keep track of your symptoms and their location and severity in a symptoms diary or online document.

Tests That Monitor Your Rheumatoid Arthritis

A rheumatologist may use several different tests to monitor your condition and see if it’s getting worse over time.² There is no single test that says whether your RA is getting worse. Some tests that a health care provider may use include^2,3:

Your rheumatologist will help you manage your RA if it is getting worse. There are also some signs you can watch out for. If you experience these signs, schedule an appointment with your health care provider.

1. You Experience More RA Flares

If you have RA, you’ve probably noticed that your symptoms feel worse for periods of time. These periods are called flares. Flares may last for days or months.³ After a flare, your symptoms like joint pain may resolve back to a lower level.⁴ Flares can happen, but the aim is to manage them when you’re living with a chronic disease like RA.²

If you notice more frequent flares, however, this could be a sign that inflammation is increasing and you have higher RA disease activity.⁵ If you experience an RA flare, see your health care provider to discuss what’s going on and your next steps.

2. You Develop Rheumatoid Nodules

Rheumatoid nodules are lumps under the skin caused by inflammation from RA.³ According to a research study in a journal called Advances in Rheumatology, about 30 percent of people with RA have rheumatoid nodules.⁶ Rheumatoid nodules are considered an extra-articular manifestation, or feature, of RA. This happens when inflammation from RA affects parts of the body in addition to the joints.⁶

Your health care provider should check you for rheumatoid nodules during physical exams. A physical exam should be part of regular follow-up care for people with RA.² If you notice any lumps under your skin that you think might be rheumatoid nodules, schedule an appointment with your doctor.

3. Your Joints Feel More Swollen and Painful

Joint pain and inflammation, which causes feelings of tenderness, swelling, and stiffness, are hallmark symptoms of rheumatoid arthritis.³ Over time, RA inflammation can worsen and affect more of your joints. If you notice that the number of your joints affected by these symptoms increases over time, it might be a sign your RA is getting worse.¹

Joint symptoms can vary for other reasons. They may increase and feel worse during flares.³ However, if you find more of your joints are painful, tender, or stiff, ask your doctor about these changes.

4. You Have More Trouble Moving Around

Have you noticed changes in your ability to walk, climb stairs, or hold objects? Are these changes because you have more pain and stiffness in the joints of your hands or feet? Over time, inflammation from RA can cause damage and deformity in the joints the disease affects. These changes can make you less able to move around easily. They may also affect your ability to do daily activities like bathing, dressing yourself, and preparing meals.

If symptoms like pain and stiffness increase and start to affect your daily life, it may be a sign that your RA is worsening.² Talk to your doctor if you experience changes in your functioning. RA treatment options like disease-modifying antirheumatic drugs (DMARDs) aim to prevent and slow joint damage and deformity.¹

5. You Feel More Tired

Fatigue is a common symptom of RA.¹ Fatigue is more than just feeling tired — it is tiredness that doesn’t go away after a good night’s rest.⁷ It affects your ability to do daily activities like going to school or work.

If you notice that you feel more fatigued or your fatigue is lasting longer than it used to, this could be a sign that your RA is getting worse. Try to keep track of your fatigue levels. If you notice they’re getting worse, make an appointment to talk about this with your doctor.

6. Your Morning Stiffness Lasts Longer

With RA, a common symptom is morning stiffness in the joints.¹ The stiffness may affect your ability to move and use these joints. For many people with RA, the stiffness will eventually loosen up throughout the day. If you notice that your morning joint stiffness is lasting longer than it used to and your joints are loosening up more slowly, make an appointment with your doctor to get medical advice. This could be a sign your RA is getting worse.

Your doctor will listen to your concerns and offer suggestions for coping with this symptom. They may suggest physical therapy or new exercise programs.⁸ They may also change your treatment plan and suggest you try a new or higher dose of your RA medication.²

The signs and symptoms discussed in this article could be signs that your RA is getting worse, but they don’t always mean that. If you have any concerns, it’s best to talk to your rheumatology provider. They can help you figure out what’s going on and make suggestions to help improve your symptoms and quality of life with RA.

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Date of preparation: December 2024