What Is Inactive Rheumatoid Arthritis (RA)?

There is no cure for rheumatoid arthritis (RA), but with proper treatment, some people can achieve a state of remission, where the disease is not actively causing symptoms or joint damage. The time of RA in remission can vary significantly among people.

The goal of treatment for RA is to achieve and maintain disease control and remission for as long as possible. This can be done through medication, lifestyle changes, and other therapies.

Rheumatoid arthritis (RA) is characterized by periods of flare-ups (extremely severe symptoms of the disease) and periods of remission (the symptoms are less severe or may even disappear entirely).

Several factors can contribute to the activation of RA, such as:

• Genetics: Some people are at higher risk for developing RA due to inherited genetic factors.
• Environmental triggers: Exposure to certain environmental factors, such as cigarette smoke or infectious agents.
• Hormonal changes: Due to pregnancy or menopause.
• Stress: Chronic stress or acute traumatic events.
• Immune system dysfunction: An imbalance of certain types of immune cells or an overactive immune response may contribute to the development of RA.
• Poorly controlled inflammation: This may lead to the activation of RA.
• Infections: Weaken the immune system and trigger a flare-up of RA.
• Cold weather: Causes the joints to become stiff and sore, triggering a flare-up of RA.
• Lack of exercise: This can cause the muscles and joints to become weak and stiff, increasing the risk of a flare-up of RA.
• Certain medications: Corticosteroids can increase the risk of a flare-up of RA.

The exact cause of RA is not fully understood, and it is likely due to a combination of factors. Working with a healthcare provider to identify and address potential triggers is important to manage RA.

The symptoms of rheumatoid arthritis (RA) can vary widely among people and can change over time.

Here are some common signs and symptoms that may indicate that RA is active:

• Increased joint pain and stiffness: During a flare-up, you may experience more intense pain and stiffness in your joints, particularly in the morning or after a period of inactivity.
• Swelling: RA can cause swelling in the affected joints, which may become more noticeable during a flare-up.
• Fatigue: RA can cause fatigue, and flare-ups may make you feel more tired.
• Fever: Some people with RA may experience a low-grade fever during a flare-up.
• Decreased range of motion: Flare-ups may cause the affected joints to become stiff and difficult to move, leading to a reduced range of motion.
• Redness and warmth: RA can cause the affected joints to become red and warm to the touch.

Speak to your healthcare provider if you are experiencing any of these symptoms. You may require additional treatment.

The goal of treatment for rheumatoid arthritis (RA) is to achieve and maintain disease remission. This may not be possible for all people with RA. Doctors evaluate your symptoms and use tools, such as the Disease Activity Score, to determine the level of disease activity and guide treatment decisions.

The following strategies may keep rheumatoid arthritis inactive or in remission:

• Take your medications as prescribed: Medication reduces inflammation and prevents joint damage.
• Exercise regularly: Help reduce joint pain and stiffness, improve flexibility and mobility, and strengthen muscle. Find an exercise program that works for you and be consistent with your routine.
• Getting enough sleep: Important for overall health and can help manage RA symptoms. Aim for seven to eight hours of sleep per night.
• Eat a healthy diet: This can help reduce inflammation and improve overall health. Eat various fruits, vegetables, and whole grains, and limit the intake of processed foods and saturated fats.
• Manage stress: Chronic stress can worsen RA symptoms. Relieve stress through relaxation techniques, meditation, or counseling.
• Avoid smoking: Smoking has been linked to an increased risk of developing RA and can worsen RA symptoms. If you smoke, quitting can improve your overall health and RA symptoms.
• Seek support: From friends, family, and support groups to help manage the challenges of living with RA.

To prevent a flare-up of RA, manage stress, exercise regularly, and avoid infections. If you are taking any medications that may increase your risk of a flare-up, discuss them with your doctor and follow their recommendations.

Rheumatoid arthritis (RA) can lead to joint damage and disability if left untreated. The goal of treatment for active RA is to reduce inflammation, improve symptoms, and slow the progression of the disease.

• Medications
  • Nonsteroidal anti-inflammatory drugs: These are pain relievers and can help reduce inflammation and swelling in the joints. Examples include ibuprofen and naproxen.
  • Disease-modifying antirheumatic drugs (DMARDs): Can slow the progression of RA and prevent joint damage. They work by suppressing the immune system and reducing inflammation. Examples include methotrexate, hydroxychloroquine, and sulfasalazine.
  • Biologics: These are a newer type of medication that targets specific parts of the immune system to reduce inflammation and improve symptoms. They are usually administered through injections or infusions. Examples include tumor necrosis factor (TNF) inhibitors (such as adalimumab, etanercept, and infliximab), and interleukin-6 (IL-6) inhibitors (such as tocilizumab).
• Surgery
  • In some cases, surgery can repair or reconstruct damaged joints. Options may include joint replacement surgery, synovectomy (removal of the lining of the joint), or joint fusion.

If a person with RA has an inactive disease, their symptoms are well-controlled, and there is little or no evidence of disease activity. 

Having inactive RA does not mean that the disease has been cured, and flare-ups are possible. People with inactive RA may have fewer symptoms and be able to lead relatively normal lives. Work closely with your healthcare team to monitor their disease activity and make any necessary adjustments to the treatment plan.