Residual Symptoms in Patients with Rheumatoid Arthritis

The Arthritis Foundation estimates over 54 million adults1 and almost 300,000 children2 have a doctor-diagnosed form of arthritis or other types of rheumatic disease in the US. Rheumatoid arthritis is a chronic inflammatory disorder that affects your joints and damages other organs. Care of patients who suffer from rheumatoid arthritis is directed at ensuring a sustained remission of the disease. By doing so, patients can avoid the chronic pain, joint instability, and joint deformity that characterized RA only 20 years ago.

Rheumatoid Arthritis (RA) is also an autoimmune disorder, meaning your immune system mistakenly attacks your own body tissues. Recent studies have reported a high frequency of residual symptoms in patients with rheumatoid arthritis who are thought to be in remission.3 Some of the typical “residual” symptoms include pain (or soreness), ongoing fatigue, morning joint stiffness, and difficulty sleeping. 


Studies reveal one of the inherent residual symptoms in patients with rheumatoid arthritis is pain. Notably, one study using the Visual Analog Scale (the chart that everyone has seen in their doctor’s office with the happy face or sad face) revealed that, of the 157 patients under observation, pain scores reported as ‘clinically significant’ occurred in up to 12 percent of patients.4 This finding gives credence to the thought that some pain levels persist despite achieving low disease activity — and underscores why building an honest relationship with your ARBDA Rheumatologist is key for the best long-term outcome.


Fatigue is also a common residual symptom reported in patients with rheumatoid arthritis. RA  can cause low-level inflammation inside of the body that can lead to general weakness, drowsiness, and exhaustion. In studies investigating remission or Low Disease Activity (LDA), one study by Castrejón and colleagues revealed the percentage of patients in remission who experience fatigue ranges between 53 to 65 percent, depending on the definition of remission.4

Morning Joint Stiffness

Joint stiffness (especially when waking up in the morning) was reported in five studies investigating residual symptoms in RA patients.3 Although the symptom can ease up after an hour, proper control of RA can greatly reduce the occurrence of this particularly bothersome symptom. Common areas where patients feel the stiffness include their fingers, hands, wrist, elbows, knees, ankles, feet, jaw, hips, and shoulder. 

Trouble Sleeping

Studies using the Pittsburgh Sleep Quality Index (PSQI) measuring tool reported substantial sleep disturbances in RA patients — even in those who were deemed to be in remission. Talk to your ARBDA Rheumatologist about proper sleep hygiene and maintenance.

Key Takeaway

Residual symptoms can indicate incomplete remission that occurs in patients after acute treatment. If you have any questions or need help with managing the symptoms of rheumatoid arthritis, contact ARBDA today! ARBDA has the best rheumatoid arthritis specialist in New Jersey. Schedule an appointment at your earliest convenience.