Signs Rheumatoid Arthritis Is Getting Worse

Rheumatoid arthritis (RA) is unpredictable and often relentless. It’s a progressive disease that, if left unchecked, can lead to severe pain, joint deformities, and even disability.¹ What starts as occasional stiffness or mild discomfort can gradually escalate, making everyday tasks more difficult and affecting overall quality of life.

The reality is that rheumatoid arthritis doesn’t just stay the same — it either worsens over time or improves with proper management and RA treatments. The good news is that patients have more control than they think. Recognizing the early warning signs of disease progression is the first step in slowing RA progression, preventing irreversible joint damage, and maintaining one’s independence.¹

If you’ve been living with RA, you may already know that some days are better than others. But when do those occasional bad days turn into a bigger problem? Learn the key symptoms that signal disease progression and when it’s time to take action.

What You Need to Know About Rheumatoid Arthritis Progression

Rheumatoid arthritis is an autoimmune disease characterized by inflammation that primarily affects the joints. This disease typically follows a pattern of flare-ups (periods of increased disease activity) and remissions (periods of reduced symptoms), though the severity of RA progression varies from person to person.²

The goal of treatment is to:

Manage rheumatoid arthritis symptoms³
Prevent joint deformities³
Reduce inflammation to keep the condition from advancing³

However, if you start noticing worsening symptoms, it could mean that the disease is progressing more aggressively, requiring adjustments to your treatment plan.

Early Warning Signs of Worsening RA Symptoms

Rheumatoid arthritis symptoms can fluctuate, but when flare-ups become more frequent, pain intensifies, or new issues arise, it could mean the disease is progressing.⁴ Catching these changes early is crucial to preventing long-term joint damage and maintaining mobility.⁵

Increased Joint Inflammation

One of the most significant signs of RA progression is persistent or worsening joint pain and swelling. Inflammation within the joints can become more severe, resulting in heightened tenderness, warmth, and stiffness.⁶ Pain relief measures that previously worked but are no longer effective, or flare-ups that have become more frequent, may indicate disease advancement.^4,6

Morning Stiffness Duration

Morning stiffness is a hallmark symptom of RA, but if stiffness lasts longer than an hour or persists throughout the day, it may suggest increased inflammation and joint damage.^7,8 Prolonged joint stiffness needs to be discussed with a rheumatoid arthritis specialist.

Fatigue and General Malaise

Worsening rheumatoid arthritis can extend beyond joint symptoms, affecting overall energy levels. Increased fatigue and a persistent sense of being unwell (malaise) are common signs that inflammation is affecting your entire body.⁷

Unlike ordinary weariness, RA-related fatigue is often overwhelming and does not improve with rest. This type of exhaustion goes beyond feeling tired; it can make even simple daily activities feel overwhelming.

Development of Joint Deformities

As rheumatoid arthritis progresses, chronic inflammation can lead to irreversible joint deformities. This happens when the immune system continues to attack the joint lining, damaging cartilage and bones. Over time, this can cause fingers, wrists, and other joints to become misshapen or misaligned, significantly impacting movement and function.⁷

Appearance of Rheumatoid Nodules

Rheumatoid nodules are firm lumps that develop under the skin, typically near joints affected by RA. While they don’t always cause pain, their presence is often a sign that the disease is becoming more aggressive. These nodules can range in size from small to quite large and may form in clusters or on their own.^7,9

Reduced Range of Motion

Stiff and swollen joints can progressively limit mobility, reducing a patient’s range of motion. Over time, affected joints may lose flexibility, making it difficult to perform routine movements such as bending, grasping objects, or walking without discomfort.⁶ Physical therapy and early diagnosis can help slow mobility loss and preserve joint function.

Impact on Daily Activities and Quality of Life

As rheumatoid arthritis worsens, it can significantly impact the ability to carry out everyday tasks. Some of the most common challenges include:

Difficulty with Fine Motor Skills: Simple activities like buttoning a shirt, holding a pen, or opening jars become more challenging due to increased stiffness and pain in the fingers and wrists.¹⁰
Reduced Mobility: Walking, climbing stairs, or standing for extended periods may become harder as RA affects weight-bearing joints like the knees, hips, and ankles.¹¹
Increased Dependence on Assistive Devices: Many people with advanced rheumatoid arthritis rely on mobility aids like canes, walkers, or braces to move around safely and reduce strain on affected joints.¹²
Interrupted Sleep: Joint pain and discomfort often worsen at night, making it difficult to get restful sleep, which can contribute to daytime fatigue and overall exhaustion.¹³
Emotional and Mental Health Struggles: Living with worsening RA can lead to anxiety, depression, and frustration, especially if the condition limits independence and quality of life.¹³ A strong support system and early treatment are essential.

Monitoring Disease Activity

Regular monitoring is key to managing RA effectively. Rheumatologists may use the following tools to assess disease progression:

Routine blood tests to check inflammation markers (such as ESR and CRP levels)¹⁴
Imaging tests (X-rays, MRIs, or ultrasounds) to assess joint damage¹⁴
Patient-reported symptom tracking to assess rheumatoid arthritis flares, including pain levels, stiffness, and mobility changes¹⁵

Tracking these factors enables rheumatologists to adjust treatment strategies and prevent further joint deterioration.

When to Consult Your Rheumatologist

If you notice any signs of worsening RA, don’t wait — reach out to your rheumatologist.

Pain and swelling are no longer manageable with current medications
Frequent or prolonged flare-ups that interfere with daily life
New joint deformities or rheumatoid nodules develop
Severe fatigue or malaise that affects overall well-being

Early intervention can help slow disease progression, improve symptom management, and maintain a better quality of life. Treatment adjustments, physical therapy, or additional medications may be necessary to regain symptom control.

Schedule a Consultation with an ARBDA Doctor Today

Treating rheumatoid arthritis requires a proactive approach, and having the right medical team by your side is essential. At ARBDA, our experienced rheumatologists in New Jersey are dedicated to providing personalized, cutting-edge care to help you maintain your mobility and quality of life.

If you’re experiencing signs that your RA is worsening, don’t wait for the symptoms to take control — take action today! Schedule an appointment with an ARBDA specialist and get the expert care you deserve. Your joints (and future self) will thank you!

¹https://pmc.ncbi.nlm.nih.gov/articles/PMC3766928/

²https://www.med.upenn.edu/inflammatory-arthritis/rheumatoid-arthritis-ra.html

³https://www.arthritis.org/diseases/rheumatoid-arthritis

⁴https://pmc.ncbi.nlm.nih.gov/articles/PMC4553940/

⁵https://www.cdc.gov/arthritis/rheumatoid-arthritis/index.html

⁶https://nras.org.uk/resource/common-signs-rheumatoid-arthritis-is-getting-worse/

⁷https://www.hopkinsarthritis.org/arthritis-info/rheumatoid-arthritis/ra-symptoms/

⁸https://pmc.ncbi.nlm.nih.gov/articles/PMC9071544/

⁹https://my.clevelandclinic.org/health/symptoms/rheumatoid-nodules

¹⁰https://pmc.ncbi.nlm.nih.gov/articles/instance/1753004/pdf/v059p00812.pdf

¹¹https://pmc.ncbi.nlm.nih.gov/articles/PMC5356260/

¹²https://pmc.ncbi.nlm.nih.gov/articles/PMC7389411/#CD006729-bbs2-0028