The outlook is perhaps better than many people imagine.

• About 2 in 10 people with RA have a relatively mild form of the disease, and can continue to do most normal activities for many years after the condition first starts.
• About 1 in 10 people with RA become severely disabled.
• About 7 in 10 fall somewhere in between with varying degrees of difficulties and disability. Most will have to modify their lifestyle to some extent, but can expect to lead a full life.

However, these figures are probably becoming out of date as treatment has improved in recent years. Symptoms can often be well controlled with medication. Because of the newer and better drugs, in particular the newer disease modifying drugs, the outlook for a person who is diagnosed with rheumatoid arthritis these days is likely to be much better than it was a few years ago. Follow up studies of people being treated with the newer drugs should give a clearer idea of prognosis over the next few years.

Another factor to bear in mind is that because of the increased risk of developing 'associated diseases' such as heart disease (see above), the average life expectancy of people with RA is a little reduced compared to the general population. This is why it is important to tackle any factors that you can modify such as smoking, diet, weight, etc.

In summary

• Rheumatoid arthritis can range from relatively mild to severe.
• The outlook cannot be predicted for an individual when the disease starts.
• Treatment usually includes:

* A disease-modifying drug which reduces joint damage. You should take this all the time. It may take up to 4-6 months to begin working.
* An anti-inflammatory painkiller to ease pain. This helps symptoms but does not affect the progress of the disease. You do not need to take this if symptoms settle.

• A painkiller such as paracetamol or codeine may be added for extra pain relief.
• A short course of a steroids may be advised now and then to relieve a severe flare-up of symptoms.
• Other treatments such as physiotherapy, occupational therapy, and surgery may also be advised, depending on the severity of the disease and other factors.
• If possible, leading a healthy lifestyle such as not smoking, eating healthily, taking regular exercise, etc, can help to reduce the chance of developing associated diseases such as heart disease, stroke, osteoporosis, and certain cancers.

Further help and advice

Arthritis Research Campaign - ARC
Copeman House, St Marys Court, St Marys Gate, Chesterfield, Derbyshire, S41 7TD.
Tel: 0870 850 5000 Web: www.arc.org.uk

Arthritis Care
18 Stephenson Way, London, NW1 2HD
Helpline: 0808 800 4050 Tel: 020 7380 6555 Web: www.arthritiscare.org.uk

National Rheumatoid Arthritis Society (NRAS)
Unit B4 Westacott Business Centre, Westacott Way, Littlewick Green, Maidenhead, Berks, SL6 3RT
Helpline: 0845 458 3969 General Number: 01628 823524 Web: www.rheumatoid.org.uk

© EMIS and PIP 2005 Updated: August 2005 PRODIGY Validated

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