Untreated RA can cause severe damage to the hips, knees, and feet. However, with current treatments, RA shouldn't progress to the point that you cannot walk. You and your doctor can work together to limit any joint damage and maintain your mobility.
Inability to walk owing to severe RA may involve factors other than RA. Obesity or previous joint damage may lead to secondary osteoarthritis, particularly in the knees. Treatment with corticosteroids (prednisone or Medrol) is sometimes necessary to curb the intense inflammation and stiffness associated with RA. Unfortunately, these drugs are a “doubleedged sword”: They can cause significant weight gain, which in turn contributes to arthritis of the legs. Bacterial joint infection (septic arthritis) can also cause severe permanent joint damage. Fortunately, this is a very infrequent complication of RA.
Corticosteroids
Any of the steroid hormones made by the cortex (outer layer) of the adrenal gland; also called cortisol and steroids. These potent drugs are used to reduce the pain and inflammation associated with rheumatoid arthritis and other autoimmune disorders.
Septic arthritis
Arthritis caused by invading microorganisms.
Chronic treatment with corticosteroids may lead to muscle weakness that can complicate walking-related problems. These medications are also a risk factor for the development of osteoporosis. Falling—or fear of falling—can also dissuade patients from walking. Adaptive devices such as canes, walkers, or Rollators (a rolling walker with a seat) can make a world of difference, although younger patients are sometimes reluctant to use these devices.
Managing RA frequently requires a team approach. For example, your team may include your rheumatologist, primary care physician, orthopedic surgeon, rehabilitation specialist (or physiatrist), and physical and occupational therapists. Not everyone needs the care of every member of the treatment team at the same time, of course. As on any team, each member has a specialty that he or she brings to bear as the patient's symptoms dictate.
Rheumatologist
A physician who specializes in the treatment of diseases of the joints and connective tissue.
All patients with a diagnosis of RA should be involved in an exercise program to maintain their strength and flexibility. A physical therapist can help determine your need for therapy and teach you the exercises you should perform every day.
All patients with a diagnosis of RA should be involved in an exercise program to maintain their strength and flexibility.
When joint pain is severe or the range of motion in the joint is limited, consultation with an orthopedic surgeon may be necessary. Hip or knee replacement can create dramatic improvements in the quality of life for patients with severe arthritis of those joints. While orthopedists are skilled in the treatment of severely damaged joints, they should not be solely in charge of the management of a patient with RA. This situation frequently leads to too many surgeries and too little use of disease-modifying drugs.
The worst thing you can do is to ignore your disease. Medical studies have shown that early treatment of RA can halt its
progression and reduce the risk that you will suffer permanent joint damage.