Will I Become Disabled And Unable To Work?

It is impossible to predict the course of RA for a particular person, so it is equally difficult to tell if someone with RA will become disabled. However, the pattern of disease can influence the risk of disability.

For 10% of patients, RA symptoms disappear completely on their own. If disease remission occurs, it usually takes place within the first six months after the onset of symptoms. Remissions occur more commonly in those patients who do not have rheumatoid factor (RF) in their blood (Question 47 discusses rheumatoid factor). For other individuals, recurrent explosive attacks of joint pain and swelling are followed by periods of little or no symptoms.The most common pattern, however, is one of persistent and progressive disease activity that waxes and wanes in intensity.

Remission

A period in the course of a disease during which symptoms of a disease diminish or disappear.

Rheumatoid factor (RF)

An antibody found in about 85% of people with rheumatoid arthritis; it also appears in other diseases and is sometimes found in healthy people.

Risk factors for disability in RA include the following:

  • Long duration of disease
  • Many joints involved
  • High severity of inflammation of the joints
  • Presence of high levels of rheumatoid factor in the blood
  • Presence of high levels of cyclic citrullinated peptide (CCP) antibody in the blood (Question 55 discusses CCP antibody)
  • High sedimentation rate (Question 26 discusses sedimentation rates)
  • Family history of RA

In studies performed before the new therapies became available, approximately one third of patients were disabled after five years and 60% of patients were unable to work after having RA for ten years. These kinds of statistics prompt many patients to ask, “Isn't rheumatoid arthritis the ‘crippling arthritis’?”

Fortunately, the news is not so bad these days. If RA is diagnosed and treated promptly there is no reason why patients should become “crippled” or disabled. The large majority of patients who are unable to work become disabled during their first few years of the disease. This fact merely emphasizes the importance of seeking early treatment during this window of opportunity to control the disease process. Early treatment can prevent permanent joint damage and muscle weakness. By contrast, a lack of adequate treatment or noncompliance with treatment (that is, not taking your medications as prescribed) are leading factors contributing to disability.

Early treatment of RA can prevent permanent joint damage and muscle weakness.

Obviously, a person with RA may find it more difficult to continue to perform a physically demanding job, such as factory work, than to stay with a more sedentary job. If you think you won't be able to continue to work at your current job, it might be a good idea to take stock of the other sorts of job skills you have or to consider retraining. Government vocational rehabilitation training programs can be a good resource for you. Obtaining Social Security disability benefits is a very slow and frustrating process and should be considered a last resort.

I became disabled and unable to work at age 58. I do agree with your risk factors in this question. But in my own case not taking medications as prescribed was not a factor. Not taking meds as prescribed is a fool's errand.