Remission Through Early and Aggressive RA Treatment


People with rheumatoid arthritis (RA) can suffer permanent joint damage as early as into the first six months of the disease.  As a result, many rheumatologists believe early and aggressive treatment is the best approach to managing rheumatoid arthritis.   Many also prescribe to a theory that today’s newer RA medications along with older ones can allow at least half of the people with RA to achieve remission.

What is rheumatoid arthritis remission?

The term remission is defined as a period when disease symptoms are greatly reduced or no longer apparent.  For rheumatoid arthritis patients, clinical remission is when all or most of the symptoms, such as fatigue, pain and inflammation, of RA have gone and damage to joints has stopped.

The American College of Rheumatology has several critical factors that determine whether a patient is in clinical remission from rheumatoid arthritis.  These are:

  • Morning stiffness for less than or equal to fifteen minutes;
  • No fatigue;
  • No joint pain;
  • No joint tenderness or pain with movement;
  • No tissue swelling in joints and tendons; and
  • An ESR or erythrocyte sedimentation rate (blood test to measure inflammation) less than 30 in men and less than 20 in women.

Achieving Remission by Treating Early and Aggressively

Early and aggressive treatment is not a new concept.  In fact, it goes back to the late 1980s when the Lancet published a study that promoted starting anti-rheumatic drugs early. That study, according to the National Institutes for Health, looked at medications that were on the market at the time, including Plaquenil (Hydroxychlorquine) and Azulfidine (sulfasalazine). Methotrexate and biologic agents were not yet available.   The main difference between the current theory and 1989 study is just in the types of drugs used in treatment but essentially the idea is the same. An alternative study looked at 92 medical centers in Australia and Europe wherein three quarters of those treated with a combination of methotrexate and Enbrel experienced no advancement of joint damage by the three year mark and more than 40 percent achieved clinical remission.

Remission is the best outcome when RA patients treat early and aggressively. Further, disease advancement can be stopped before joint damage occurs. For patients who do not experience remission, there is still a potential for major improvement of RA symptoms and low disease activity.

For patients who have the potential to develop a more serious form of rheumatoid arthritis, early and aggressive treatment is vital.  Because doctors do not know who these patients are, they must take the presumption that joint damage and severe disease activity is possible for all patients.

What Does This Mean for You?

A major goal of disease management is to begin treatment as soon as possible in order to prevent damage to joints and allow patients the best chance of achieving and staying in remission.   Through available research, doctors and patients know that treating early and before damage occurs, patients have a higher probability of achieving remission.  Further, if RA is treated aggressively, the chances of remission are even greater.

Most RA patients who are treating with methotrexate and biologics are already experiencing low or moderate disease activity.  As the patient, make it a point to talk to your doctor if you are still experiencing disease activity.  Trying a higher dose of your current medication or even a different medication may get you in the right direction. If you are seeing major improvement in symptoms and low disease activity, you are much closer than you think.

Rheumatoid Arthritis and Diet: Things You Can Do – Guest Post

It’s probably not the news you wanted to hear, but despite countless studies by a number of different researchers testing a number of different methods, there has yet to be any conclusive data that suggests certain foods can help with your rheumatoid arthritis.

That said, there’s still plenty that you can do to help quell your symptoms, and much of that can be predicated on what you’re eating.

Keep a Watchful Eye

First and foremost, it’s important to note that, no matter what you read here or anywhere else on the web – or even hear from a doctor – the only thing that matters is how your body responds to certain things. While many of the people giving you this advice surely know what they’re talking about, they are, of course, generalizing. And while this generalization could be backed by boat loads of experience, it’s still generalizing.

So, when trying to figure out how to deal with your rheumatoid arthritis, you must accept that you’re committing to a perpetual game of guess and check. You need to experiment, stick with what works and move on from what doesn’t.

Anti-Inflammatory Foods

This should go without saying, but if you’re trying to quell the symptoms of rheumatoid arthritis, it’s probably a good idea for you to try to eat as many foods that have anti-inflammatory properties and capabilities.

At the top of that list is fish, which are packed with huge amounts of omega-3 fatty acids, which have been proven time and time over to be great for helping the body move blood around.

It’s also important to remember that, while what we said earlier about the dearth of evidence pointing to any conclusive diet that can absolutely help with symptoms no matter what, fish oil supplements are very popular for use with people with rheumatoid arthritis.

Seeing as fish oil is, well, exactly that, the extract of oils from many of the same fish you can find at the seafood department of your local grocery store, it’s probably a good idea for you to start your experimenting there and see how that works out for you.

Eating Less Altogether

This may not apply to many people, and this certainly isn’t to suggest that any of the problems you’re having are your own fault. Of course they’re not.

That said, if you’re suffering from rheumatoid arthritis, weight loss may be a great way for you to help alleviate some of your symptoms.

This is because no matter what the cause of your rheumatoid arthritis, many of the pains and swelling you’re experiencing is only going to get worse if you’re putting a ton of stress on those areas by way of weight.

This is particularly true of joints, which are often the worse sites of rheumatoid arthritis pain. Even if they’re not, it’s worth pointing out that being overweight or obese could contribute to a number of problems later on down the road, many of which will only make dealing with the rheumatoid arthritis you’ve got that much worse.


This isn’t simply an extension of the weight loss subsection, but it’s certainly worth noting that exercise is one of the best ways to help you lose weight.

Exercise, though, is also remarkably effective at helping move blood throughout the body. This is because when you exercise, your heart begins to race to try to ensure that you’re being provided with enough oxygen-rich blood to get you through your workout.

In the meantime, though, all of that circulating can help get all of that blood away from your problem areas, which should certainly help alleviate pain.

Valerie Johnston is a health writer located in Lake Fork, Texas. She is passionate about running and clean eating and writing for ensures she stays up-to-date on the latest trends and news in the health and fitness industry.

Guest Post: Applying for Social Security Disability with Rheumatoid Arthritis

If you have rheumatoid arthritis which has progressed to the stage that it severely affects your daily abilities, including your ability to complete typical duties required to maintain gainful employment, then you may be eligible for Social Security Disability (SSD) benefits.

The Social Security Administration (SSA) has two disability programs for which you may be eligible:

  • Social Security Disability Insurance (SSDI), which is a benefit program for workers who have paid into the Social Security system in the past.
  • Supplemental Security Income (SSI), which is a need-based program intended to provide benefits to disabled workers and their dependents who have very limited income and other financial resource and who may or may not be eligible for SSDI.

Meeting the Basic SSD Requirements for Both Programs

To be eligible for SSD benefits, you must meet both the medical and technical requirements defined by the SSA. The medical requirements include having a medical condition that:

  • prevents gainful employment
  • has lasted or is expected to last a year or more or which is terminal

The technical eligibility for SSDI dictate you have:

  • the predetermined number of work credits built up over the course of your employment, based on your age at the time you become disabled,


  • earnings from employment of $1,040 per month or less, which is what the SSA considers gainful employment (as of 2013).

SSI technical eligibility is determined by your total countable income and resources. The calculation of these resources is fairly complex, with some sources of income and some financial resources and assets being counted and others not. As a need-based program however, your income and available resources must be very limited to qualify for SSI.

You can learn more about the differences between SSDI and SSI HERE.

Meeting the SSA’s Listing for Rheumatoid Arthritis

The SSA maintains a list, which is known as the Blue Book, of conditions known to be disabling. Rheumatoid arthritis is included on that list and falls under the listing in Section 14.09, which is titled “Inflammatory Arthritis”.

To qualify for benefits under this listing, your application and your medical records must specifically show one of the following to be true:

  1. At least one of your major joints that support your weight or which allow you to walk, reach, grasp, or perform other essential functions is affected by ongoing inflammation or persistent or advancing deformity.
  2. deformity or inflammation of at least one of your major joints that is accompanied by:
    • severe affects to one of more of your organs or body systems


    • a minimum of two full body symptoms of the autoimmune affects of rheumatoid arthritis, including any of the following:
      • unintentional and uncontrolled weight loss
      • severe fatigue
      • persistent fever
      • malaise
  1. inflammation in your spinal column, or fusing of vertebrae in your spine resulting in significant malformation of the spine and an inability to maintain a proper stance
  2. continuous symptoms with at least two of the autoimmune symptoms listed above, which also results in:
    • pronounced reduction in your overall daily abilities
    • significant effects on your ability to function socially
    • an inability to complete tasks in a reasonable timeframe or to maintain a consistent pace, to concentrate, or remain on task

Submitting Your Application for SSD

You can complete your disability application online at the SSA’s website or in person at your local SSA office. The online application is often the fastest way to file a claim, as there is no need to wait for an appointment.

You may wish to get help with your claim from a Social Security advocate or disability attorney. Having help from someone more familiar with the process can potentially increase your chances of being approved for benefits.

Article by Ram Meyyappan