Understanding Rheumatoid Arthritis Symptoms
Rheumatoid arthritis symptoms may vary from person to person. In some people with RA, symptoms may come and go or will vary in severity.
Some will experience periods (or episodes called flare-ups) of intense pain and discomfort that may last for days, weeks or even months at a time. While some people may experience periods of no symptoms at all. Over time, this rheumatoid arthritis symptom roller coaster will cause your joints to deform.
It's important to know that RA symptoms do not just affect the joints, they also affect the entire body or specific parts of the body, such as eyes and skin.
RA is generally symmetrical, which means if one side is affected, the other is likely affected as well. However, most people with RA can tell you that this is not always the case.
First, in order to understand the second part of what rheumatoid arthritis is, you must begin with its symptoms, starting from rheumatoid arthritis joint symptoms to the physical symptoms of RA, to the severe symptoms of RA itself. Below you will learn more about the 20 symptoms of rheumatoid arthritis you should watch for.
Rheumatoid Arthritis Joint Symptoms
RA always affects the joints and causes the following classic joint rheumatoid arthritis symptoms:
Stiffness
One of the earliest signs of RA is stiffness in the small joints, usually the small joints of the hands and feet. Stiffness comes on slowly, but it is possible for it to be sudden and affect multiple joints over a period of a few days.
Morning stiffness, upon waking, is also common. Stiffness that lasts for several hours is also normal with RA. It is also possible to feel stiffness after sitting down for long periods of inactivity.
Pain
Joint stiffness eventually results in pain and tenderness during movement and while at rest. The most common pain sites in RA are the hands, fingers, and wrists. Later on, you may also develop pain in the feet, ankles, shoulders, knees, and hips.
Swelling
Inflammation of joints causes joints to appear swollen. Swollen joints may also feel warm and tender to touch. Swelling and inflammation can last day or weeks, and flares will increase the longer you live with RA.
Limited Range of Motion
Dealing with stiffness, swelling and pain can result in limited motion in joints, especially in people with advanced RA. In some cases, range of motion loss in certain joints can be permeant.
Working with a physical therapist can help to preserve your range of motion. RA medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), can also help.
Joint Locking
Joint locking is common in advanced RA. It’s the result of cartilage wearing away and bony growths. It most often affects the knees and finger joints. It is basically what happens when your joints get stuck and you can’t release them.
Joint locking can be painful, and frequent joint locking should be reported to your doctor. Treatments for joint locking include cortisone injections to decrease inflammation in affected joints and surgery as a last resort and especially of the joint remains locked, such as is the case for a condition called “trigger finger."
Deformity and Disability
Over time, RA can cause joints to shift out of place and become deformed. RA may also cause joint immobility and disability.
Surgical intervention can repair and replace damaged bones and joints and is often successful in restoring joint function.
Whole-Body Rheumatoid Arthritis Symptoms
RA most often affects the body’s joints, but because it is also systematic, meaning it affects the entire body, including organs.
Fatigue
Fatigue is common in all stages of RA. Early on, however, fatigue is felt long before any other rheumatoid arthritis symptoms became noticeable, and it may start weeks or months prior to any symptoms.
RA fatigue is often accompanied by with an overall feeling of ill health and/or a depressed mood. This fatigue is the body’s response to inflammation, sleep issues, medications used to treat the disease, and other effects of the disease, including anemia.
Rheumatoid arthritis fatigue causes lack of energy and motivation and negatively affects mood, relationships, productivity, and happiness. Fatigue is also associated with poor appetite, weight loss, and digestive problems.
Muscle Aches
Just as inflammation affects the joints, it can also affect the muscles. Muscle soreness and stiffness are common in RA. Muscle aches can cause muscles to spasm and cramp up. Stretching the muscles near affected joints may help you regain motion.
Malaise
Malaise is a feeling of discomfort, illness and overall uneasiness often experienced by people with RA. Signs of this condition are lack of energy, sleepiness, weakness, and achiness. Some people with RA describe it similar to the exhaustion and sickness experienced when having the flu.
Depression
RA and depression tend to occur together. Studies have shown when depression in people with RA is not addressed, RA treatment is less effective.
Researchers do not know what exactly causes people with RA to experience depressed moods, but they speculate it is related to their physical symptoms. Left untreated, depression in people RA can result in more pain, increase the risk for heart problems, and cause relationship problems, loss of productivity at work and sexual problems.
The good news is t RA and depression respond to treatment when both conditions are addressed. If you have RA and feel depressed, it is important to talk to your doctor, as medication, support, and personalized treatment can significantly improve your quality of life.
Anemia
Research shows that 33% to 60% of RA patients suffer from anemia. Anemia occurs when your body is not producing enough blood red cells.
Researchers do not know why anemia affects people with RA, but they think whole-body inflammation is to blame. Inflamed tissues release proteins that affect the body’s ability to use iron and make new red blood cells, resulting in low red blood counts.
Bruising
RA causes blood platelet levels to drop quicker than normal, which makes it easier for you to bruise. Certain medications used to treat RA, including prednisone, also increase your risk for bruising, and if you are anemic, you are also likely to bruise more easily.
Fever
Some people with RA development low grade fevers frequently, while offers feel feverish only during flare-ups. If you experience fevers due to RA, getting your inflammation under control will improve fevers.
GI Symptoms
Studies show people with RA have more gastrointestinal (GI) problems than people without the disease. High levels of inflammation and impaired immunity are likely culprits, as are the medications used to treat inflammation, including NSAIDs.
GI symptoms in people with RA include diarrhea, constipation, indigestion (heartburn) and acid reflux. Further, people with RA have an increased risk for upper GI events and lower GI events.
Upper GI events include ulcers, inflammation of the esophagus, and GI perforation (a hole in the stomach wall). Lower GI events include bleeding, diverticulitis (infection of the lining of the intestine) and colitis (large intestine swelling).
Symptoms of Severe RA
One of the problems with treating RA is that the progression of the disease is not the same in everyone who has it, and despite the availability of better and more aggressive treatments, some people with RA will still develop symptoms that may indicate a more severe disease.
Skin Symptoms
RA affects your skin and about a quarter of people with RA develop rheumatoid nodules or lumps of tissue under the skin. RA also causes you to experience itchy and dry skin, and skin rashes, skin ulcers, and even mouth sores.
While some skin irritation and dryness are not unusual with RA, painful skin rashes and ulcers and mouth sores are related to a condition called vasculitis or inflammation of blood vessels. It is possible for this type of inflammation to stop blood flow, so it is a good idea to see your doctor if you show any signs of vasculitis.
Eye Symptoms
Eye conditions, including dry eye syndrome, are common people with RA. Dry eye syndrome causes blurred vison.
Talk to your eye doctor about eye drops or invest in a humidifier to relieve dryness. If you experience eye pain, redness or swelling, get checked out as these symptoms may be a sign of more severe eye conditions.
Patients with RA also have an increased risk for Sjögren’s, another autoimmune disease that affects the eyes and mouth. It is known for affecting the tear glands, causing redness and dryness of the eyes.
Mouth Symptoms
Research has shown people with RA are more likely to develop periodontal (gum disease) disease. This is likely due to having dry mouth, which may eventually cause tooth decay and gum infections.
Research reported in the medical journal, PLOS One, suggests the bacteria associated with gum disease can make RA symptoms worse and even cause RA to progress quicker. But treating gum disease improve RA symptoms.
To minimize the effects RA has on your dental health and improve rheumatoid arthritis symptoms, make sure you see your dentist twice a year to catch minor issues before they become worse. Further, make sure you are brushing and flushing twice daily.
Numbness and Tingling
Inflammation in the tendons puts pressure on nerves and may cause numbness, tingling and/or burning in the hands and feet of people with RA. These symptoms may also be a sign of a complication, a condition called neuropathy.
While there are different types of neuropathy, sensory neuropathy is the most common in people with RA. This type of neuropathy affects the nerves responsible for carrying pain signals to the brain.
Nerve pain should never be ignored so if you experience this symptom, notify your doctor immediately.
Lung Symptoms
According to research, up to 67% of people with RA have some degree of lung involvement that can be seen on imaging studies. In many cases, lung involvement is not severe enough to cause symptoms, but according to this same report, at least 40 percent of people experience respiratory symptoms.
Severe and prolonged inflammation can lead to a condition called pulmonary fibrosis, a condition that is difficult to treat and affects breathing. It is also possible for rheumatoid nodules to form on lungs, but much like those on skin, they are often harmless.
Heart Symptoms
Having RA increases your risk for heart disease. Further, RA inflammation affects the heart and eventually hardens the arteries.
The best way to decrease your risk for heart conditions related to RA is to get inflammation on under control. It is also important to not smoke, avoid second-hand smoke, eat a healthy diet low in saturated fats, be active, and make sure you are treating and managing all health conditions, especially high blood pressure and diabetes.
Shortness of breath and chest pain are signs something is wrong. If you find yourself running of breath or experiencing chest pain, you should seek medical attention right away.
Do All of These Rheumatoid Arthritis Symptoms Mean I Have RA?
Your healthcare provider may conduct a thorough evaluation in order to make an accurate diagnosis of RA or if it is another condition mimicking RA. This evaluation may encompass a history and physical and possibly blood tests, imaging studies, and biopsies. They may assess your symptoms and determine if they are due to RA or some other form of arthritis.
During the history, your healthcare provider may ask you lots of questions. It can be easy to feel overwhelmed, but try to be succinct, clear and honest. Before arriving at your appointment, you can prepare by asking yourself:
- When did my symptoms start?
- Did my symptoms develop slowly over time or rapidly?
- Does anything seem to trigger my symptoms?
- Do my symptoms remain constant or do they wax and wane?
- Do I feel better or worse in the morning when I wake up?
- What makes my symptoms worse?
- What makes my symptoms better?
- How are my symptoms impacting my life?
- How severe are my symptoms on a scale from 1 to 10, with 10 being the worst?
If your healthcare provider determines that you have RA, they may refer you to a physician or nurse practitioner who specializes in rheumatology. It is absolutely imperative that you schedule and attend this appointment because delaying treatment will lead to further joint damage.
Understanding the Risk Factors of Rheumatoid Arthritis
A meta-analysis published in the Annals of the Rheumatic Diseases found that any history of smoking cigarettes increased both men and women’s risk of developing RA; men with a history of smoking were almost twice as likely to develop RA, and women with a history of smoking were 1.34 times more likely.
Other possible risk factors for developing RA include:
- Genetic predisposition
- First-degree relative with lupus
- Increased blood levels of rheumatoid factor
- Drinking more than three cups of decaffeinated coffee per day
- Post-traumatic stress disorder
Some misconceptions exist about risk factors for RA. The following factors are not associated with an increased risk of developing RA:
- Silicone breast implants
- Vitamin D supplementation
- Occupational exposure to cutting oil, motor oil, form oil, hydraulic oil or asphalt
- Postmenopausal hormone therapy
- Drinking alcohol
- Breastfeeding your children for longer than 13 months
A Note on Symptoms
Symptoms of rheumatoid arthritis will vary in severity and will often come and go. For example, you may experience periods of flare-ups or periods of remission when the swelling and pain slow down or disappear altogether.
Rheumatoid arthritis symptoms can be debilitating and impact more than just your joints. The chronic inflammation caused by RA has devastating consequences to your entire body including your eyes, mouth, heart, blood, skin, and nerves.
If you think you may have the symptoms of RA, you should seek medical advice at once. Make an appointment with your doctor as soon as you start to experience persistent pain, discomfort, and swelling in your joints or symptoms that affect your quality of life.
Delaying treatment may worsen the damage to your joints and overall health. Your healthcare provider (or team) may conduct a thorough evaluation to determine if you are suffering from RA or another condition that relates to RA or mimics it.
While it is not always easy to live with RA, just remember this: RA is not a death sentence, you are still you at the end of the day and even RA or RA symptoms can't change that.
Lastly, just continue to learn more and more about your condition, what causes your RA flare-ups, and what type of treatment options are available.