Rheumatoid Arthritis - Early Symptoms and Signs

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What were your symptoms and signs at the onset of your rheumatoid arthritis?

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What are rheumatoid arthritis symptoms and signs?

RA symptoms come and go, depending on the degree of tissue inflammation. When body tissues are inflamed, the disease is active. When tissue inflammation subsides, the disease is inactive (in remission). Remissions can occur spontaneously or with treatment and can last weeks, months, or years. During remissions, symptoms of the disease disappear, and people generally feel well. When the disease becomes active again (relapse), symptoms return. The return of disease activity and symptoms is called a flare. The course of rheumatoid arthritis varies among affected individuals, and periods of flares and remissions are typical.

What does rheumatoid arthritis feel like?

When the disease is active, RA symptoms can include

  • fatigue,
  • loss of energy,
  • lack of appetite,
  • low-grade fever,
  • muscle and joint aches, and
  • stiffness.

Muscle and joint stiffness are usually most notable in the morning and after periods of inactivity. This is referred to as morning stiffness and post-sedentary stiffness. Arthritis is common during disease flares. Also during flares, joints frequently become warm, red, swollen, painful, and tender. This occurs because the lining tissue of the joint (synovium) becomes inflamed, resulting in the production of excessive joint fluid (synovial fluid). The synovium also thickens with inflammation (synovitis).

Rheumatoid arthritis usually inflames multiple joints and affects both sides of the body. In its most common form, therefore, it is referred to as a symmetric polyarthritis. Early RA symptoms may be subtle. The small joints of both the hands and wrists are often involved. Early symptoms of rheumatoid arthritis can be pain and prolonged stiffness of joints, particularly in the morning. Symptoms in the hands with rheumatoid arthritis include difficulty with simple tasks of daily living, such as turning door knobs and opening jars. The small joints of the feet are also commonly involved, which can lead to painful walking, especially in the morning after arising from bed. Occasionally, only one joint is inflamed. When only one joint is involved, the arthritis can mimic the joint inflammation caused by other forms of arthritis, such as gout or joint infection. Chronic inflammation can cause damage to body tissues, including cartilage and bone. This leads to a loss of cartilage and erosion and weakness of the bones as well as the muscles, resulting in joint deformity, loss of range of motion, destruction, and loss of function. Rarely, rheumatoid arthritis can even affect the joint that is responsible for the tightening of our vocal cords to change the tone of our voice, the cricoarytenoid joint. When this joint is inflamed, it can cause hoarseness of the voice. Symptoms in children with rheumatoid arthritis include limping, irritability, crying, and poor appetite.

Picture of rheuamtoid arthritis joint deformity in the feet
Picture of rheumatoid arthritis joint deformity in the feet; Image provided by Getty Images
Return to Rheumatoid Arthritis (RA)

See what others are saying

Comment from: Liz, 55-64 Female (Patient) Published: May 19

To the patient who said her doctor will not treat her because she does not have that much pain in her hands even though she was tested positive for rheumatoid arthritis (RA), find yourself another rheumatologist. I have RA and most of my pain is in my back/neck, hips and knees and feet. It started with swelling in my knees, and stiffness. I also have found that the antibiotic Cipro seems to make my symptoms worse. Also tell all of your dentists, surgeons, etc., before you go under any anesthesia all of the medications you are taking. I am taking Zyprexa and Neurontin and did not divulge this to my oral surgeon and was given a strong pain reliever and I think I may have had an adverse reaction, as shortly after the surgery (root canal) I started getting the symptoms. A healthy diet helps and I am currently taking a once monthly injection. Methotrexate did not help that much. Exercise, even if it is mild such as walking helps also.

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Comment from: tinker sad, 55-64 Female (Patient) Published: June 21

I had my head in the sand, in denial for about a year! We live out in the country so at first I thought I had been bit by a spider. I would rest for a bit and ice the hands/feet and then it would stop, until recently. Now if I lift a suitcase, make up bag or anything my hands/fingers swell way up, turn deep red, and the only thing that helps is plunging my feet in a bath of ice water. Taking Benadryl and NSAIDs did not help. I found a new doctor and she pushed me to do all this bloodwork after I took pictures on my cell phone of my fingers. I have rheumatoid arthritis and it is scary! I am a caretaker for my husband and our farm, and well, it is going to be a big adjustment. I was put on a pain medicine that also helps with the swelling. My guess is I will end up on methotrexate or prednisone. Good luck each and every one of you, this disease is a learning process. Don't give up.

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