Symptoms may come and go, making diagnosis difficult
Rheumatoid arthritis (RA), an autoimmune disorder that causes inflammation of the lining of the joints, is a chronic disorder that usually strikes between the ages of 30 and 60, though younger and older people do get it. When you have RA, your body tissue is mistakenly attacked by its own immune system. It can also affect the skin, eyes, lungs, heart, blood or nerves.
Early, aggressive treatment is key to slowing or stopping RA’s progression. But symptoms may come and go, especially during the early stages of the disease, making diagnosis difficult.
Here’s what to watch for:
Joint stiffness in the morning. Many people wake up with some morning stiffness, but it fades as they stretch and start moving. But with RA, you may be unable to move about easily for 30 minutes or more. Stiffness can also occur if you’ve been sitting for a while. Exercise will help. With RA, the more you move, the better it feels.
Pain when climbing stairs. If your knee joint locks or sends stabs of pain when you bend it, it’s a sign of RA. Being overweight can raise your risk of developing arthritis, too. (Sixty percent of obese people have RA.) Extra pounds can feel like an extra load of four pounds on your knees. Other painful physical signs include limping, trouble standing on tiptoe, being unable to extend your elbow and changes in how steadily you can stand or walk.
Sudden, excruciating pain in a big toe. A joint with sudden intense pain (many sufferers give it a 10 on a pain scale of one to 10), that is red, hot to the touch and tender usually signals gout, the second-most common form of arthritis. You can experience this pain in other joints, but the big toe is the most common site. This sudden onset of pain has been linked to eating a lot of protein or drinking more alcohol than usual.
Ongoing fatigue. When a combination of chronic tiredness, loss of appetite, weight loss, anemia, fever that lasts for weeks (longer than the flu), stiffness and pain occur, it’s likely RA. You might even notice changes in non-joint tissue, such as eyes that feel dry and sore.
Bumps on your fingers. Bony spurs on the joints of fingers is a visual sign of RA. The joint may be stiff, but not necessarily painful. Your toes can also be affected.
Pain that interferes with sleep. Some sufferers are unable to get a good night’s sleep because awakened by joint pain. Pain that interferes with your ability to enjoy activities you enjoy can also lead to depression.
Achy hands. Many different joints in the hands and wrists are involved with RA, making actions that require fine-motor skills—using a knife and fork, buttoning buttons, tying shoelaces or grasping a doorknob—difficult. Affected joints can be redder than surrounding skin, tender and warm to the touch.
One in five Americans has been diagnosed with RA, which occurs two to three times more often in women than in men. If you have a family history of the disease or you smoke, your risk of developing RA is higher.