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Early Signs of Rheumatoid Arthritis (RA), Diagnosis, and More

How RA affects your body

Rheumatoid arthritis (RA) is a type of arthritis caused by your immune system. When your immune system targets the lining of your joints, it can cause significant pain and discomfort.

The most common joints it targets are in your:

  • hands
  • wrists
  • elbows
  • feet
  • ankles
  • knees

Untreated or severe RA can damage your bones and joints, as well as affect other systems in your body. RA is a chronic condition, meaning that it isn’t yet curable. However, early diagnosis and treatment can reduce your symptoms and prevent the condition from worsening.

RA is typically diagnosed in adults between the ages of 30 to 50, though it can develop at any age. According to the Arthritis Foundation, approximately 1.5 million people have RA, and nearly three times as many women have RA as men. Your family history may increase the likelihood of developing RA. But many people develop RA without it running in their family.

You may not realize you have RA right away. The early symptoms of this condition can go unnoticed for years. Many healthy people living an active lifestyle may already have the condition by the time they enter middle age.

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Spotting the signs

Recognizing the early signs of RA

Though most diagnoses of RA occur in middle age, you may experience symptoms long before this time. These symptoms may go unnoticed for a number of reasons:

  • they happen infrequently
  • they’re mild at first
  • they seem to be symptoms of another condition, such as the flu

To complicate an RA diagnosis even more, you may not have the same RA symptoms as someone else. What one person experiences isn’t necessarily experienced by another. This fluctuation of symptoms results in three possible characterizations of the condition:

In some people, the condition is monocyclic. This means that symptoms occur once and may not occur again for 2 to 5 years.

Others experience fluctuating symptoms over the course of the condition, worsening and improving throughout. This is called polycyclic.

A third characterization, progressive, is often more common. The RA presents itself and becomes more severe over a period of time. It doesn’t come and go.

If you notice any of the following symptoms, consult your doctor. These may be early signs of RA:

  • one or more swollen finger-knuckle joints
  • swollen ankle, knee, shoulder, or elbow that lasts for at least 6 weeks
  • feeling like you’re “walking on golf balls”
  • flu-like symptoms, such as fever and fatigue
  • small, tender bumps just under the skin of your elbow
  • wrist or elbow joint stiffness that lasts for an hour or longer in the morning

Spotting the condition in its early stages can be difficult. Understanding the symptoms of RA and seeking treatment for it can help reduce the pain caused by RA. Early treatment may also prevent the condition from progressing.

Early symptoms

What the early symptoms of RA are

Early symptoms can begin to occur as early as age 18. In most cases, RA symptoms present in the smaller joints first. This includes the joints that connect your fingers to your hands and joints in your toes.

The most common symptom of RA is joint pain. You may notice that the pain in your joints comes on at certain times and then fades away completely. This is called a flare. You may experience flares for a few days or even longer.

Other symptoms include:

  • tender joints
  • swelling in your joints
  • a feeling of warmth in the joint areas, sometimes spreading outward
  • stiffness or difficulty moving your joints that lasts for more than 30 minutes in the morning

You may also experience symptoms that appear unrelated to RA. For example, many people develop low-grade fevers that are unexplained by other sources. Some people have a general feeling of being ill, though they may be unable to pinpoint a specific cause. Others have a loss of appetite at this stage that leads to unplanned weight loss.

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Progression

How RA progresses

For many people, RA symptoms worsen over time. In addition to joint pain and tenderness, you may experience the following symptoms:

  • chest pain
  • difficulty breathing
  • painfully dry eyes or mouth
  • feelings of tingling or numbness
  • painless, red lumps on your knees, toes, or elbows
  • anemia

Learn more: Are rheumatoid arthritis and anemia connected? »

Diagnosis

When to see your doctor

If you’re experiencing joint pain, swelling, or other symptoms of RA, schedule an appointment with your doctor. They can assess your physical health and determine what may be at the root of your aches and pains.

Early diagnosis can help reduce your discomfort, as well as minimize the damage the condition can cause on your body.

During your appointment, your doctor will assess your family history and perform a physical exam. From there, they may use an X-ray, ultrasound, or other imaging test to gather information about the affected areas.

Your doctor may also conduct a blood test. Your blood levels may indicate inflammation in your body or antibodies that point to RA. A blood test can also reveal whether you have anemia. This can occur with chronic inflammation or blood loss.

If your doctor is unable to make a diagnosis or rule out RA at this time, you’ll need to come in for regular follow-ups. This will help your doctor determine whether your joints are undergoing any changes.

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Other causes

Other causes of your symptoms

People with RA often experience the same symptoms as people with other forms of arthritis. Sometimes this makes it difficult to get an accurate diagnosis early in your condition.

Your symptoms may also be the result of:

  • fibromyalgia, which causes widespread muscle pain and tenderness
  • Lyme disease, which often resembles the flu
  • other connective-tissue or autoimmune diseases, which can cause overall weakness and targeted pain

It’s important to take note of any symptoms you’re experiencing. This may help your doctor make a diagnosis sooner rather than later.

You may want to jot down the following:

  • where you feel pain, swelling, or tenderness
  • the time of day this happens
  • how often this happens
  • if you’re unable to perform certain physical activities, such as standing up for long periods of time
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Treatment

Treatment options for RA

There isn’t a cure for RA. Treatment emphasizes pain management, often through the use of over-the-counter or prescription medications.

These include:

  • nonsteroidal anti-inflammatory drugs
  • corticosteroids
  • disease-modifying antirheumatic drugs and biologics, which may prevent RA from progressing

Your doctor may also recommend physical therapy or even surgery for your RA, depending on your symptoms.

Certain lifestyle changes may also help reduce your symptoms:

  • staying active with moderate exercise, such as walking or swimming
  • eating a diet that focuses on low-inflammatory foods, and less processed sugar and wheat
  • using heat and cold to help with inflammation

Find out more: Remedies for rheumatoid arthritis flare-ups »

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Outlook

Outlook

Living with RA requires vigilance, including seeing your doctor regularly to keep your condition in check. You should discuss your symptoms with your doctor, particularly if they’ve changed over time. Together, you and your doctor can develop a treatment plan that can reduce your symptoms and improve your quality of life. Treatment may also slow or prevent the condition from spreading to other parts of your body.

Keep reading: Assessing your RA treatment »

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