The Early Signs and Symptoms of RA

The chronic inflammatory disorder called rheumatoid arthritis can cause significant pain and discomfort. Though most diagnoses occur in individuals between ages 40 and 60, the early signs and symptoms can occur prior to this and may easily go unnoticed.

Early Signs Can Go Unnoticed

According to the Centers for Disease Control and Prevention, about 1.5 million adults in the United States suffered from RA in 2007. Many more may have it. The early symptoms of this condition can go unnoticed for years. Many healthy individuals living an active lifestyle may already have the condition by the time they enter their middle years.

To complicate diagnosis even more, patients do not often suffer the same symptoms. What one individual experiences is not necessarily experienced by another. This fluctuation of symptoms results in three possible characterizations of the condition.

In some individuals, the condition is monocyclic, meaning symptoms occur once and may not occur again for two to five years. Others experience activity levels of these symptoms that change over the course of the condition, worsening and improving throughout. This is called polycyclic. A third characterization is often more common. The RA presents itself and increases in severity over a period of time; it does not come and go.

This makes spotting early symptoms of rheumatoid arthritis difficult to do in some individuals. However, if it is possible to diagnose early on, treatment may help to reduce pain.

Common Early Symptoms

In most cases, early symptoms of RA are present in smaller joints first. The most common occurrence is in the fingers at the joints that connect the fingers to the hands. It can also occur in the toes in its earliest stages. Symptoms may include: 

  • tender joints
  • swelling in the joints
  • a feeling of warmth in the joint areas, sometimes spreading outward
  • Many individuals wake up to stiff or difficult-to-move joints in the early stages that improves over a period of hours. 

These symptoms are often most commonly associated with the condition. However, other symptoms may also occur that tend to not relate specifically to joint pain. For example, many individuals have a low-grade fever that is 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, again without any easily identified cause.

The Progression

Most individuals with RA will see a significant worsening of symptoms over time. The early signs of rheumatoid arthritis progress from this point to symptoms such as the following:

  • red and swollen joints that are painful
  • painless, red lumps on the skin, called rheumatoid nodules, that can occur on other joints including the knees, toes, and elbows
  • chest pain and difficulty breathing
  • dry mouth and painfully dry eyes

According to Johns Hopkins Medicine, early symptoms can begin to occur as early as age 20. Some, on the other hand, experience symptoms as late as age 50 without having previously experienced any associated joint pain or discomfort.

Early Diagnosis

The only way for doctors to know if a patient has the early signs of RA is to conduct diagnostic testing on the individual. This often begins with a patient history and an exam. Most often, doctors will use X-rays to gather specific data, but this is possible only when the symptoms begin to affect specific joints. Blood tests can help to pinpoint autoimmune rheumatoid factors, as anemia is present in about half of those with the condition. 

Ultimately, though, there is no test to specifically define early-stage RA. Rather, doctors will need to use long-term observation to determine if there are changes occurring to the joints and, if so, if the condition seems to be rheumatoid arthritis rather than other types of arthritic conditions.

There’s no cure for RA. There’s no way to prevent it or to slow its progress. By understanding the early symptoms of rheumatoid arthritis, though, doctors may be able to provide pain management to patients.