Symptoms of rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease. When someone has RA, their immune system mistakenly attacks the joints as well as other organs and tissues.

According to Mayo Clinic, the most common symptoms of RA are directly related to joint damage. Additional symptoms are due to the widespread effects of an overactive immune system.

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Rheumatoid arthritis is named after its effects on the joints. However, the autoimmune symptoms it causes can affect systems throughout the body.

Joint pain and swelling

The primary symptom of RA is joint pain and swelling. Symptoms usually begin in the smaller joints. RA typically starts in the fingers (knuckles) and wrists. Other joints commonly affected by RA include:

  • ankles
  • knees
  • elbows
  • shoulders
  • neck
  • jaw

Affected joints may feel warm and spongy to the touch. According to Mayo Clinic, joint damage caused by RA is usually symmetrical. This means that if your left hand is affected, your right hand will be as well.

Symmetrical symptoms are one of the things that distinguish RA from osteoarthritis (OA). Since OA is caused by physical wear and tear on joints, it’s less likely to be symmetrical. OA is the type of arthritis most people associate with aging or an injury that occurred years before.

Fever and fatigue

Although joint pain is the most characteristic symptom of RA, it’s not always the first symptom. According to the Centers for Disease Control and Prevention, many people with RA first experience a low-grade fever (under 100°F) and extreme fatigue for several hours after waking up. However, these early signs and symptoms may not be automatically associated with RA. Fever and fatigue can be caused by many other health conditions, even the common cold. There is usually no reason for a doctor to suspect RA until joint symptoms appear.


Prolonged stiffness upon waking is another symptom that can help distinguish RA from other forms of arthritis.

RA is also associated with stiffness after a long period of inactivity, such as sitting. This stiffness usually lasts an hour or more. In general, stiffness from other types of arthritis lasts for shorter periods of time.

Rheumatoid nodules

According to Mayo Clinic, rheumatoid nodules are hard, flesh-colored lumps that may appear under the skin of the arms. They can range from pea-sized to walnut-sized. They may be either movable or firmly connected to tendons under the skin. The nodules tend to occur at points of pressure, like the elbows or heels. Rheumatoid nodules are a symptom of advanced RA.

RA can affect a number of organs throughout the body. However, this type of damage is not common, and is less common now with more effective treatments available. The symptoms below are associated with more severe or advanced disease.

Dry mouth and eyes

Rheumatoid arthritis is often associated with Sjogren’s disease. This is a condition where the immune system attacks the salivary glands and tear ducts. It can cause:

  • dry or gritty sensations in the eyes, mouth, and throat
  • cracked or peeling lips
  • difficulty talking or swallowing
  • dental damage

Some people with RA also experience other discomfort in their eyes, including:

  • burning
  • itching
  • light sensitivity


Pleurisy is a severe tightness or sharp pain in the chest when breathing. It’s caused by inflammation of the membrane surrounding the lungs.


Advanced RA can cause severe joint damage, if left untreated. The hands and fingers may bend at unnatural angles. This could give them a gnarled and twisted appearance. Such joint deformities can also interfere with movement. Other joints that may become damaged in this way include the:

  • wrists
  • elbows
  • ankles
  • knees
  • neck (C1-C2 bone or vertebrae level)