What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is an autoimmune disease that affects the joints. In autoimmune diseases, the immune system tries to destroy healthy tissue in the body for unknown reasons. With RA, the immune system attacks the lining of the joints, which causes the joints to become inflamed, swollen, and painful. However, RA is systemic, meaning it can affect other areas of the body in addition to joints.

According to the Arthritis Foundation, about 1.5 million Americans have RA, and three times as many women as men are affected by the disease. Listen to your body’s clues for symptoms of RA.

RA is often thought to be a condition related to old age, but this isn’t always the case. According to the Arthritis Foundation, the average onset of RA is between the ages of 30 and 60, and children can also get it.

RA is a chronic condition that progresses over time with periods of increased disease activity, called flares, and periods of remission. Symptoms of RA vary from person to person depending on the severity of the condition.

General, nonjoint symptoms such as fatigue, low-grade fever, and loss of appetite are early symptoms of RA. These warning signs usually precede the painful joint symptoms commonly associated with RA.

Recurrent bouts of fatigue along with a general sense of not feeling well may occur weeks and months before other symptoms. As the disease progresses, these symptoms may accompany joint-related symptoms during a flare.

Morning joint stiffness is a strong indication of RA. Joint stiffness usually lasts anywhere from one to two hours and sometimes longer. It can also occur after prolonged periods of rest or inactivity such as napping or watching television.

Stiffness and decreased range of motion can eventually make simple daily tasks such as buttoning a shirt or opening a jar difficult.

When the disease is active, affected joints become red, swollen, painful, and feel warm to the touch. In the early stages of RA, smaller joints in the hands, wrists, and feet tend to be affected first. Over time, larger joints in the knees, shoulders, hips, and elbows may become affected.

What differentiates RA from other types of arthritis is that RA symptoms attack symmetrically. This means that if your left wrist is inflamed, your right wrist likely will be inflamed as well.

According to the Johns Hopkins Arthritis Center, 20 to 30 percent of RA sufferers develop rheumatoid nodules, firm lumps of tissue that grow under the skin at bony pressure points.

Rheumatoid nodules are most often found on elbows, but can be found on other areas of the body, such as on the fingers, over the spine, or on the heels. They’re usually painless and can appear alone or in clusters.

Chronic inflammation caused by RA over the long term may cause damage to cartilage, tendons, and ligaments. In advanced stages, RA can lead to bone erosion and joint deformity. A telltale sign of severe RA is twisted fingers and toes bent at unnatural angles.

Severely disfigured hands can impair fine motor skills and make performing daily tasks challenging. Deformity can also affect wrists, elbows, knees, and ankles.

In severe cases of RA, persistent inflammation may affect other areas of the body, such as the eyes, lungs, heart, and blood vessels. Long-term inflammation may cause:

  • severe dry eyes and mouth
  • rheumatoid inflammation of the lung lining (pleurisy)
  • inflammation of the covering of the heart (pericarditis)
  • reduction of the number of healthy red blood cells (anemia)
  • a very rare yet serious blood vessel inflammation that can limit blood supply to tissues, leading to tissue death (vasculitis)