Rheumatoid arthritis (RA) causes a number of painful symptoms, including stiffness, visible swelling, and deformation of the joints in the fingers and hands, if inflammation isn’t controlled. Although joint pain and stiffness are the defining features of the condition, they are by no means the only symptoms of RA. The inflammation process that affects the joints can also affect other body systems.
The early symptoms of RA can be easy to miss, may seem like no big deal, or may appear to be symptoms of another disorder. Symptoms like fever, fatigue, and morning stiffness may be mistaken for the flu, while joint pain and swelling could be mistaken as symptoms of overuse or injury.
Joint problems caused by RA are often mirrored, meaning the same joint is affected on both sides of the body. This mirroring can help make RA more recognizable. Still, this mirroring may not be present during the early stages of the disease.
Typically, your wrists, feet, and knuckles are most commonly affected. Some people show symptoms in their ankles, knees, elbows, and shoulders.
Joints become stiff, particularly in the morning or after long periods of rest. Joints are often described as “tender” or “achy,” and range of motion can be limited. Along with pain and stiffness, joints affected by RA are often warm to the touch. They also become swollen. Over time, the long-term damage to the joints can cause severe deformities, if inflammation isn’t controlled.
Rheumatoid nodules are lumps of swollen tissue just below the skin. These nodules can range from the size of a pea to the size of a grape. They’re usually found in places that receive pressure, like elbows from resting on a table.
Nodules generally aren’t dangerous, but they can be uncomfortable. In rare cases, they can be found in the eye, lungs, or other major organs, and may require surgical removal.
Rheumatoid vasculitis occurs when the small blood vessels become inflamed. Narrowed blood vessels can lead to decreased blood flow, and the tissue they feed can die. This can result in red spots around the fingernails or a poorly healing ankle ulcer. This also occurs in scleroderma, another autoimmune rheumatic disease.
Neuropathy can present itself as numbness or tingling. It is most commonly felt in the feet. There are different types of neuropathy, but the type that affects the nerves which carry pain signals to the brain (sensory neuropathy) is common in RA.
Nerve pain should never be ignored, as it can also be an early symptom of vasculitis. In this case, the small blood vessels feeding the nerve are inflamed, the nerve receives less blood, and pain results.
Many people don’t realize that chest pain and shortness of breath can be symptoms of RA. In fact, heart and lung problems can be a serious complication of the disease. People with RA have an increased incidence of blocked and hardened arteries, which could lead to heart attack or stroke, especially if they also smoke.
Pericarditis, or inflammation of the sac that surrounds the heart, is also more common in people with RA. Chronic inflammation can also damage lung tissues, resulting in reduced lung function.
Other symptoms of RA include:
- sleep difficulties, often due to pain
- dry eyes and mouth (Sjogren’s syndrome)
- eye burning, itching, and discharge
- chronic or recurrent bacterial infections
If you notice symptoms of RA, schedule a visit with your healthcare provider. If you have already been diagnosed with RA, and you notice new or worsening symptoms, talk with your doctor to learn more about managing your RA symptoms.