Rheumatoid arthritis (RA) may sound like a condition that you don’t need to worry about until your golden years, when you’re comfortably settled into a senior home. But this condition often strikes women between the ages of 30 and 50 — and can quickly become debilitating.
However, early and aggressive treatment of rheumatoid arthritis with the latest generation of drugs can potentially delay or even prevent the joint destruction, disability, and organ damage often associated with the disease — but only if you know what to look for.
Being aware of the early signs of rheumatoid arthritis and discussing them with your doctor is the first step to diagnosing the disease and starting treatment.
Early Signs and Symptoms of Rheumatoid Arthritis
Rheumatoid arthritis is a chronic inflammatory disease that affects the immune system and causes joint pain and swelling. Although there's no cure for the disease, new disease-modifying anti-rheumatic drugs (DMARDs), includingbiologics, can target the inflammation associated with the disease and can significantly slow its progression.
Signs and symptoms of rheumatoid arthritis can vary from person to person, but three hallmarks of the disease distinguish it from other types of arthritis:
  1. Swollen joints. Tenderness, swelling, and puffiness of the small joints in the hand, especially at the knuckles where the fingers meet the palm, are early signs of RA. “Rheumatoid arthritis tends to involve the knuckles,” says Theodore Fields, MD, professor of clinical medicine at Weill College of Medicine of Cornell University and director of the Rheumatology Faculty Practice Plan at the Hospital for Special Surgery in New York City. “Tenderness and puffiness in those joints is an important clue.”
  2. Morning stiffness. Compared with osteoarthritis, which causes joint pain throughout the day, rheumatoid arthritis symptoms tend to be much worse in the morning. Morning stiffness in the joints can make them hard to move, but typically joints loosen up as the day goes on.
  3. Whole-body symptoms. Because RA affects the immune system, it can cause symptoms that affect the whole body, like fatigue, loss of appetite, weight loss, and a low-grade fever. If you experience these symptoms, it’s important to discuss them with you doctor sooner rather than later, Dr. Fields says. “We have much more we can do now for early rheumatoid arthritis,” he says.
How Rheumatoid Arthritis Progresses
After it begins in the small joints of the hand or foot, RA usually progresses to larger joints in the body, such as the ankle, knee, shoulder, hip, and neck.
“Rheumatoid arthritis tends to be symmetrical over time,” Fields says. “It’s not uncommon for one hand to be involved at first, and then the other becomes affected as well within a month or two.”
For some people, the symptoms of rheumatoid arthritis may come and go. Most people experience flares of intense disease signs. Then the flares may be followed by long periods of remission, with no signs at all. However, some people have continuous symptoms.
Firm lumps, called rheumatoid nodules, may also grow under the skin at the joints or bony areas exposed to pressure, like the elbows.
Over time, rheumatoid arthritis can damage the cartilage that cushions the joints as well as the bones, leading to loss of movement, deformity, and disability. Plus, the inflammation associated with RA may eventually damage internal systems and organs, like the eyes or lungs.
That's why it's important to get a diagnosis and start treatment as soon as possible. Don't hesitate to bring any early signs of rheumatoid arthritis to your doctor's attention right away.