Over 1.3 million Americans have rheumatoid arthritis, which is around 2% of the population, according to John Hopkins Arthritis Center. This autoimmune disorder makes the body's immune system attack joints. As a result, patients struggle to move, and some develop lung and heart complications.
Rheumatoid arthritis (RA) is a chronic disease, and the likelihood of getting it increases with age. It's essential to learn the symptoms, as they can affect your joints, eyes, or head. For the sake of your health, you'll want to learn these early signs of RA, as well as the diagnosis and prevention methods.
Persistent Joint Pain
Patients with RA experience inflammation inside of their joints. According to Versus Arthritis, the body sends extra fluid to combat the inflammation, which increases pressure on the joints. As a result, RA patients often experience joint pain in multiple areas.
The Arthritis Foundation says that pain from RA usually lasts for six weeks or longer. Common locations include the fingers, wrists, shoulders, knees, and ankles. Some patients may also feel chest pain from the inflammation. If your symptoms last for a long time with no obvious cause, visit a doctor.
Numbness And Tingling With No Apparent Cause
At least 5% of patients with RA will feel numbness or tingling, usually in their hands. According to the Arthritis Foundation, this symptom may not stem from RA, but carpal tunnel syndrome. CTS is a fairly common side effect of RA.
So how do you know if you have rheumatoid arthritis or carpal tunnel syndrome? Dr. Eric Ruderman, a professor of rheumatology at Northwestern University, recommends seeing a professional. Your diagnosis will depend on how long episodes last, where you feel the numbness, and what other symptoms you experience.
Unexplained And Continuous Joint Stiffness
Although joint stiffness is a common symptom of RA, many patients have trouble distinguishing muscle soreness from an autoimmune disorder. According to the Johns Hopkins Arthritis Center, joint pain from RA may last from days to weeks, then disappear, only to reappear over time.
Although the number of stiff joints varies by person, many patients have more than two affected areas. Stiffness usually occurs in the fingers, wrists, ankles, knees, elbows, hips, and shoulders, according to WebMD. The pain may begin as tenderness but become more intense over time.
Patients with RA often feel intense physical exhaustion that interrupts your personal life, a symptom called fatigue. According to the Arthritis Foundation, 80% of people with RA feel run down, while 50% experience extreme exhaustion. Fatigue can manifest in inactivity, depression, and poor sleep, says Arthritis Care and Research.
Fatigue likely stems from the inflammation that RA spreads throughout the body. Rheumatologist Terence Starz emphasizes that fatigue is different from tiredness. The symptom seems to come from nowhere and has a noticeable impact on daily life.
A Low-Grade Fever
Generally, fevers under 101°F are not considered dangerous for adults. However, persistently having a temperature between 99°F and 101°F may indicate rheumatoid arthritis. Harvard Health Publishing says that this low-grade fever usually accompanies sweating and difficulty sleeping.
According to Arthritis Health, RA fevers often appear alongside symptoms. These include fatigue and joint pain or stiffness. Although many people may mistake these symptoms for a common fever, they may disappear and reoccur if you have RA. Remember that the average fever lasts less than a week.
Long Periods Of Morning Stiffness
Morning stiffness occurs when your joints feel tense after waking up. In RA, the stiffness often lasts longer than 30 minutes, according to the UK's National Health Service. Rheumatologist Nathan Wei told WebMD that morning stiffness is a common issue for patients with RA.
Why does morning stiffness happen? According to research in the Scandinavian Journal of Rheumatology, it comes from pro-inflammatory chemicals. The symptom usually grows more prominent after long periods of inactivity, such as sleeping. If your morning stiffness has no discernable cause, see a doctor.
Rheumatoid arthritis dries out the eyes as well as the mouth. Keratitis Sicca, also known as Dry Eye Syndrome, can appear during RA, reports the Arthritis Foundation. Dr. Sunir J. Garg, a retina physician, says that chronic dry eye can cause itchiness and blurry vision.
Dry eyes can also stem from an infection, menopause, or a problem with your eyelids. According to the Gordon Schanzlin New Vision Institute, you should see a doctor if your dry eyes last longer than a week or two.
Frequent Headaches Or Migraines
Although people receive headaches for many reasons, rheumatoid arthritis could be one of them. According to the National Headache Foundation, RA patients may experience inflammation in the neck, spine, or jaw. The inflammation puts pressure on the joints and causes pain.
The National Rheumatoid Arthritis Society warns that RA headaches are very similar to symptoms of fibromyalgia. If your headaches are sudden and severe, or if you experience headaches more than three times a week, see a doctor. Even headaches with a stiff neck could indicate something more, says WebMD.
Difficulty Moving Your Joints
Because RA creates inflammation in the joints, patients can experience difficulty moving. The University of Rochester Medical Center states that patients may struggle to tie shoes, button shirts, or open jars. During some occasions, people may have a hard time pinching or grasping things.
The lack of mobility may have several causes. Physiopedia reports that the symptom may come from weakness, pain, or physical changes such as nodules. If your symptoms become worse over time or disappear and reappear, consult a professional.
Consistent, Reoccurring Hives
People with RA often receive consistent hives. The American Academy of Dermatology states that hives sometimes occur during autoimmune diseases like RA, or an allergic reaction. In 2010, a study determined that 24% of people with chronic hives have an autoimmune disorder.
Chronic hives, or urticaria, happen to 20% of people at some point in their lives. The American College of Asthma, Allergy, and Immunology recommends seeing a doctor if your hives last more than a few days. If you receive hives frequently, you may also want to see a professional.
Rashes Or Skin Redness (Vasculitis)
Although many people may associate RA with joint pain, it also affects the skin, the largest organ in our body. One in 100 RA patients will experience vasculitis, according to the Vasculitis Foundation. The condition inflames blood vessels close to the skin, which creates visible red areas.
In RA patients, vasculitis frequently appears on the tips of fingers and toes. It can also affect larger blood vessels throughout the legs. According to Cleveland Clinic, only around 5% of people with RA have vasculitis, but it is still a symptom to watch out for.
Having a dry mouth is common after exercising or dehydration. But if your dry mouth doesn't disappear after drinking water, it could be a problem with your salivatory glands. According to the Arthritis Foundation, RA patients are at a higher risk of Sjögren's syndrome, when the immune system attacks salivatory glands.
Chronic dry mouth could stem from a dental complication, so check with your dentist, says the National Rheumatoid Arthritis Society. The symptom could also be a side effect of certain medications. When it doubt, talk to a professional.
Bumps On The Skin (Nodules)
One-fourth of RA patients receive bumps on their joints, says the American Osteopathic College of Dermatology. In some cases, rheumatoid arthritis can produce rheumatoid factor, a protein that attacks healthy tissues. The result is visible bumps on the fingers, knuckles, elbows, forearms, knees, or backs of heels, says Dr. Matthew Ezerioha.
These bumps, called nodules, can vary from the size of a pea to a lemon. In rare cases, nodules can grow on the eyes, lungs, or vocal cords as well. Usually, these bumps are harmless, but you'll still want to consult a professional just in case.
Brain fog describes the symptom of not thinking clearly and struggling to remember day-to-day tasks. In 2012, a study in Arthritis Care & Research reported that 30% of RA patients experience brain fog. Rheumatologist Robert Hylland suggests that the percentage could be even higher--up to 70%.
Dr. Hylland told U.S. News that few patients report brain fog as a symptom, possibly because they don't think it's necessary. Difficulty concentrating may stem from the pain or lack of sleep in RA patients. See a doctor if you have brain fog with any of the other symptoms listed.
Purple Skin Discoloration (Livedo Reticularis)
Rheumatoid arthritis may accompany livedo reticularis, a skin condition that creates purplish lace patterns on the skin. According to the Current Opinion in Rheumatology, 75% to 89% of RA patients experience this symptom.
In cold weather, livedo reticularis is usually common and harmless. But RA patients can receive it in the legs, along with lesions that could be painful, according to the Rheumatologic Dermatology Society. If this happens, or if your skin appears purple for a long while, consult a professional.
According to research in the Journal of Clinical Medicine, 56.8% of patients with RA have difficulty sleeping. At least 42% of these cases result from joint pain or discomfort. In other cases, insomnia may stem from restless leg syndrome or sleep apnea.
Dr. Suneel Valla of the Arthritis Foundation says that RA patients tend to experience chronic pain due to the inflammation. In other words, RA-related insomnia usually accompanies joint pain or discomfort. If you're experiencing the same symptoms, you may want to talk to a professional.
In some cases, symptoms of RA can be mistaken for a heart attack. This pain stems from a condition called costochondritis when inflammation affects the cartilage in the chest bone. A sports cardiologist, Dr. John Higgins, says that this pain may feel worse when you breathe deeply or press your ribs.
Unlike a heart attack, costochondritis doesn't create light-headedness or nausea. The pain only occurs in the center of the chest, according to the Arthritis Foundation. Over time, this condition could develop into a heart condition called pericarditis. Call a doctor if you're concerned.
In 2016, research in The Open Rheumatology Journal found that RA patients have a higher risk of hearing loss as they age. Since the chances of RA increases with age, this could be mistaken for age-related hearing loss.
However, not all studies agree. Research by Mayo Clinic did not find a correlation between RA and hearing, and some professionals have attributed the symptom to medications, not the condition itself. If you experience hearing loss along with these other symptoms, you may want to get it checked.
Changes In Your Fingernails
People with rheumatoid arthritis may begin to see changes in their fingernails. People with RA may see their nails yellow, thicken, or develop vertical ridges. These could be indicators of RA or another condition, so it's best to consult with your doctor.
Changes in nail color may be treated with medication. If you experience nail ridging, it's recommended to adopt a regular nail care routine at home, keeping nails clean and trimmed.
Shortness Of Breath
Besides joints, your lungs are most frequently affected by rheumatoid arthritis, says Dr. Elinor Mody of Harvard Medical School. The European Respiratory Review reported that 70% of RA cases cause damage to the lungs. This can result in trouble breathing.
In RA, shortness of breath happens because the tissues around the breastplate become inflamed. For those who have had RA for years, this inflammation can cause lung disease, according to the National Rheumatoid Arthritis Society. In the beginning, it can suggest the possibility of RA.
Mood Swings And Mood Disorders
In 2015, neuropsychiatrists discovered that 40% of RA patients have depression, and 21% to 70% experience anxiety. Unfortunately, mood disorders are common in people with rheumatoid arthritis. Chronic pain, fatigue, and insomnia have a terrible impact on a person's emotions.
The Arthritis Foundation states that RA patients are two to ten times more likely to receive a mood disorder. Chronic inflammation can increase a person's chance of mood instability, even if it goes undetected. Before you see a rheumatologist for your symptoms, though, visit a psychiatrist for a professional diagnosis.
What Causes Rheumatoid Arthritis?
Despite decades of research on rheumatoid arthritis, scientists still don't understand what causes it. The disease begins when the immune system's antibodies attack the lining of joints, but it's still unclear what causes the condition.
Although we don't know what causes RA, the National Health Service has pinpointed some risk factors for it. More women get RA than men, and the chances of diagnosis increase over age 50. It's also genetic, meaning that if a family member has it, you have a higher chance of contracting RA.
The Sooner It's Diagnosed, The Better
Although rheumatoid arthritis is hard to diagnose, it's important to catch it early. Over time, the inflammation from RA may damage joints, says rheumatologist David Pugliese. Tendons may suffer, which will make it harder and more painful to perform basic movements.
"Early diagnosis [of RA] leads to earlier treatment and obviously better outcomes," explains Hareth Madhoun, an assistant professor of Ohio State University. Unfortunately, the condition can take a while to diagnose, so it's important to see a professional if you worry about your symptoms.
How To Diagnose RA
If a doctor suspects rheumatoid arthritis, they will first perform a physical exam. They will check joints for reflexes, warmth, and swelling. Afterward, they may draw blood to search for markers of an autoimmune disorder (not specifically rheumatoid arthritis).
Another possible step to diagnosis is an imaging test. Doctors may use an x-ray, ultrasound, or tomography scan to locate signs of RA. These images show any damage done to the joints and how the disease has progressed. Because the diagnosis requires so many steps, RA needs to be caught quickly.
Can You Prevent It?
Is there a surefire technique to protect yourself against RA? According to rheumatologist Kristen Demoruelle, no. She told U.S. News that multiple factors can influence the diagnosis of RA, and since doctors don't know the cause, there's no guarantee that you can avoid it.
Even so, some factors heighten the chance of contracting rheumatoid arthritis. According to the Centers for Disease Control, some people may have a genetic disposition for the disease. However, you can lower other risk factors for RA.
Prevention: Limit Sugar
A study in Nutrition and Diabetes located a strong link between consuming sugar and contracting RA. During the study, adults who drank five or more sugary drinks per week were three times more likely to get arthritis later in life.
Plus, rheumatoid arthritis and diabetes seem to feed off of each other. According to another study, having diabetes raises your risk of RA by 20%. Both are autoimmune diseases that can stem from over-consuming sugar. To prevent both illnesses, you may want to limit your sugar intake.
Prevention: Exercise Regularly
Since rheumatoid arthritis weakens the joints over time, some may assume that exercise worsens the disease. But research indicates that the opposite is true. In 2011, a study in the Journal of Aging Research reported that working out helps arthritis patients, with no negative outcomes.
The Arthritis Foundation encourages patients who have RA to exercise consistently. If you don't want to contract the disease, you may want to fit in a consistent workout. Your joints and immune system will become stronger as a result.
Prevention: Maintain A Healthy Weight
Obesity increases the risk of several diseases, with RA being one of them. In 2014, researchers reported in BMJ Journals that obese people have a higher risk of getting rheumatoid arthritis. Two-thirds of people with RA are obese. If you want to prevent rheumatoid arthritis, try your best to maintain a healthy weight.
Plus, obese patients with RA may not respond to medications as well. In the International Journal of Clinical Practice, scientists wrote that "obesity is significantly associated with RA." Keep a healthy diet and exercise routine to lower your chances of the disease.
Prevention: Eat A Healthy Diet
In 2017, researchers at KIIT's Disease Biology Lab in India set out to find foods that could alleviate RA. They divided the healthy food into eight categories: fruits, legumes, whole grains, herbs, oils, spices, cereals, and "miscellaneous." In essence, they prove that eating healthy may help people avoid the disease.
The foods listed--which included green tea, ginger, olive oil, prunes, bananas, and whole grains--are ones that reduce inflammation. "Incorporating probiotics into the diet can also reduce the progression and symptoms of this disease," said scientist Dr. Bhawna Gupta.
Prevention: Avoid Air Pollution
In recent years, researchers have explored the relationship between RA and environmental factors. A study in Joint Bone Spine reported that air pollution raises a person's risk of contracting RA. If you can, try to stay away from air pollutants and airborne chemicals.
Scientists at Michigan Medicine located some chemicals that likely contribute to RA. These include smoke and dioxin, a chemical that rests in the soil of some foods. If you engage in substances, you have higher chances of getting rheumatoid arthritis as well.
Prevention: Drink Moderately
Oddly enough, drinking moderately may help your chances of rheumatoid arthritis. In 2014, research in Arthritis & Rheumatology found a "modest association" between regular drinking and a lower risk of RA. But what is modest drinking?
According to the Dietary Guidelines for Americans, moderate intake includes one drink a day for women and two drinks for men. Be mindful of the serving size for whatever beverage you choose. If you already have RA, know that some drinks can conflict with certain medications.