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16 Early Rheumatoid Arthritis (RA) Signs & Symptoms

Fatigue is a common symptom of rheumatoid arthritis (RA).
While early signs and symptoms of RA can be mimicked by other diseases, the warning signs and symptoms are very characteristic of rheumatoid disease.Source: Getty Images

What are early signs and symptoms of rheumatoid arthritis (RA)?

While early signs and symptoms of RA can be mimicked by other diseases, the warning signs and symptoms are very characteristic of rheumatoid disease. The 16 early RA symptoms and signs discussed in this article include the following:

  1. Fatigue
  2. Joint pain
  3. Joint tenderness
  4. Joint swelling
  5. Joint redness
  6. Joint warmth
  7. Joint stiffness
  8. Loss of joint range of motion
  9. Many joints affected (polyarthritis)
  10. Limping
  11. Joint deformity
  12. Both sides of the body affected (symmetric)
  13. Loss of joint function
  14. Anemia
  15. Fever
  16. Depression
Fatigue is a common symptom of rheumatoid arthritis (RA).
Fatigue is a common symptom of rheumatoid arthritis (RA).Source: Getty Images

Fatigue

Fatigue is a very common symptom in all stages of rheumatoid arthritis, particularly when the joint inflammation is active. Fatigue in rheumatoid arthritis can be caused by the body's reaction to inflammation, poor sleep, anemia, and medications.

The fatigue of rheumatoid arthritis that results in a lack of energy can adversely affect emotions and mood, occupation, relationships with people, sex drive, productivity, attentiveness, creativity, and happiness.

A man experiences rheumatoid arthritis (RA) joint pain in his wrist.
A man experiences rheumatoid arthritis (RA) joint pain in his wrist.Source: Getty Images

Joint pain

Joint pain from rheumatoid arthritis is caused by the inflammation present in a joint when the disease is active. Joint pain can also occur when the disease is inactive or controlled if the joint has been damaged by rheumatoid arthritis in the past.

Active rheumatoid arthritis flare-ups cause the joint to swell because of both thickenings of the joint lining tissue (synovium) and because of excess joint fluid. The swollen inflamed joint stretches and irritates the capsule that surrounds the joint. The joint capsule has nerve endings within it that immediately send pain signals to the brain.

Past rheumatoid arthritis can lead to permanent joint destruction with damaged cartilage, bone, and ligaments. When the damaged joint is used, it can cause intense pain.

A patient feels joint tenderness as a doctor examines her hand for rheumatoid arthritis (RA).
A patient feels joint tenderness as a doctor examines her hand for rheumatoid arthritis (RA).Source: Getty Images

Joint tenderness

Rheumatoid arthritis characteristically leads to the tenderness of the involved joints. This is because the inflamed joint lining tissue has irritated the nerves in the joint capsule. When the irritated joint capsule is compressed by external pressure, such as from touching the joint, it is frequently tender.

  • The pain elicited from compression is immediate.
  • This is one of the reasons that rheumatoid arthritis can lead to difficulty sleeping and insomnia.
A woman's hands show swollen finger joints due to rheumatoid arthritis (RA).
A woman's hands show swollen finger joints due to rheumatoid arthritis (RA).Source: iStock

Joint swelling

Swollen joints are very common in rheumatoid arthritis. Sometimes the joint swelling is minimal and can be difficult to appreciate. Other times the joint swelling is very apparent. Generally, people who are affected by rheumatoid arthritis can easily tell when their joints are swollen.

  • The joint swelling can lead to loss of range of motion of the joint.
  • Joint swelling in the fingers can make it hard to get rings off and on easily.
Red, inflamed toe joints may indicate rheumatoid arthritis.
Red, inflamed toe joints may indicate rheumatoid arthritis.Source: Getty Images

Joint redness

Redness occurs over joints when they are inflamed. The redness in the skin over an inflamed joint from rheumatoid arthritis occurs because the capillaries of that skin are widened by the adjacent inflammation. These widened capillaries are referred to as dilated capillaries.

  • Joint redness does not occur in all inflamed joints from rheumatoid arthritis.
  • Sometimes the inflammation in the joint is inadequate to cause the capillaries in the skin to dilate.
A doctor examines a patient for joint warmth, a symptom of active rheumatoid arthritis (RA) inflammation.
A doctor examines a patient for joint warmth, a symptom of active rheumatoid arthritis (RA) inflammation.Source: Getty Images

Joint warmth

The warmth of the joints affected by rheumatoid arthritis is a sign of active inflammation. Doctors look for joint warmth as they monitor the activity of the disease. As rheumatoid arthritis responds to treatment, joint warmth resolves.

  • Sometimes joint warmth is present without visible joint swelling or redness.
Joint stiffness may be a result of RA pain.
Joint stiffness may be a result of RA pain.Source: Getty Images

Joint stiffness

Stiffness is a typical rheumatoid arthritis symptom. Joints that are affected by active rheumatoid arthritis are inflamed and characteristically stiffer in the morning than later in the day. Doctors use the duration of the morning stiffness as a measure of the severity of the active joint inflammation.

  • As rheumatoid arthritis responds to treatment, the duration of the morning joint stiffness diminishes.
A radiograph of the hand of a 71-year-old woman with rheumatoid arthritis (RA) shows joint deformity.
A radiograph of the hand of a 71-year-old woman with rheumatoid arthritis (RA) shows joint deformity.Source: Medscape - image courtesy of LH Brent, MD

Joint deformity

Joint deformity can occur from chronic rheumatoid arthritis. Deformity in rheumatoid arthritis occurs because the unchecked inflammation leads to erosions of cartilage and bone as well as ligament loosening (laxity).

  • Early diagnosis and treatment of rheumatoid arthritis are critical to prevent permanent joint damage and joint deformity.
Rheumatoid arthritis can cause a loss of joint range of motion.
Rheumatoid arthritis can cause a loss of joint range of motion.Source: Getty Images

Loss of joint range of motion

As the joints of rheumatoid arthritis become more inflamed with active disease, they tend to have an incomplete range of motion. The range of motion is limited by the swelling within the joint. This is typically associated with weakness in the involved areas.

A person suffering from RA has multiple swollen joints on both hands and wrists.
A person suffering from RA has multiple swollen joints on both hands and wrists.Source: iStock

Many joints affected (polyarthritis)

Usually, but not always, rheumatoid arthritis affects many joints. Classically, RA affects the small joints of the hands and wrists and balls of the feet. Also, not uncommonly, knees, elbows, hips, ankles, and shoulders can be inflamed.

A man with rheumatoid arthritis (RA) limps after retrieving his newspaper.
A man with rheumatoid arthritis (RA) limps after retrieving his newspaper.Source: iStock

Limping

Limping from poor lower extremity function can be caused by many diseases of the nerves, muscles, and bones of the lower extremities. Limping frequently occurs when rheumatoid arthritis affects the hips, knees, ankles, or feet.

This X-ray of hands affected by rheumatoid arthritis (RA) shows colorized symmetry of affected joints on both hands.
This X-ray of hands affected by rheumatoid arthritis (RA) shows colorized symmetry of affected joints on both hands.Source: Getty Images

Both sides of the body affected (symmetric)

Typically, the distribution of the joints involved in a person with rheumatoid arthritis is similar on both sides of the body. This symmetric joint involvement is a feature of classic rheumatoid arthritis. This does not mean that joint involvement is always symmetric, but it is common.

Rheumatoid arthritis usually (not always) involves many joints on both sides of the body. It is, therefore, sometimes referred to as an asymmetric polyarticular form of arthritis.

As described above, the manner that each of the symptoms affects an individual can be very different from individual to individual and can vary during the day. The intensity and effect of each of the symptoms are dependent upon the RA patient's age, activity, the medications he or she takes, as well as any additional medical conditions that are present.

Loss of joint function may occur with rheumatoid arthritis due to joint pain and swelling.
Loss of joint function may occur with rheumatoid arthritis due to joint pain and swelling.Source: Getty Images

Loss of joint function

Because rheumatoid arthritis leads to pain, swelling, and tenderness of the involved joints, there is the loss of joint function. The swelling and sensitivity impede the full motion and stability of the joint and it becomes incapable of carrying the movement with confidence, balance, and completeness.

The inflammation of RA may cause anemia.
The inflammation of RA may cause anemia.Source: N/A

Anemia

The chronic inflammation of rheumatoid arthritis commonly causes the bone marrow to decrease the release of red blood cells into the circulation. This lowers the red blood count to cause anemia when rheumatoid arthritis is active. It is not unusual for the anemia of rheumatoid arthritis to spontaneously correct as the inflammation of the disease is quieted by treatment.

Fever may occur when RA is causing inflammation.
Fever may occur when RA is causing inflammation.Source: N/A

Fever

Fever, while not common in rheumatoid arthritis, does occur in some patients when the disease is actively causing inflammation. Typically, there is only mild low-grade temperature elevation and this corrects rapidly as the inflammation of rheumatoid arthritis is treated.

Because patients with rheumatoid arthritis frequently require medications that can decrease the normal immune response, it is important that when they develop fever, infection is considered as a possible cause.

Depression
Because rheumatoid arthritis is a chronic condition potentially associated with pain and disability, it can lead to depression.Source: N/A

Depression

Because rheumatoid arthritis is a chronic condition potentially associated with pain and disability, it can lead to depression. A person with rheumatoid arthritis can commonly feel frustrated, but it can also lead to real depression with sadness, hopelessness, and a blue mood that goes beyond frustration. Doctors refer to this form of mood change as "reactive depression" because it is a person's response to a particular situation, in this case, a new chronic disease.

Initially, rheumatoid arthritis (RA) may affect one joint or a few joints.
Initially, rheumatoid arthritis (RA) may affect one joint or a few joints.Source: N/A

What are the less common forms of rheumatoid arthritis?

Rheumatoid arthritis can begin in less common forms. For example, it can begin with the involvement of only a single joint or a few joints. Sometimes, this can later evolve to the more common presentation of many joints on both sides of the body.

12 Early Signs of Arthritis in Hands
Hand arthritis results from wear and tear on the joints of the hands.Source: N/A

12 Early Signs of Arthritis in Hands

A joint is the area where two bones meet. Within joints is a tissue called cartilage that acts as a cushion between two bony surfaces. Synovial fluid within joints protects them and helps facilitate movement. Synovial fluid is secreted by the inner lining of the joint called the synovial membrane. Hand arthritis occurs when there is inflammation in one or more joints of the hand and wrist. There are over 100 types of arthritis. A few of the common types of arthritis that affect the hands are osteoarthritis, rheumatoid arthritis, post-traumatic arthritis (arthritis as a result of an injury), psoriatic arthritis and gout. The two most common types of arthritis that affect the hands are osteoarthritis and rheumatoid arthritis. Hand osteoarthritis occurs when there is wear and tear of one or more joints of the hand as seen with increasing age. Rheumatoid arthritis occurs when the body’s immune system attacks the joints of the hand.

14 Early Signs of Arthritis in the Legs
Arthritis in the legs may affect the hips, knees, ankles, or feet.Source: N/A

14 Early Signs of Arthritis in the Legs

The term arthritis refers to redness and swelling of the joints characterized by joint pain and stiffness. A joint is the area where two bones meet. The two bones at the site of the joint are separated by a cushioning tissue called the cartilage that protects the joint and facilitates proper movement. The joint space is lined by the synovial membrane that secretes a fluid called synovial fluid. Synovial fluid lubricates and protects the joints to allow for adequate movement. Arthritis may result when any of the joint structures are damaged. Leg arthritis affects the joints of the hips, knees, ankles, or feet. There are over 100 types of arthritis. The most common types of arthritis affecting the legs are