Arthritis Rheumatoid Arthritis Rheumatoid Arthritis Guide Rheumatoid Arthritis Guide Symptoms Causes Diagnosis Treatment Coping Symptoms of Rheumatoid Arthritis By Carol Eustice facebook Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis. Learn about our editorial process Carol Eustice Medically reviewed by Medically reviewed by Grant Hughes, MD on June 30, 2019 linkedin Grant Hughes, MD, is a board-certified rheumatologist. He is an associate professor at the University of Washington School of Medicine and the head of rheumatology at Seattle’s Harborview Medical Center. Learn about our Medical Review Board Grant Hughes, MD Updated on May 11, 2020 Print Table of Contents View All Initial Symptoms Disease Progression Complications When to See a Doctor Next in Rheumatoid Arthritis Guide Why Rheumatoid Arthritis Develops Pain, swelling, and stiffness of several joints are classic signs and symptoms of rheumatoid arthritis, and all of them stem from the disease's chronic inflammatory nature. Persistent inflammation can, over time, lead to the progressive loss of mobility, worsening bouts of illness, and joint deformity. The heart, lungs, eyes, and circulatory system can also become affected, bringing about other symptoms and increasing the risk of disability and death. By understanding the signs and symptoms of rheumatoid arthritis, you can seek diagnosis and treatment early before the more serious complications develop. Illustration by Verywell Initial Symptoms What makes rheumatoid arthritis so confounding is that no two cases are alike. While some will develop gradually with sustained periods of remission, others strike fast and hard. Generally speaking, the first signs of the disease tend to be vague—maybe a dull ache or stiffness that disappears with gentle movement. The smaller joints are usually the first affected, such as those of the hand or feet. In cases like these, the symptoms will most often be chronic, progressing gradually but persistently with occasional flare-ups. However, this isn't always the case. In about 10% to 20% of patients, the initial symptoms will be sudden and intense, followed by a prolonged period with no symptoms at all. Others may have intermittent symptoms that come and go with a certain regularity. Early Indications Joint pain, swelling, and stiffnessWarmth and redness around the affected jointMorning stiffness that usually lasts longer than 30 minutesFatigue and malaise (a general feeling of unwellness)Low-grade fever and, occasionally, flu-like symptoms While the disease may initially involve only one joint (monoarthritis), it will usually affect additional joints over time (polyarthritis). The pattern of the affected joints, meanwhile, will most often be symmetrical, meaning that any joint affected on one side of the body will be affected on the other. Symptoms of Disease Progression Rheumatoid arthritis is a chronic, progressive disorder. Unless the underlying inflammation can be brought into remission, the disease will continue to advance, causing not only pain and stiffness but undermining the integrity of the joint itself. Over time, the relentless autoimmune response can deteriorate joint cartilage, erode bone tissue, and cause the bonding ("tethering") of joints, further restricting the range of motion. This is especially true of weight-bearing joints in which damage can result in the loss of mobility, such as the knees. Edema, the swelling of tissue caused by fluid retention, is also common. With rheumatoid arthritis, swelling is typically associated with inflamed joints of the feet, ankles, legs, arms, and hands. Eventually, as their structural underpinnings are destroyed, the joints will begin to lose their shape and alignment, resulting in joint deformity. Common examples of this include: Ulnar deviation: Deformity of the big joints in the knucklesJoint contracture: The restrictive foreshortening of muscles around a jointWrist subluxation: Dislocation and misalignment of the wrist bones It is usually at this stage that other, more potentially serious complications can develop. How Rheumatoid Arthritis Affects Each Part of the Body Complications Unlike osteoarthritis ("wear-and-tear" arthritis), in which inflammation is localized, rheumatoid arthritis involves systemic (whole-body) inflammation. This means that more than just the joints can be affected in RA. Skin and Mucous Membranes Around 20% of people with rheumatoid arthritis will develop hardened bumps beneath the skin called rheumatoid nodules. They most often develop on the elbows, knees, or knuckles. Another condition, known as Sjögren's syndrome, affects anywhere from 4% to 31% of rheumatoid arthritis sufferers. It involves dry eyes, dry mouth, vaginal dryness, and dry skin. Several skin-related symptoms may develop in later-stage disease, including: RashesUlcersBlisters Cardiovascular Complications RA is associated with a few problems involving the heart and circulation, including: Pericarditis, inflammation of the membrane surrounding the heartVasculitis, constriction of capillaries that may cut off circulation Increased risk of stroke and heart attack Your doctor can help you find ways to lower your risk of these possible complications. Cardiovascular Disease Risk With RA The long-term complications of RA translate to reduced life expectancy. People with RA may live 10 to 15 years less than they otherwise would if they didn't have the disease. Cardiovascular disease is leading cause of death in people with rheumatoid arthritis. Lung Complications While uncommon, lung-related complications can be life-threatening. Possible complications include: Pleuritis, inflammation of the lining around the lungs Chronic obstructive pulmonary disease (COPD), especially in smokersInterstitial lung disease, inflammation and scarring of the lungs Eye Complications Sjögren's syndrome is the most common cause of rheumatoid arthritis-related eye complications. The long-term dryness of the eye can often lead to scarring, ulceration, infection, and even perforation of the cornea. Scleritis is another eye complication caused by the inflammation of the sclera (the white of the eye). Left untreated, scleritis can permanently damage the eyeball, leading to vision loss. Sexual Dysfunction Broadly speaking, studies suggest that sexual dysfunction affects anywhere from 31% to 76% of people with arthritis. Causes may include pain, fatigue, stiffness, depression, anxiety, negative body image, reduced libido, and hormonal imbalance. Men with rheumatoid arthritis are, according to research, 67% more likely to experience erectile dysfunction (ED) than men without the disease. The Widespread Effects of RA Rheumatoid Arthritis Doctor Discussion Guide Get our printable guide for your next doctor's appointment to help you ask the right questions. Download PDF Email the Guide Send to yourself or a loved one. Sign Up This Doctor Discussion Guide has been sent to {{form.email}}. There was an error. Please try again. When to See a Doctor Rheumatoid arthritis can be scary, and not only because of the symptoms but because of the uncertainty of what lies ahead. Don't let this stop you from taking action if you suspect you have the disease. The advantage of an early diagnosis is that it allows you early treatment. Simply put, the sooner you take disease-modifying medications, the better your long-term outlook is. This is especially true if you have a family history of rheumatoid arthritis. Having a sibling or parent with rheumatoid arthritis nearly triples your risk of the disease, while having a second-degree relative doubles your risk. Possible RA symptoms that warrant a trip to the doctor include:Pain, swelling, or stiffness in one or more jointsJoints that are red or warm to the touchRegular joint stiffness in the morningDifficulty moving a joint or doing daily activitiesAn episode of increased joint pain and stiffness lasting for more than three days Why Rheumatoid Arthritis Develops Was this page helpful? Thanks for your feedback! Dealing with chronic inflammation? An anti-inflammatory diet can help. Our free recipe guide shows you the best foods to fight inflammation. Get yours today! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Rheumatoid Arthritis Support Network. RA progression: What are the signs of rheumatoid arthritis progression? Published October 27, 2018. Weisman MH. Rheumatoid arthritis. Oxford, UK: Oxford University Press; 2011. Sarazin J, Schiopu E, Namas R. Case series: Monoarticular rheumatoid arthritis. Eur J Rheumatol. 2017;4(4):264-267. doi:10.5152/eurjrheum.2017.17011 Amaya-Amaya J, Rojas-Villarraga A, Mantilla RD, et al. Rheumatoid arthritis. In: Anaya JM, Shoenfeld Y, Rojas-Villarraga A, et al., editors. Autoimmunity: From bench to bedside [Internet]. Bogota (Colombia): El Rosario University Press; 2013. National Rheumatoid Arthritis Society. Rheumatoid nodules. Updated September 16, 2015. 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Arthritis Care Res. 2016: 68(1);1-25. doi:10.1002/acr.22783 Vignesh AP, Srinivasan R. Ocular manifestations of rheumatoid arthritis and their correlation with anti-cyclic citrullinated peptide antibodies. Clin Ophthalmol. 2015;9:393-7. doi:10.2147/OPTH.S77210 Tristano AG. Impact of rheumatoid arthritis on sexual function. World J Orthop. 2014;5(2):107-11. doi:10.5312/wjo.v5.i2.107 Patel DP, Schenk JM, Darke A, Myers JB, Brant WO, Hotaling JM. Non-steroidal anti-inflammatory drug (NSAID) use is not associated with erectile dysfunction risk: results from the Prostate Cancer Prevention Trial. BJU Int. 2016;117(3):500‐506. doi:10.1111/bju.13264 Monti S, Montecucco C, Bugatti S, et al. Rheumatoid arthritis treatment: The earlier the better to prevent joint damage. RMD Open. 2015;1:e000057. doi:10.1136/rmdopen-2015-000057 Frisell T, Saevarsdottir S, Askling J. Family history of rheumatoid arthritis: an old concept with new developments. 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