Did you know that there are more than 100 forms of arthritis? Here, we will take a look at rheumatoid arthritis, one of the most common forms, and the early signs and symptoms that you can look out for.
What is Rheumatoid Arthritis?
Rheumatoid arthritis is an autoimmune condition in which the joints, and occasionally the organs, come under threat from the body’s own overactive immune system. This can be very painful, and can lead to permanent damage over time. The condition is characterised by chronic inflammation in the joints, which causes pain and limits movement.
Rheumatoid arthritis may begin in a way that is similar to many other arthritic or autoimmune conditions, and symptoms may initially appear periodically. There are 16 early warning symptoms of rheumatoid arthritis, and a diagnosis will involve a combination of these.
Early Warning Signs of Rheumatoid Arthritis
Rheumatoid arthritis presents in different ways in different people, and we have explored some of the common early symptoms here. If you are experiencing any or all of the following, you should talk to your doctor and discuss a referral to a Consultant Rheumatologist, such as Dr Peter Browne.
Early symptoms of Rheumatoid Arthritis to look out for:
- Tiredness/fatigue. Fatigue is characteristic of all stages of rheumatoid arthritis, and this may be a result of the way the body reacts to the inflammation caused by the condition, as well as poor sleep, any medications you are taking, and anaemia. Fatigue can have multiple effects on the physical and mental health, as well as the work and social life of those with rheumatoid arthritis, and this is often the first symptom that is noticed.
- Painful joints. Joint pain is a common symptom noticed by those who are developing rheumatoid arthritis, and it is caused by the inflammation characteristic of the condition. This can affect joints in any part of the body, but often affects the hands first. Excess joint fluid and the thickening of the synovium tissue that lines the joints, will cause the joint to swell, irritating the area and causing discomfort and pain. If you are noticing pain in certain joints, which is often intermittent to begin with, you should talk to your doctor.
- Swollen joints. Sometimes it is barely noticeable when a joint is swollen, but often swollen joints can reduce the range of motion and cause pain and irritation. If a joint appears larger or feels hot to touch, this may be an early sign of rheumatoid arthritis. When this happens intermittently, it is known as a ‘flare up’, and can last for days or weeks. It is likely that this will become more frequent as the condition progresses, and that it will also affect other joints.
- Tenderness in the joints. Many people notice tenderness in the joints caused by rheumatoid arthritis, and this is because the inflamed lining tissue of the joint has caused the nerves around the joint to become irritated. This can make the joint tender to touch, and can cause pain if the area is touched or compressed, making it more difficult to enjoy good quality sleep when you suffer from the condition.
- Redness in the joints. Joints that become inflamed may appear red, and this is because the capillaries in the skin are dilated, or widened, by the inflammation. This may not always occur, particularly if the joint is not severely inflamed, but it is likely that you will notice this if your joints are significantly inflamed.
- Warmth in the joints. This is another early symptom of rheumatoid arthritis that is likely to worsen as the condition progresses. An inflamed joint will often feel warm to the touch, and this may be resolved as the condition begins to be treated. You may notice that joints are warm before you observe any swelling or redness, or you may notice all of these symptoms together.
- Stiffness in the joints. Many people with rheumatoid arthritis first become aware of stiffness in their joints in the mornings, and this can also occur at other times during the day. This joint stiffness is not usually related to your level of activity, and may be limited to one specific area or affect many joints at the same time. Your doctor may ask you to record your level of stiffness in the morning in order to monitor how the condition and treatment are impacting upon your body.
- Limited range of motion. The inflammation that occurs in the joints as a result of rheumatoid arthritis can limit the range of motion within the joint and lead to weakness in the areas that are affected. It is possible that range of motion may be permanently compromised or lost as rheumatoid arthritis progresses, especially if effective treatment is not sought. Gentle exercise can help to retain range of motion and keep the joints active.
- Polyarthritis. Polyarthritis is the term given to rheumatoid arthritis that affects many joints. Rheumatoid arthritis often progresses through the smaller joints, beginning in the hands and the wrists, and often affecting the balls of the feet as well as the knees, hips, ankles and shoulders. Sometimes rheumatoid arthritis affects only one or two joints, and this is more common in juvenile rheumatoid arthritis, but the condition usually involves several joints and is known as polyarthritis when four or more joints are affected.
- Deformity in the joints. If rheumatoid arthritis is not treated or managed effectively, it can lead to joint deformity, which can affect many joints within the body. This occurs when the inflammation in the joints causes the erosion of cartilage and bone and leads the ligaments to loosen. Permanent deformity of the joints is much less likely if rheumatoid arthritis is diagnosed early and treatment is ongoing.
- Symptoms on both sides of the body. Rheumatoid arthritis generally affects both sides of the body in similar ways, and inflammation is often seen in symmetrical joints. The joints may be affected gradually or suddenly become very inflamed, and although not always seen to affect symmetrical joints, this is a common factor in diagnosis in most cases.
- Loss of function in the joints. Those who live with rheumatoid arthritis often experience a loss of joint function in the affected areas. This is a result of the inflammation and pain, which restricts the range of motion and can lead to problems with mobility and dexterity. Some forms of exercise, particularly swimming, yoga and walking, can be very helpful in increasing flexibility and retaining joint function.
- Limping. Limping is often seen in those who have rheumatoid arthritis, and is often caused when the condition affects the joints in the hips, ankles, knees and feet. The inflammation and associated pain, as well as a restricted range of motion, can lead to a limp that may or may not be painful.
- Fever. A low level fever often accompanies the inflammation that characterises rheumatoid arthritis, and this is not harmful. However, it is important to be vigilant as a higher temperature could indicate an infection, and this could cause further problems for the immune system and require a different approach to rheumatoid arthritis treatment.
- Depression. As with many conditions that involve chronic pain, rheumatoid arthritis can be isolating and frustrating and can lead to depression. This is not uncommon in response to a chronic condition, and you can talk to your doctor about how you are feeling or join a support group locally or online to help you to find new ways to cope with the condition and the stresses it brings.
- Anaemia. Anaemia is another potential symptom of rheumatoid arthritis, and it is commonly caused by the way in which the condition affects the red blood cells in the body. This can lower the red blood cell count, leading to anaemia, which can also lead to many other health complications.
Rheumatoid Arthritis is Different for Everyone
Although the symptoms mentioned above are very common to people with rheumatoid arthritis, and can often lead to a diagnosis, the condition is not predictable or fixed in its course. Many people experience it in different ways, and it is important to work with a specialist in order to find a treatment pathway that suits you and your lifestyle.
Peter Browne, Consultant Rheumatologist in Tralee & Limerick
Dr Peter is a qualified rheumatologist who sees patients in Tralee and Limerick. To make an appointment, you will need to visit your GP or other healthcare professional, who can refer you to our rheumatology clinic. If you have a query, you can contact us online