Rheumatoid arthritis (RA) is an autoimmune disease that causes inflammation, swelling, and pain in a person’s joints. The condition is chronic and progressive and can be disabling. Symptoms develop over time, with early signs including fatigue, joint tenderness, and pain.

According to the Arthritis Foundation, 1.5 million people in the United States have RA. Biological females are three times more likely than biological males to develop RA.

This article looks at the early signs that a person might have RA. It also discusses later stage symptoms and when to speak with a doctor.

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If a person has an autoimmune disease, such as RA, their immune system mistakes the body’s cells for foreign invading cells. Their immune system then releases inflammatory chemicals to attack them.

If someone has RA, their immune system attacks the tissue called synovium. This tissue lines the joints and produces fluid that helps them move smoothly.

RA most commonly affects the joints in the hands, wrists, and knees. It causes the lining of the joints to become inflamed, which can damage their tissues. The damage that RA causes can lead to a person developing long lasting or chronic pain. It may also cause deformities and a lack of balance.

RA may also affect other tissues in a person’s body, including organs such as the heart, eyes, and lungs.

A person can develop RA at any stage in their life. However, the condition most commonly develops between the ages of 30 and 50 years old.

People with early stage RA may not see redness and swelling in their joints. However, they may experience some joint tenderness and pain. A general feeling of stiffness throughout the body in the morning may suggest a person has RA.

Someone with early stage RA may also experience fatigue. Fatigue can be both mental and physical and can cause a person to feel extremely tired, preventing them from performing their usual daily tasks.

The inflammation that comes with RA may cause a person to develop a fever. A person has a fever if their body temperature rises above the typical range of 98–100°F (36.7–37.7°C). Fever is a common sign of inflammation in people with autoimmune diseases.

A person may also experience weight loss due to the inflammation from RA. In addition, someone with fatigue and fever may experience appetite loss, which can contribute to weight loss.

As the inflammatory process of RA progresses, symptoms can worsen. A person may experience more extreme fatigue and continue to have fevers and lose weight.

Common symptoms of RA include the below.

Joint pain and stiffness

Joint pain and stiffness is the most common symptom of RA. The person’s joints may become red, warm, swollen, and tender to touch.

Joint stiffness is often at its worst in the morning. It can last for several hours or the entire day, depending on the severity of the disease.

RA tends to cause pain and stiffness in the hands and feet first. However, a person may experience these symptoms in the knees or shoulders.

RA will often affect both sides of a person’s body. In fact, finding symmetrical symptoms across the joints is key to how doctors diagnose RA.

Decreased range of motion

RA can cause damage to a person’s ligaments and tendons. This can make it more difficult for them to achieve a typical range of motion in the joints. This can result in a person being unable to bend or straighten certain joints.

This can have a negative effect on their quality of life, as it may restrict them from doing things they were once able to do.

Numbness and tingling sensations

Inflammation from RA can cause nerve compression, which can affect the nerves around the joints. This can cause a person to develop damaged nerves, called peripheral neuropathy.

This nerve damage can cause a loss of sensation, and people may experience numbness or a tingling sensation in their hands and feet.

Rheumatoid nodules

Rheumatoid nodules are lumps that develop under a person’s skin. They are a common symptom of RA.

These lumps often appear next to the joints that the RA is affecting. However, rheumatoid nodules do not require treatment and are not contagious or dangerous. They can sometimes indicate that a person could make improvements to how they manage their RA.

RA mostly affects a person’s joints. However, the disease can also affect other parts of the body, including the heart, lungs, and eyes.

This can cause a variety of other symptoms, including the following.

Eye symptoms

RA can affect a person’s eyes. This can cause them to have dry eyes, the most common type of eye involvement in RA. People with RA can also experience increased sensitivity to light and trouble seeing clearly.

They may also experience eye pain and redness of the eye when RA inflammation affects the eye tissues, such as the iris or the uvea. This involvement is called iritis or uveitis, respectively.

Mouth symptoms

RA can cause a person to have a dry mouth and inflamed gums.

People may also develop irritated gums or a gum infection.

According to a 2020 meta-analysis of 18 studies, up to 19.5% of people with RA may also have Sjögren’s disease. This is a chronic autoimmune disorder affecting the moisture-producing glands, including those in the mouth.

Lung symptoms

RA can cause damage to a person’s lungs, particularly in the form of interstitial lung disease, an umbrella term for a group of conditions that cause inflammation and scarring in the lungs.

This can cause the person to experience shortness of breath and may lead to chronic lung disease.

Blood and blood vessel symptoms

Inflammation can affect a person’s blood vessels.

This can cause damage to their skin and nerves, resulting from inflammation of the veins, arterioles, and venules. The latter involvement can develop as a peripheral neuropathy.

A person with RA may also have anemia or a lower than expected red blood cell count due to the chronic inflammation.

Heart symptoms

A person with RA may experience inflammation of the heart. This can damage the heart muscle and the surrounding areas.

The chronic inflammation that RA causes can also increase the risk of developing coronary artery disease (CAD).

The inflammation affects the lipid profile of people with RA, contributing to the onset of CAD. People with RA are almost twice as likely to experience heart conditions, such as angina and congestive heart failure, as those without.

Weight gain

Some people with RA experience weight loss.

However, others may find that painful joints make it hard to exercise.

This can cause the person to gain weight. People who maintain a moderate weight can reduce their risk of high cholesterol, heart disease, and high blood pressure.

To treat RA effectively, it is important that a person gets an accurate diagnosis as soon as possible. If they experience symptoms of RA, they should seek medical help.

If a doctor suspects RA, they may arrange for the person to consult a rheumatologist, a doctor with specialized training in treating arthritis.

A doctor will first ask about the person’s medical history before discussing joint symptoms. They will want to know about any pain, tenderness, stiffness, and any mobility difficulties they might be experiencing.

The doctor may also want to know about any family history of autoimmune diseases.

They will then carry out a thorough physical examination, documenting vital signs, examining joints, and looking for tenderness, swelling, or warmth of the joints. The doctor may also order blood and imaging tests to support the suspected diagnosis.

RA is a chronic autoimmune condition.

If a person has RA, their immune system confuses the body’s own cells for foreign invading pathogens. This causes the immune system to attack its own cells.

The immune system will also attack synovium, the tissue that lines the joints and produces fluid that helps them move smoothly.

RA tends to affect the joints in the hands, wrists, and knees.

Common symptoms of RA include swelling and pain in the joints, fatigue, fever, decreased function of joints, and compromised mobility.

Anyone who thinks they may have RA should consult with a doctor as soon as possible.