Diagnosis, Nurse Mary
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The Classic Symptoms Of RA

The Classic Symptoms Of RA

Symptoms may vary during a day and from day to day and from person to person. The unpredictability of symptoms makes daily activities harder to plan. The following are symptoms common to Rheumatoid Arthritis.

Pain is a hallmark of rheumatoid arthritis. Pain comes in many forms in the same person. It is sharp as the edge of broken glass. It is burning. Aching. It is incapacitating and it can be unrelenting. Consuming. Sometimes it is excruciating. The middle joints of the fingers, the knuckles, wrists, the joints in the toes and the feet are affected. The shoulders, elbows, knees and ankles, and the hips become affected. The cervical spine is frequently affected. The lumbar and thoracic spines can be affected but less commonly. Pain may make it hard to get out of bed in the morning. Pain may increase as the day wears on. Pain can wake you in the middle of the night. The trouble is that the pain is not isolated to one spot. It encompasses many joints giving the pain a global effect. Pain management is a vital component to managing RA.

Symmetrical joint involvement is also a hallmark characteristic of RA.  The joints eventually match up and become symmetrically affected.  For example, the right wrist may be inflamed and in pain. Soon the left wrist joins in and hurts, too. My right middle toe has the same swelling and pain as my left middle toe.

The stiffness seen in active RA is frequently worst in the morning. It may last one to two hours (or even the entire day). Stiffness for a long time in the morning is a clue that you may have RA, since few other arthritic diseases behave this way. Stiffness may also occur after sitting or being inactive for an extended length of time. This is called gelling.

Certain cytokines, produced by the inflammation process, are a major factor in this profound malaise. As inflammation is reduced, the overwhelming fatigue is also usually reduced.  RA malaise is unlike the fatigue associated with being tired. This fatigue is not relieved by rest. RA malaise is immobilizing. It is overwhelming. It is due to the process of inflammation in the body.  Other factors may contribute to fatigue associated with RA, but the malaise of RA is unique and a product of generalized inflammation.

The inflammation in the joints may cause swelling to spill over into the surrounding tissue. According to my rheumatologist, the joints in my toes and feet are so swollen she cannot feel the joints. To me my feet don’t look swollen. Swelling may be more noticeable in the hands and the feet. When I was diagnosed, my left hand was so swollen, it hardly looked like a hand anymore. Swelling can occur in any joint affected by RA.

A temperature between 37 °C and 38°C or 99°F and 100° F is characteristic of inflammation.  A temperature over 100.5 F (38°C) is characteristic of infection. A low-grade temperature of 99° to 100°is common with RA.

The hallmark feature of RA is persistent symmetric polyarthritis that affects the hands and the feet. Joint inflammation frequently begins in small joints. More than one joint is affected. The middle joints of your fingers, the joints that attach your fingers to your hands. Your wrists.   Your toes. The joints that attach your toes to your feet. Your ankles. Subtalar joints, joint between the talus and the calcaneus (heel). RA may start out or occur later in the following joints:  Knees, shoulders, elbows, hips, cervical spine and the jaw. The little bones in the ear may also be affected. The bones in your larynx may make you hoarse. Almost every movable joint in the body can be affected by RA, especially as people get older.

Duration greater than 6 weeks   Joint pain, tenderness, swelling or stiffness continues for six weeks or longer.

Loss of appetite/ weight loss Some have no appetite because the process of inflammation is so pervasive that their bodies lack the energy to process food. Nausea is common both due to the inflammation process and due to the drugs used to treat RA.  Metabolism is increased in RA.

 

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