Most patient literature fails to distinguish between early symptoms, later developments, and complications. The following are common early rheumatoid arthritis symptoms.
Pain
Pain is a hallmark of rheumatoid arthritis.
The pain comes in many forms in the same person.
- It is sharp as the edge of broken glass. It is burning. It can be a dull ache. It is incapacitating and it can be unrelenting. Pain is more noticeable on movement. Sometimes it is excruciating. The proximal joints of the fingers, the knuckles, wrists, the toes, and joints in the feet are affected. The shoulders, elbows, knees, and ankles become affected. The cervical spine is frequently affected. The temporomandibular(jaw) joints can be affected.
- Pain may increase as the day wears on. Trouble is the pain is not in one spot. It usually encompasses many joints, and the pain feels global. Sometimes overwhelming.
- Some RA pain comes from the pressure inflammatory swelling exerts within a joint.
- Pain also comes from irritated nerves that have been affected by the proteins and chemicals that are released by the inflammatory cells.
- Pain can come from the ligaments and tendons affected by the joint inflammation.
- Pain can come from bony erosions.
- And so it goes. Our RA is a different combination than anyone else. And in our own body, RA will surprise us and change.
Fatigue
RA fatigue is unlike the fatigue associated with being tired. This fatigue is not relieved by rest. RA fatigue is immobilizing. It is overwhelming. It is as a result of RA inflammation in the body. Cytokines, chemicals produced by the inflammation process, are a major factor in this profound fatigue. As inflammation is reduced, the overwhelming fatigue may also be reduced. RA’s general feeling of being unwell, without energy is both biologic and genetic in origin.
Morning stiffness
The bilateral stiffness seen in active RA is most often worst in the morning. It may last one to two hours (or even the whole 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.
Swelling
Inflammation in the joints may cause swelling to spill over into the surrounding tissue. Swelling is going to stretch against the joint capsule and against the skin. The pressure of the swelling will cause pain. Swelling may be more noticeable in the hands and the feet, but it can occur in any joint affected by RA. My feet and toes are always swollen.
Systemic polyarthritis
The hallmark feature of RA is persistent symmetric polyarthritis that affects the hands and the feet. Although one joint or multiple joints may initially be involved. Joint involvement eventually becomes symmetrical. For example, the right wrist may be inflamed and in pain. The left wrist joins in and hurts, too
Symptoms that last six weeks
Joint pain, tenderness, swelling, and stiffness continues for six weeks or longer in order to be given a diagnosis of RA.
Small Joints
Joint inflammation frequently begins in the small joints of the hands and feet. 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.
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. Every moveable joint in the body can be affected by RA. My shoulders were initially involved too.
Low grade temperature
A temperature between 99° (37.22°) and 100.5 F (38°C) is characteristic of inflammation. A temperature over 100.5 F (38°C) is characteristic of infection. A low-grade temperature is common. when the joints are inflamed.
Loss of appetite
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.
Your early symptoms will be your own. My onset was severe. Both my hands and feet were swollen. The pain in my shoulders was sharp and excruciating. I felt exceedingly fatigued. I lost my appetite. Mornings were tough. I ended up in the ER. The doc gave me a steroid in my IV. For the first time in months, I felt like a new person.
Thank you for that information! My diagnosis really came out of the blue, very early, when the hands were just a little stiff but not super obvious. I’d had some weird itching stuff for about 8 months before, but no fatigue, no swelling, some pain in my elbows and shoulders. But I’d had over 10 years of weird joint issues, a lot of tendonitis, bursitis, pain, mainly blamed on repetitive movements. I remember 10 years ago even having a body scan for inflammation and a lot of joint areas lit up like a Christmas tree but nothing showed up in testing, nothing was suggested but I always thought in the back of my mind about RA as my grandmother had it, so there was a genetic connection. A chiropractor even told me about that time don’t be surprised if something shows up in testing years from now-i just had a lot of weird myofascial pain, was seeing her for back problems. How prophetic is that?!
Anyway, just I had my shoulders checked for a lot of chronic pain, hey guess what? No RA erosions but moderate osteoarthritis and bursitis. I am just full of the “itis’s” ….arghh
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