RA body
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Early RA symptoms- a book excerpt

My book My Rheumatoid Arthritis Handbook is in the editing stage. Here is a description of early rheumatoid arthritis symptoms.


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 heat. It is a dull, nagging ache. It is incapacitating and it can be unrelenting. Pain may make movement difficult. It may make sitting still difficult. 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. The spine. The temporomandibular (jaw) joints. All are affected.

  • Pain may increase as the day wears on. Trouble is the pain is not in one spot. It usually encompasses many joints and soft tissue. The pain feels global.
  • 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 inflammatory cells.
  • Pain can come from the ligaments and tendons affected by the joint inflammation.
  • Pain comes from bony erosions.
  • As you can see there are many sources and many types of  RA pain.


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 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 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 phenomenon is called gelling.


The inflammation in the joints may cause swellingto 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.

Symmetric polyarthritis

The hallmark feature of RA is persistent symmetric polyarthritis that affects the hands and the feet. 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. Soon the left wrist joins in and hurts, too. Symmetrical joint involvement is characteristic of RA. 

Duration greater than 6 weeks  

Joint pain, tenderness, swelling, and stiffness continues for six weeks or longer in order to have a diagnosis of RA made.

Small joints

 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.

RA may start out or occur later in the following joints:  Knees, ankles, 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.  As people age larger joints become affected.

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

People lose their appetite because the process of inflammation is so pervasive that their bodies lack the energy to process food. Additionally, those with RA just lose their appetites. Additionally, nausea is common both due to the inflammation process and due to the drugs used to treat RA.

This entry was posted in: RA body


Woman, friend, mother, RN, photographer, gardener, writer, researcher, observer, swimmer. Pretty much the same as everyone else with my own little twist to things. RA, and three cancers and counting. Life is good despite the obstacles. It's worth the ride just to see the infinite variations of the human spirit.

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