Symptoms of rheumatoid arthritis may be characteristic of the disease or may be generalized mimicking other types of arthritis like osteoarthritis, gout etc. The onset and development of symptoms is usually in a slow and progressive manner.
The initial symptoms are often felt in the small joints such as those of the fingers and toes. Larger joints like knees, wrists, shoulders or hips may also be the first to be affected.
Symptoms of rheumatoid arthritis:
- One of the initial features of rheumatoid arthritis is stiffness of the joints and muscles around the joints.
- As the joint damage progresses there is pain. The pain often feels aching and dull. The typical feature of pain in rheumatoid arthritis affected joints is pain that is worse in the mornings after a night’s rest. Pain is also worse when resting rather than when working.
- Stiffness of the joints is another symptom. Stiffness of the muscles during the morning after waking up is seen in patients of rheumatoid arthritis as well as osteoarthritis. However, among patients with osteoarthritis the stiffness goes away after around half an hour of activity. For patients of rheumatoid arthritis the stiffness may last longer.
- The joints may become inflamed. This is characterized by warmth and redness of the joint. There is swelling over the joint along with redness. The joint feels hot and painful to touch.
- Over time the small joints that are affected by the disease may be damaged leading to permanent deformities. Deformities are caused due to erosion of bones that end in the joints, erosion of cartilages and rupture of the tendons around the joint. These deformities are characteristically seen in the hands and finger joints. For example, the thumb is deformed and deformed and this us called the Boutonniere deformity of the thumb. The tips of the finger appear curved and this is termed swan neck deformity etc.
- In patients of rheumatoid arthritis there may be presence of inflammations around the joint. These appear as swollen lesions called rheumatic nodules. These are usually painless, hard, oval or spherical masses that are common over pressure points such as the wrist, elbows, ankles etc.
- Rheumatoid nodules can also occur in the eyes or in other organs such as lungs. In lungs they may lead to complications like accumulation of fluids in and around the lungs.
- Another feature of rheumatoid arthritis is anemia or low red blood cell count. This is because there may be a deficiency of production of new red cells to make up for the lost ones. Platelet counts may also be altered.
- Some patients may suffer from (inflammation of the blood vessels or rheumatoid vasculitis. This complication may be life-threatening. It can lead to skin ulcerations that can get infected, stomach ulcer and nerve damage. Stomach ulcers can cause complications like bleeding or perforations and nerve pathologies may lead to pain, numbness or tingling sensations. Blood vessels of the brain and heart may also be involved causing stroke or heart attacks.
- In the heart there may be accumulation of fluid called pericarditis. The heart muscles may be inflamed leading to myocarditis. These conditions may lead to heart failure.
- Some persons may experience a sudden increase in symptoms and this is called a flare-up. Flare ups are usually difficult to predict and may occur more commonly in the morning after waking up.
- Rheumatoid arthritis overall has a severe impact on the quality of life. There is a severe impact on physical function, social and emotional well being as well as mental health. Other associated conditions with this condition include depression and anxiety.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)