For a few years, Andrew Ellis tried to tough out the pain, which started in his thumb. A boxer and football player in college, Ellis, 58, was used to aches and pains. He’d even broken his thumb once, so he told himself the new pain was from the old break. Then his other thumb began to hurt. Soon, he had pain in his toes and the balls of his feet. When his neck began to hurt, he finally admitted to himself that it was time to see a doctor.
“I said to myself, ‘There’s something wrong,” recalls Ellis, who retired after 28 years in the military and now lives in Bel Air, MD.
Diagnosing rheumatoid arthritis (RA) in the early stages can be difficult. There is no single test that can clearly identify rheumatoid arthritis. Instead, doctors diagnose rheumatoid arthritis based on factors that are strongly associated with the disease. The American College of Rheumatology uses this list of criteria:
Morning stiffness in and around the joints for at least one hour.
Swelling or fluid around three or more joints simultaneously.
At least one swollen area in the wrist,...
He was right. Ellis learned that he had rheumatoid arthritis.
For a man, that’s a rather uncommon diagnosis. Of the estimated 1.3 million people with the disease in the U.S., women outnumber men by as much as three to one.
It’s not known why the condition is so much more common among women, though there’s evidence to suggest that hormonal differences might explain at least some of the disparity in numbers. In fact, other rheumatic diseases, such as lupus and fibromyalgia, also affect many more women than men.
Good News and Bad News for Men with RA
Rheumatoid arthritis is an autoimmune disease. It causes the body’s immune system to attack the lining of joints and other parts of the body. This leads to painful inflammation, swelling, and stiffness. In advanced stages, the damage caused by such inflammation can be quite debilitating.
RA symptoms can last anywhere from a few months to a lifetime. For some people, it flares up on occasion, then temporarily goes into remission; for others, it can be a constant, painful presence.
For men with the disease, there may be some good news. According to rheumatologist Grant Louie, MD, an arthritis specialist at The Johns Hopkins Hospital in Baltimore, men may have a less severe disease course than women. Men may also be more likely to have their disease go into remission, especially if it is caught and treated early.
Diagnosing and treating the disease early is important for other reasons, as well. Joint damage often happens during the first two years of having RA, according to the Arthritis Foundation.
Many men, though, are much less likely than women to see a doctor, for arthritis or anything else. Ellis is a perfect example. He put up with his pain for three to four years before consulting with a physician.
“Men are often diagnosed later because they tend to downplay their symptoms,” says Louie, who is treating Ellis' RA. “They may not recognize that it is something that they need treatment for.”
Louie adds that men also may have fewer functional disabilities than women do. But the reason may be that men are underreporting the extent of the difficulties that the disease is causing. This also comes up when diagnosing RA.