Rheumatoid arthritis (RA) is a chronic (long-term) disease. Rheumatoid arthritis symptoms can come and go, and each person with RA is affected differently. Some people have long periods of remission. Their rheumatoid arthritis is inactive, and they have few or no symptoms during this time. Other people might have near-constant rheumatoid arthritis symptoms for months at a stretch.
Although rheumatoid arthritis can involve different parts the body, joints are always affected. When the disease acts up, joints become inflamed. Inflammation is the body's natural response to infection or other threats, but in rheumatoid arthritis inflammation occurs inappropriately and for unknown reasons.
Joint inflammation is a hallmark of rheumatoid arthritis. That includes:
Stiffness. The joint is harder to use and might have a limited range of motion. "Morning stiffness" is one of the hallmark symptoms of rheumatoid arthritis. While many people with other forms of arthritis have stiff joints in the morning, it takes people with rheumatoid arthritis more than an hour (sometimes several hours) before their joints feel loose.
Swelling. Fluid enters into the joint and it becomes puffy; this also contributes to stiffness.
Pain. Inflammation inside a joint makes it sensitive and tender. Prolonged inflammation causes damage that also contributes to pain.
Redness and warmth. The joints may be somewhat warmer and more pink or red than neighboring skin.
Which joints does RA affect? The hands are almost always affected, although literally any joint can be affected with rheumatoid arthritis symptoms: knees, wrists, neck, shoulders, elbows, even the jaw. Joints are usually affected in a symmetrical pattern -- the same joints on both sides of the body.
Rheumatoid Arthritis Symptoms That Affect the Entire Body
Rheumatoid arthritis can affect many areas of the body. These effects all result from the general process of inflammation, leading to a wide variety of symptoms of rheumatoid arthritis:
Malaise (feeling ill)
Loss of appetite, which can lead to weight loss
These feelings have been compared to having the flu, although they are usually less intense and longer lasting.
Rheumatoid arthritis may affect other areas of your body. Involvement of multiple areas of the body occurs is more common with moderate to severe rheumatoid arthritis.
Rheumatoid nodules are bumps under the skin that most often appear on the elbows. Sometimes they are painful.
Lung involvement, due to either damage to the lungs or inflammation of the lining around the lungs, is common but usually causes no symptoms. If shortness of breath develops, it can be treated with drugs that reduce inflammation in the lungs.
Rheumatoid arthritis can even affect a joint in your voice box or larynx (cricoarytenoid joint), causing hoarseness.
Rheumatoid arthritis can cause inflammation in the lining around the heart, but it usually has no symptoms. If symptoms do develop, it may cause shortness of breath or chest pain. In addition, people with rheumatoid arthritis are more likely to develop clogged arteries in their heart, which can lead to chest pain and heart attack.
The eyes are affected in less than 5% of people with rheumatoid arthritis. When the eyes are affected, symptoms can include red, painful eyes or possibly dry eyes.
When you have symptoms of rheumatoid arthritis, early and aggressive treatment can help prevent further symptoms as well as stop progression of rheumatoid arthritis.
SOURCES: Ching D., British Journal of Rheumatology, November 1992; vol 31: pp 775-7. eMedicine.com: "Rheumatoid Arthritis-Symptoms." Kelly, C. Bailliere's Clinical Rheumatology, February 1993; vol 7: p 1. Klippel, J. Primer on the Rheumatic Diseases, 12th edition, Arthritis Foundation, 2001. Lee, D., Weinblatt, M. Lancet, 2001; vol 358: pp 903-911. Masi A. American Journal of Medicine, Dec. 30, 1983; vol 75: pp 16-26. Venables PJW, UpToDate topic: "Clinical Features of Rheumatoid Arthritis," Jan. 20 2005.