Last winter, after spending a few afternoons shoveling snow, Heather Miceli, 27, woke up in the middle of the night and couldn’t get out of bed. “My joints had swelled up so much that I couldn’t move without crying,” she says.
Two months later, the college professor at Johnson and Wales University in Providence, R.I., who had always been healthy, was diagnosed with rheumatoid arthritis (RA) -- a debilitating autoimmune disease that causes inflammation and swelling in the joints and surrounding tissues,...
Rheumatoid arthritis mainly affects joints. It causes:
Any joint can be affected by RA. But the joints most often affected include:
Knuckles of the hands
Rheumatoid arthritis inflames other joints less often. These include some areas of the body that most people don't realize have joints, such as the:
Morning stiffness is a common symptom of rheumatoid arthritis. The joints of RA patients with morning stiffness are particularly stiff first thing in the morning. The stiffness improves somewhat after at least an hour of movement.
RA typically involves more than one joint. Often, but not always, joints on both sides of the body (“symmetrical,” such as both wrists) are equally affected.
RA Symptoms Away From the Joints
Although rheumatoid arthritis almost always affects joints, it can also involve other areas of the body. The resulting inflammation can lead to varied symptoms outside the joints, such as:
Painful lumps under the skin (nodules)
Eye pain and redness
Shortness of breath
Carpal tunnel syndrome
Dry eyes (Sjogren's syndrome)
Progression of RA Symptoms
The progression of symptoms in rheumatoid arthritis varies widely. Some people with RA have a steady progression of disease with joint damage. Others have mild symptoms that never worsen.
In a few people with rheumatoid arthritis, symptoms may come in episodes or flares. These flares can be separated by months without any symptoms.
More often, symptoms of rheumatoid arthritis are persistent. They occur on most days. The symptoms may be worse on some days than others.
No two people with rheumatoid arthritis may have exactly the same pattern of symptoms. Recent advances in rheumatoid arthritis treatments have resulted in better symptom control and reduced progression of disease for many people with RA.
Signs of Rheumatoid Arthritis
Symptoms refer to what a person feels or experiences. Signs are observations a doctor makes using an exam and tests.
Signs of rheumatoid arthritis are often related to symptoms. A doctor can frequently detect swelling and stiffness in inflamed joints by examining the hands, wrists, knees, and other joints. A joint that's inflamed and swollen by rheumatoid arthritis often has a "boggy" or "mushy" texture when pressed with a finger.
Other signs of rheumatoid arthritis include:
Reduced grip strength in the hands
Swelling over the back of the hand (aside from the joints in the hand)
Limited joint motion
Lumps just under the skin, called rheumatoid nodules
Joint misalignments (permanent changes in joint shape or structure)
Wearing away of bones or erosions on X-rays
Doctors consider both the signs and symptoms of rheumatoid arthritis when diagnosing RA. They also use signs and symptoms when evaluating a person's progression and response to treatment.