You may have heard about Rheumatoid Arthritis (RA), but when it happens to youor a loved one, it is easy to miss even obvious symptoms.
Most patients are unable to describe their pain even when they are swollen and sore all over. To top it off, untrained caregivers, typically family members, are unfamiliar with RA and cannot understand what the patient is going through.
Many also mistake RA for osteoarthritis, the most common form of arthritis that happens due to wear-and-tear of the joints due to old age or excessive use. Little do they realize that there are many other forms of arthritis.
What is Rheumatoid Arthritis?
RA is a chronic, progressive autoimmune and destructive disease that can lead to disability if not treated correctly early. This means the body’s immune system, which normally defends the body from invading organisms, mistakenly attacks healthy tissue in the body, causing inflammation in the joints.
In the case of RA, the target is the synovial membrane – the tissue that lines the joints.
This thin and delicate lining produces a clear fluid that helps keep joints healthy, lubricated, and moving smoothly. However, when the membrane becomes inflamed, the fluid thickens and begins to build up, putting painful pressure on the surrounding nerves.
This is when the RA sufferer begins to feel muscle aches, stiffness, or heat around the affected joints.
Early Symptoms of RA
Women are three times more likely to get RA than men. Some evidence suggests that hormones may be at play since the peak incidence occurs during the productive years between 30-50. Both men and women experience the same symptoms.
Early signs are gradual and often relates to how a person feels overall. But because RA can be elusive, spotting specific signs can be challenging.
Here are some warning signs – physical and mental – that can help you determine if you or a loved one has RA.
Early Warning Signs
1. Joint pain and stiffness
Pain is an obvious symptom of RA. It can affect any joint, usually on both sides of the body. It often starts at the smaller joints, such as the fingers, wrists, ankles, sometimes the shoulders, hips and knees.
Waking up feeling stiff all over is also a classic symptom. Many people experience morning stiffness, but the distinguishing sign of RA is a stiffness that last much longer into the day and does not go away with physical movement.
RA patients may notice some swelling, tenderness and redness of joints, typically in the wrists and finger joints, long before it becomes evident to their caregivers.
The reddish appearance is a telltale sign of RA that can interfere with everyday tasks, especially during a flare-up. An RA patient might have trouble with daily tasks such as turning a door knob, opening a milk carton, buttoning up, or typing on a keyboard.
At the hands, the joint in the middle and at the base of the fingers may feel tender when pressed or during movement. At the feet, the joints at the base of the toes may be tender. This soreness may cause people to walk on their heels or lift their toes up as they walk.
4. Radiating warmth
Joint warmth is caused by inflammation and may be present before redness or swelling occurs. This early sign of RA may not be obvious. Place the back of your hand or fingers on the joint and then on a nearby bone. If the joint is warmer than the skin over other body parts, it could be a sign of RA, especially if it is accompanied by other symptoms.
Other Symptoms of RA
Nearly everyone with RA complains of being extremely tired and lacking energy. This is a common symptom of many autoimmune conditions, which affects daily activities, relationships, sex drive, and work.
The good news is, once RA is under control, the fatigue fades away. As such, early diagnosis and treatment are important because the fatigue can become chronic over time.
Depression and chronic conditions go hand in hand. Some studies suggest depression is 2 – 4 times more common in RA patients than the general population.
In other conditions, depression is slowly developed from an ongoing health issue. For RA, however, depression tends to be an early symptom or systemic manifestation of inflammation. Treatment for depression needs to be included into the treatment plan for RA.
3. Feeling under the weather
Because RA makes you tired and achy, you will feel generally unwell. Anyone experiencing the signs on this list and feeling ‘under the weather’ for more than six weeks should see a doctor for evaluation.
4. Muscle and weight loss
Muscle loss is a serious complication that can affect patients within a year of developing RA. This goes hand in hand with unexplained weight loss, which is possibly an indirect effect of inflammation. When RA patients are feeling fatigued, they may lose appetite, which leads to the weight loss.
5. Skin nodules
About one in four people with RA develops firm, fleshy lumps beneath the skin. These so-called nodules usually occur at bony pressure points on the body, such as the knuckles, elbows, and heels.
You may leave them alone if they do not cause trouble. However, do consult your doctor if they hurt or affect daily activities, put pressure on your nerves, limit your movement, or happen in sensitive locations.
6. Nerve, skin, or organ damage
RA does not just cause joint complications but can affect other areas of the body. For example, skin ulcers may develop when inflammation attacks your blood vessels. When it affects the nerves, you may experience numbness or weakness in your limbs.
People with RA are also more likely to develop heart disease independent of other risk factors, and various lung complications such as interstitial lung disease, which can cause shortness of breath.
RA may also hasten the development of Metabolic Syndrome, a cluster of conditions – high blood pressure and blood sugar, and abnormal cholesterol levels – that increase the risk of stroke, diabetes, and heart disease. If your numbers are borderline and you develop RA, be extra cautious and ask your doctor how you can stay healthy.
There is no cure for RA but clinical studies indicate that remission of symptoms is more likely when treatment begins early with medication.
The tricky part is recognising and detecting RA early. Early detection is vital in managing RA because the disease can progress rapidly and will lead to irreversible joint damage soon after the onset of the disease.
Early treatment will help to manage pain more effectively and at the same time minimize long-term joints damage. If you suspect yourself or your loved one to have RA, speak to your doctor or consult a rheumatologist.