What Are the Early Signs of Rheumatoid Arthritis? 

Medically Reviewed By Margaret R. Li, MD, FACR

Rheumatoid arthritis (RA) is an autoimmune disease that causes joint pain and inflammation. The first signs of RA may include pain and stiffness in the joints of your hands and feet. According to the American College of Rheumatology, rheumatoid arthritis (RA) affects more than 1.3 million Americans, and 75% of people with RA were assigned female at birth. The condition can occur at any age but typically starts between ages 30 and 50.

This article explores the early signs of RA and how doctors diagnose and treat the condition. 

What are the early signs of rheumatoid arthritis? 

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Early signs of RA may include aching pain in your hands, wrists, and feet. The pain may worsen in the morning or after rest periods, and it can last several hours. 

RA symptoms may worsen at times. Health experts call this a flare. There are also times of remission, which is when the symptoms get better.

Joint pain

RA causes inflammation in the layers between your joints. This inflammation typically starts in the hands and feet. As a result, you may feel pain in the little joints in your feet, toes, and fingers. 

Joint swelling

Inflammation from RA also causes extra fluid to move to the area to try and decrease the inflammation. This excess fluid causes swelling in those areas. As a result, you may notice swollen joints in your hands and feet. 

Joint tenderness

Along with inflammation and swelling, your joints may feel tender to the touch or when you move them. You may feel this tenderness at the base of your fingers or toes.

Joint warmth

Inflammation also causes an area to be warmer than other body parts. You may notice that the joints in your fingers and toes feel warmer, and the skin may even look a little red or discolored.

Joints affected on both sides

Some conditions affect only one side of the body. However, RA affects both sides of the body, typically at the same time Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source . This may help you tell the difference between an injury and the early signs of RA.

What are some other symptoms of rheumatoid arthritis?

Other early signs of RA include symptoms that may make a person not feel well overall. 

Fatigue 

Many people experience fatigue. They may feel tired throughout the day doing their usual activities, even after getting good rest at night. 

Low grade fevers

Low grade fevers are another symptom of RA. You may notice you are running a slight fever most of the time. 

Loss of appetite and weight loss

Some people also notice they do not have a good appetite. They do not feel like eating much and may even notice some weight loss. 

Rheumatoid nodules

Rheumatoid nodules are another symptom of early RA. These are firm lumps that grow under the skin in areas such as the elbows and hands. 

Learn more about the symptoms of RA.

How do I treat early symptoms of rheumatoid arthritis?

Currently, there is no cure for RA. However, some treatments may take away symptoms of active RA.

The goal of treatment is to reduce joint pain and swelling, as well as improve your mobility. In addition, treatment may also reduce the progression of the condition and help reduce joint contractures and deformities.

Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs), low dose corticosteroids, and disease-modifying antirheumatic drugs (DMARDs).

When starting treatment, immediate relief of inflammation can be found by taking NSAIDs and corticosteroids. These treatments work quickly and are bridging therapy for DMARDs.

DMARDs can take a few weeks to a few months to take effect. As the DMARDs start to work, the NSAIDs and corticosteroids can be tapered off. NSAIDs and corticosteroids can also be used in the short term for flare-ups.

This combination can greatly improve your pain, swelling, and quality of life. 

Conventional DMARDs are usually first-line medications for rheumatoid arthritis. These include:

  • methotrexate (Rheumatrex, Trexall, Otrexup, Rasuvo)
  • leflunomide (Arava)
  • hydroxychloroquine (Plaquenil)
  • sulfasalazine (Azulfidine)

For more advanced cases, or if your symptoms do not respond to conventional DMARDs, a doctor may recommend biologics.

Other ways to improve your symptoms include staying physically active most of the time. Activities such as low impact aerobic exercises help boost your muscle strength. These exercises include yoga, swimming, and stationary bicycling.

This improves your overall health and takes the pressure off your joints. 

However, resting during flares or when you feel fatigued is advisable. Gentle range-of-motion exercises such as stretching can help your joints stay flexible during these times.  

No single treatment works for each person, and some people will need to change their treatment at least once in their lifetime. The earlier you start treatment, the better. This will help decrease the risk of long-term damage to your joints.

Learn more about drugs doctors commonly prescribe for RA.

When should I see a doctor?

Let your doctor know if you are frequently feeling pain in your joints, especially if you are also experiencing other symptoms such as:

  • joint stiffness
  • joint swelling
  • low grade fever
  • fatigue
  • loss of appetite and weight loss

RA inflammation starts the process of irreversible damage in your joints, so the sooner you start treatment, the better. 

Find out more about when to contact a doctor for RA.

How do doctors diagnose rheumatoid arthritis?

Your doctor may first ask you questions about your health history and any medications you currently take. They may also carry out a physical examination.

Your doctor may ask you to demonstrate your range of motion and test your strength. They may also need to feel your joints to check for warmth, tenderness, and swelling. 

Blood tests check your levels of inflammation and look for certain antibodies that sometimes rise in people with RA. 

X-rays are sometimes helpful. However, early RA is sometimes not detectable on X-ray images. Nevertheless, the images can be useful for checking for arthritic joint changes in the future. 

What are the risk factors for rheumatoid arthritis?

Experts Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source have found several genetic and environmental factors determining a person’s risk of developing RA. 

These factors include:

  • Age: RA can start at any age, but the likelihood of it starting increases with age. 
  • Biological sex: RA is two-to-three times more common in females than in males. 
  • Genetics: Certain genes from your family, such as the human leukocyte antigen (HLA) class II genotypes, can increase your risk.
  • Smoking: Cigarette smoking increases a person’s risk for RA.
  • Obesity: Having obesity increases your risk for RA.
  • Early life exposures: Early exposure to secondhand smoke may increase your risk for RA.
  • History of live births: People who have given birth may have less risk than those who have not. 

Learn more

Summary

Early signs of RA may include pain, swelling, and stiffness in your hands and feet. The condition typically affects both sides. Other symptoms may include fatigue, low grade fever, and loss of appetite.

Early treatment helps prevent irreversible damage to your joints. Your doctor may prescribe certain medications to help decrease swelling and relieve pain. Keeping active and performing range-of-motion stretching can also help improve the health of your joints.

If you feel you are experiencing early symptoms of RA, make an appointment with your doctor so you can receive an accurate diagnosis and start treatment as soon as possible.

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Medical Reviewer: Margaret R. Li, MD, FACR
Last Review Date: 2023 Jan 4
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