Rheumatoid Arthritis Symptoms: Morning Stiffness, Swollen Joints and When to Be Seen

What it involves

MedlinePlus describes rheumatoid arthritis, or RA, as a long-term disease that leads to inflammation of the joints and surrounding tissues. It is an autoimmune disease, meaning the immune system mistakenly attacks healthy tissue, and it can also affect other organs.

Who this is for

• Adults with stiff, swollen or tender joints in the hands, wrists or feet on both sides
• Patients whose morning stiffness lasts longer than an hour
• People with joint pain plus fatigue, dry eyes or a dry mouth
• Anyone with joint swelling that has lasted more than a few weeks

What to expect

• Questions about which joints hurt, how long morning stiffness lasts and how long the swelling has been there
• An exam of the hands, wrists, feet and other joints, looking for warmth and swelling
• Blood work such as a blood count and metabolic panel, and referral for specialized antibody and inflammation tests when the picture fits
• A referral to a rheumatologist when rheumatoid arthritis is likely, since it usually needs specialist treatment

How the pattern differs from wear-and-tear arthritis

MedlinePlus says RA is less common than osteoarthritis, which comes from wear and tear on the joints with age, and that RA most often affects joints on both sides of the body equally. Fingers, wrists, knees, feet, elbows, ankles, hips and shoulders are the most common, and the lower spine is usually spared. Morning stiffness lasting more than an hour is typical. The osteoarthritis guide describes the other pattern, and the swollen joints guide covers swelling in general.

Early signs that are easy to dismiss

The disease often begins slowly. MedlinePlus lists early symptoms as minor joint pain, stiffness and fatigue, and says joints may feel warm, tender and stiff after an hour without use. Other symptoms it names include dry eyes and mouth, eye burning or itching, numbness, tingling or burning in the hands and feet, sleep difficulties, chest pain on breathing in, and nodules under the skin. Tiredness alone is common, and the fatigue guide covers other causes, but tiredness with stiff joints is a combination to report.

Who is more likely to get it

The encyclopedia says the cause of RA is not known. It can occur at any age but is more common in middle age, and women get it more often than men. Infection, genes and hormone changes may be linked, and smoking is linked to the risk of developing the disease. If you smoke, the quitting smoking guide explains where to start. None of this means you will develop it, and many people with stiff joints turn out to have something else, which is the reason to be examined rather than guess.

How RA is diagnosed

MedlinePlus says no single test can say for sure whether you have RA. The diagnosis is made when there is pain and swelling in one or more joints for longer than six weeks, a positive rheumatoid factor or anti-CCP antibody test, raised inflammation markers such as ESR or CRP, and other types of arthritis are not present. Other tests it lists include a complete blood count, a metabolic panel and joint x-rays or ultrasound. Our guides to the complete blood count and basic metabolic panel explain two of them.

Treatment belongs with a specialist

MedlinePlus says RA most often requires long-term treatment by an expert in arthritis called a rheumatologist, and that early treatment with disease-modifying antirheumatic drugs should be used in all patients to slow joint damage. These medicines need frequent blood tests and monitoring because of possible serious side effects. At Serenity By A Dr. Sareen the role is to recognize the pattern early, order the first blood work and make the referral, then keep following your general health. Primary care and the specialist work on the same chart.

Ordinary joint pain is also worth a visit

Not every aching joint is RA. Pain after activity, a single sore knee or a flare of an old injury has other explanations, and the knee pain guide and gout guide describe two. A joint that is suddenly hot, red and very painful, especially with fever, needs same-day attention because infection is possible. For joint pain from osteoarthritis, the practice also offers joint injections at its Loxahatchee and West Palm Beach offices.

Sources

• MedlinePlus: Rheumatoid arthritis (medical encyclopedia)
• MedlinePlus: Rheumatoid Arthritis (health topic)