Symptoms of Rheumatoid Arthritis

Rheumatoid arthritis is a chronic autoimmune disease that primarily affects the joints but can also impact the entire body. Its symptoms usually develop gradually, and early signs may be confused with other joint problems, leading to delayed diagnosis. Recognizing the characteristic symptoms early is crucial for effective treatment.

This disease is characterized by symmetrical joint involvement, meaning that the same joints on both sides of the body are inflamed simultaneously. The severity of symptoms varies among individuals, with some experiencing flare-ups and periods of remission. Long-term inflammation can cause joint destruction and functional impairment, so understanding the pattern of symptom changes helps in early intervention.

Early Symptoms and Signs

Early symptoms may be mistaken for general arthritis or muscle fatigue, but their distinctive features include:

• Low-grade fever (persistent mild fever below approximately 37.5°C)
• Unexplained fatigue that does not improve with rest
• Minor swelling and tenderness in small hand joints (such as the metacarpophalangeal joints)
• Joint stiffness lasting more than 30 minutes upon waking in the morning

About 20-30% of patients experience unexplained weight loss or abnormal appetite before joint symptoms appear. These systemic signs are often overlooked but should raise suspicion when combined with symmetrical joint symptoms.

Common Symptoms

Characteristic Joint Symptoms

The typical presentation follows the "three S's" principle: bilateral symmetry, proximal joint involvement, and small joint affliction. Common affected joints include:

• Metacarpophalangeal joints (where fingers connect to the hand)
• Metatarsophalangeal joints (where toes connect to the foot)
• Wrist and knee joints
• Shoulder joints and cervical spine

Inflammation causes swelling of surrounding tissues (synovium, ligaments), which can be felt as warmth and tenderness upon palpation. Long-term inflammation may lead to joint deformities, such as ulnar deviation or swan-neck deformities of the fingers.

Systemic Symptoms

Over 60% of patients experience systemic symptoms, including:

• Persistent fatigue affecting daily activities
• Low-grade fever (37.3-38°C) with mild chills
• Muscle weakness and decreased coordination
• Mild lymphadenopathy (in the neck or axillary regions)

When these symptoms worsen alongside joint symptoms, it indicates active disease. Systemic symptoms may improve after disease control, but joint damage may be irreversible.

Disease Progression and Symptom Changes

During active phases, patients may experience fluctuations:

• Acute flare-ups: increased joint swelling and morning stiffness extending to 1-3 hours
• Remission: temporary improvement in joint mobility, although structural damage continues

The disease may lead to the following changes:

• Joint destruction: ligament laxity and bone resorption causing joint dislocation
• Functional impairment: inability to perform fine motor tasks (e.g., buttoning)
• Secondary complications: such as dry eyes or pulmonary fibrosis

About 25% of patients develop rheumatoid nodules, usually located on the elbows or subcutaneous areas of the heels, reflecting disease severity. Extra-articular symptoms may gradually appear after 5-10 years of disease course.

When to Seek Medical Attention

Immediate medical consultation is advised if:

• Persistent bilateral joint swelling and morning stiffness lasting more than 6 weeks
• Crepitus (grating sound) during joint movement
• Unexplained weight loss exceeding 5% of body weight

The key differences from osteoarthritis include:

• Pattern of onset: rheumatoid arthritis presents with symmetrical episodes, whereas osteoarthritis usually affects one side
• Duration of morning stiffness: exceeding 1 hour suggests rheumatoid arthritis

If systemic symptoms such as dry cough and difficulty breathing occur, it may indicate lung involvement, requiring comprehensive evaluation. Early diagnosis can reduce joint destruction by 30-50%, so symptom monitoring should be combined with clinical examination and blood tests.

 

Frequently Asked Questions

Does weather change worsen rheumatoid arthritis symptoms?

Changes in temperature and humidity can affect joint relaxation, and some patients report increased pain or stiffness in damp, cold environments. Studies suggest low atmospheric pressure or cold weather may increase joint fluid viscosity. Patients are advised to keep warm, use heat packs, or adjust indoor temperatures to alleviate discomfort.

Can dietary adjustments help reduce inflammation?

Diet rich in anti-inflammatory components (such as fatty fish, nuts, olive oil) may help alleviate symptoms. Increasing intake of Omega-3 fatty acids and reducing refined sugars and processed foods can lower systemic inflammation. Maintaining adequate vitamin D levels or sunlight exposure may also improve bone health.

Do rheumatoid arthritis patients need long-term medication?

Currently, there is no cure for the disease, but symptom relief with disease-modifying antirheumatic drugs (DMARDs) or biologics can control inflammation and slow joint destruction. Treatment plans are adjusted based on disease activity. Some patients may reduce medication after remission but require regular follow-up to prevent relapse.

Does excessive rest worsen joint stiffness?

Prolonged inactivity can lead to joint stiffness and muscle atrophy. Patients are advised to perform gentle joint movements during flare-ups and gradually engage in strength training (e.g., aquatic exercises or physical therapy) once pain subsides to maintain joint flexibility and function.

What is "morning stiffness" and how can it be improved?

Morning stiffness refers to the sensation of joint rigidity lasting over 30 minutes upon waking, mainly caused by increased viscosity of joint fluid. Relief methods include slow joint movements after getting up, using heat packs, or taking anti-inflammatory medication as prescribed. Regular exercise can also prolong the duration of symptom relief from stiffness.