What Are The First Signs Of Rheumatoid Arthritis? 

 August 3, 2023

By  Linda Rook



Rheumatoid arthritis or RA is a complex and chronic autoimmune disease that affects millions of people worldwide. It is caused by inflammation of the joints, that can lead to pain, swelling, and joint deformities.

This condition involves the body's immune system attacking its own tissues these could be in the lungs, kidneys etc.

The exact cause or rheumatoid arthritis is vague, but early diagnosis can significantly improve the outcomes and therefore enhance the quality of life.

Treatment including medication, physical therapy, lifestyle adjustments, also regular medical follow-ups, can help manage symptoms and minimize joint damage affected by this condition.

In this blog I will investigate into the aspects of rheumatoid arthritis, exploring its causes, symptoms, diagnosis, and treatment options.

First, of all, 

What is Rheumatoid Arthritis.

Rheumatoid arthritis is an autoimmune disorder, which means the body's immune system mistakenly identifies its own healthy cells, mainly the synovium.  The synovium is a thin lining surrounding the joints that the immune system thinks it is a foreign invader, and starts attacking.

The result can be chronic inflammation that can lead to joint damage over time. While RA affects your joints, it can also impact other organs and systems, which causes a range of systemic symptoms.

Rheumatoid arthritis is one of the most common forms of arthritis that can affect over 1.5 million Americans.  It mainly  appears between the ages of 30 and 60 but can affect any age from the elderly to teens, even toddlers can get this terrible disease.


The following symptoms can occur when you develop rheumatoid arthritis.

  • Joint Pain and Stiffness:  You may have a persistent joint pain and stiffness, especially in the mornings or after periods of inactivity, which often affects multiple joints on both sides of the body.
  • Swelling and Warmth: Inflamed joints may become swollen, tender, and warm to the touch.
inflammation of the knee
  • Reduced Range of Motion: You may also have a progressive, joint inflammation which can damage the joints and leads to a decreased range of motion, making it difficult to perform regular activities.
  • Fatigue and Weakness: Chronic inflammation in your body can result in fatigue and a general feeling of being unwell. Also fatigue can cause low grade fever, sickness feeling and weight loss.
  • Rheumatoid Nodules: Another symptoms is nodules, that are firm lumps that develop under the skin, called rheumatoid nodules, which can develop near affected joints.
  • Spongy feeling:  When you press on the affected area, it will feel spongy.
  • The areas that RA attacks are your hand wrist and appears to be in your balls of the feet, ankles or other joints such as cervical spine shoulders, elbows. 
  • And finally, you may hear cracking noises in the jaw and joints when you move, these could be between the very small bones in your inner ear.


The exact cause of rheumatoid arthritis remains unknown. But research has found that there is a combination of the environmental, genetics and hormonal factors, which can contribute to the development.

Some common risk factors include:

  • Genetics: Family history of RA increases the risk of developing the condition. 
  • Gender: Women are more likely to develop RA than men.
  • Age: RA can occur at any age,  but  it mainly starts between the ages of 30 and 60.
  • Smoking: Smoking is a significant environmental risk factor for RA, mainly the nicotine.  
  • Another risk factor is if you are overweight or obese, you are at a greater risk of developing RA.  This is because you are putting more weight on your weight bearing joints such as your hips and knees. 


The diagnoses of rheumatoid arthritis requires a comprehensive evaluation, including a thorough medical history, physical examination, and laboratory tests, also you may need an MRI scan or x-ray.

MRI scan

Common diagnostics could include:

1.    Blood Tests: Blood tests can identify specific antibodies, such as rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies, which are often present in RA.

2.    Imaging Studies: X-rays, ultrasounds, and MRI scans may help assess joint damage and inflammation.

3.    Clinical Assessment: A rheumatologist will examine the number and pattern of affected joints, duration of symptoms, and other clinical indicators to confirm the diagnosis.

Treatment Options:

Unfortunately, while there is no cure for RA, several treatment options can help manage symptoms, slow disease progression, and improve quality of life:

1.    Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or disease-modifying antirheumatic drugs (DMARDs), and biologic agents can reduce inflammation and pain.

2.    Physical Therapy: Targeted exercises and physical therapy can help improve joint function and reduce stiffness.

3.    Changing your lifestyle: Quitting smoking, maintaining a healthy weight, and adopting a balanced diet can support overall well-being.

4.    Joint Surgery: In severe cases, joint replacement surgery may be considered to alleviate pain and improve joint function.

Recognising Rheumatoid Arthritis.

An early detection and treatment are crucial to managing the condition effectively and preventing further joint damage. Understanding the first signs of rheumatoid arthritis is essential to seek medical attention promptly.

The following symptoms you should look out for include:

1.    Persistent Joint Pain and Stiffness.

One of the most common symptoms of rheumatoid arthritis is persistent joint pain and stiffness, which affects multiple joints at the same time.

It tends to be more noticeable in the morning or after periods of inactivity, such as waking up or sitting for an extended period. 

2.    Equal Joint Contribution.

A feature of RA is the balanced distribution of joint connection, meaning that if a joint on one side of the body is affected, its counterpart on the opposite side is likely to be affected as well. 

Elbow Joint

3.    Fatigue and General Weakness.

Feeling fatigued and experiencing a lack of energy is another early sign of rheumatoid arthritis. Because the auto-immune nature can lead to complete inflammation and cause the body to feel drained, leading to overall weakness and exhaustion.

4.    Joint Swelling and Warmth.

Inflamed joints often become swollen and warm to the touch. The inflammation is caused by the body's immune system mistakenly attacking the healthy joint tissues, which can lead to swelling and redness around the affected areas.

5.    Morning Stiffness.

First thing in the morning you may feel that your joints are stiff to move, this can last for more than an hour, this is a classic sign of RA. The symptom can be particularly severe, making it challenging for individuals to perform their daily activities.

mobility in the knee

6.    Reduced Range of Motion.

As this disease progresses, it can lead to a reduced range of motion in the affected joint. Which makes it difficult perform simple tasks, like bending the knees or fully extending the fingers.

7.    Flu-Like Symptoms

Finally, in some cases, you may experience flu-like symptoms, such as a low-grade fever, loss of appetite, and a general feeling of being unwell.  These symptoms may come and go.

Understanding the four stages of RA.

Rheumatoid arthritis is a chronic autoimmune disorder that progresses through different stages, not steps. These four stages represent the progression of the disease over time.

It's important for you to work closely with healthcare professionals so that they can develop a personalized treatment plan.  That can help manage the symptoms, slow the disease down, and improve overall quality of life.

Also early detection are essential in providing you the best possible outcomes by this chronic condition.

The following four stages show the increased worsening of the condition and the possible joint damage and disability that may occur if left untreated or poorly managed.

The four stages of rheumatoid arthritis are:

Stage 1: Early Rheumatoid arthritis (Initial Stage).

The initial stage of rheumatoid arthritis is often challenging to diagnose, because the symptoms can be mild and general.

In this stage, the synovial lining of the joints becomes inflamed due to the autoimmune response.

Key Features:

1. Mild joint pain and stiffness, usually in multiple joints.


2. Symptoms that affects small joints, like the fingers, toes, and wrists.

3. Morning stiffness that lasts for at least 30 minutes.

4. Fatigue and a general feeling of being unwell.

5. Joint tenderness and mild swelling.

shoulder pain

Stage 2: Moderate Rheumatoid arthritis (Established Stage)

As rheumatoid arthritis progresses, it enters the established stage, during which, joint inflammation becomes more obvious and extensive. The autoimmune response increases, which leads to increased joint damage and deformities.

At this point, you may begin to experience more significant restrictions in your daily activities.

Key Features:

  1. Increased joint pain and swelling, could affect the larger joints such as the knees, shoulders, and hips.

2.  Morning stiffness that lasts for over an hour.

3. Decreased range of motion in the affected joints.

4. Development of rheumatoid nodules - firm lumps under the skin that often appear near joints.

5. Continued fatigue and weakness, which can impact daily functioning.

Stage 3: Severe Rheumatoid arthritis (Advanced Stage)

At stage three, the severe or advanced stage, the inflammation will become persistent, which causes substantial joint damage and deformities.

The joint cartilage erodes, and the surrounding ligaments and tendons weaken, leading to permanent disability and loss of function.

Key Features:

  1. Chronic, intense joint pain and stiffness that significantly impair movement.
  2. Severe joint deformities, including joint partial dislocation.
  3. Persistent morning stiffness that may last for several hours.
  4. Fatigue, weakness, and a general feeling of exhaustion.
  5. Difficulty in performing daily activities and self-care tasks.

Stage 4: End-Stage Rheumatoid arthritis (Terminal Stage)

The end-stage of rheumatoid arthritis is severe joint destruction and irreversible damage. At this stage you will have a significant disability, affecting your everyday simple tasks.

In some cases, people may require surgery, such as joint replacement, to improve their quality of life.

stair chair a device for the home stairs.

Key Features:

  1. Joint destruction and deformities are extensive, leading to severe functional impairment.
  2. Chronic pain and limited mobility significantly impact daily life.
  3. Loss of joint function and independence.
  4. Inflammation may spread to other organs and systems, leading to systemic complications.
  5. Psychological impact, including depression and anxiety, due to chronic pain and disability.


Rheumatoid arthritis is a chronic and debilitating disease that requires early detection, to prevent further joint damage and improve long-term outcomes.

It could help if you identify the first signs, like persistent joint pain, stiffness, swelling, and fatigue.

Rheumatoid arthritis progresses through four stages, from the initial symptoms to end-stage. If your symptoms go untreated the disease can develop into stage four where you could become wheelchair bound. 

Therefore, an early diagnosis is crucial to slowing the progression of the disease and minimizing joint damage.

If you experience persistent joint pain, stiffness, or any other symptoms associated with rheumatoid arthritis, seek medical assessment immediately.

I hope this article has helped you. Please subscribe to my website, and I will keep you updated on new blogs. Also, if you need to know anything about arthritis, please go to my contact page and leave a message, and I will get back to you.

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I am not a medical professional, and this blog is for information only. If you have any worries, you should consult your doctor.

I hope this blog has helped.


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Linda Rook

Linda is now retired and has suffered from Osteoarthritis for about 40+ years.  She struggled with her weight until she found the correct one that also helped with her arthritic pain.  Linda was in terrible pain until the physician thought her right hip needed replacement. 

Now Linda has an artificial right hip, which has left her with the left leg shorter than the right.  Therefore, her spine is now wonky, and has arthritis of the lower back, also it seems to be going all over the body, her pain is now in the knees, elbow, wrist, fingers and both hips.

Linda now spends her days writing information to help others with the same conditions, so they do not suffer like Linda.

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