Rheumatoid Arthritis: Early Signs And Symptoms.

1 in 100 people today may be suffering from RA in the community, according to senior rheumatologist Dr Anand Malaviya. Read here to know about this condition which is commonly known for causing pain and stiffness in joints.

Rheumatoid arthritis (RA) is a chronic systemic autoimmune inflammatory disorder of the joints. The condition begins insidiously with nonspecific aches and pains in the musculoskeletal system of the body that come-and-go. The symptoms progress over a period of time, within weeks or even some months when actual joint swellings become visible along with increasing stiffness and pains.

According to  , Senior Rheumatologist, “approximately 1 in 100 people may be suffering from RA in the community. The condition usually occurs in people between 20 years to 60 years of age.”

He says, “RA affects small and large joints in the arms and the legs in a symmetrical distribution (on both sides of the body).This is in contrast to the other very common joint disease (of elderly persons) called osteoarthritis. Osteoarthritis usually begins at a later age and most commonly affects one knee and then the other knee over time. RA is 5 times more common in women than men.”

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The exact cause of RA is not known. However, it is well understood that the synovial tissue (the inner lining) of the joints become inflamed due to an autoimmune response (the immune system of the body becomes imbalanced and starts self-attack).

The cause of the autoimmune response is multifactorial including certain genetic risk factors and several environmental factors including smoking, poor oro-dental hygiene.

There are several additional risk factors that enhance the possibility of a poor treatment outcome in RA. These include obesity, lack of regular exercise and imbalanced diet. Eating plenty of fruits, green vegetables, and a balanced high-fibre diet helps in the control of RA.

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The main symptoms of RA are morning stiffness (stiffness after a period of rest that may take 30 minutes to an hour before improving), pain and swelling in the small joints of the hands-fingers. But, almost all the other small and large joints in the body may get affected including wrists, elbows, shoulders, the knees, the ankles and the joints in the feet, in a symmetrical distribution.

However, spine involvement does not occur in RA (except in the upper neck) as also the hip involvement that is uncommon. Symptoms of RA are characterised by persistence (persists beyond 6 weeks), therefore, it is characterised as a form of chronic inflammatory arthritis).


“A person suffering from RA is likely to wake up with stiff joints in the morning. They experience severe pain in different joints of the body like joints of hands, wrists, elbows, foot and ankle joints. They also experience visible swelling in these joints”, says Dr Malaviya. “People with RA experience fatigue, tiredness, unexpected weight loss, swelling in joints of hands, wrists and elbows. These people find it difficult to perform day-to-day activities”, he added.

RA can lead to the joints becoming swollen and tender with restricted movement especially small joints and joints of upper extremities. One may also have fatigue, flu-like symptoms, loss of appetite and lack of sleep, weight loss etc. It is important to know that symptoms of RA are likely to fluctuate in severity over time.

Occasionally, the disease may ‘flare-up’ (a period during which inflammation and other symptoms increase and become more severe without any obvious cause). The ‘flare’may last for some days, or even months, unless treated appropriately.

A person suffering from RA is likely to wake up with stiff joints in the morning. They experience severe pain in different joints of the body like joints of hands, wrists, elbows, foot and ankle joints. They also experience visible swelling in these joints”


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1. It causes gritty sensation, pain and dryness in eyes, may cause some degree of impaired vision and sensitivity to light.

2. Dryness of mouth, infection and gum irritation are also common in patients with RA.

3. ‘Rheumatoid nodules’ (mostly seen in RA patients who smoke) a hard small – to – medium size nodules subcutaneously seen near the olecranon process and the adjacent extensor surface of the forearm. They may also be seen (occasionally) as small hard nodules near the affected small joints in the fingers.

4. Prolonged uncontrolled inflammation in RA may lead to the involvement of the lungs causing difficulty in breathing. Shortness of breath and scarring of lungs are one of the most serious complications of RA that is often seen in those who do not take proper medicines from the beginning of the disease.

5. There are several other complications in patients with RA who have not received appropriate treatment. These include blockage in the arteries of the heart causing premature heart attacks, osteoporosis (brittle bones) causing fractures, skin lesions, reduced haemoglobin, tingling and numbness (neuropathy; entrapment syndrome), and many others.

RA can result in decreased range of motion in the affected joints. Inflammation in joints causes laxity of the supporting ligaments and tendons that causes deformities. With the progression of the disease, joint disabilities increase and the person may not be able to carry out normal routine functions including self-care, house-hold chores, job-related to her/his profession and loss of all the leisure-time activities.