Rheumatoid Arthritis Symptoms, Signs, Causes and Treatments

Among musculoskeletal problems and symptoms, one of the most fearful diseases is rheumatoid arthritis. There’s a whole field of medicine that studies rheumatic diseases, which include rheumatoid arthritis because they are complex and sometimes very difficult to treat.

Rheumatoid arthritis is a degenerative disease in the joints. It features progressive deterioration and destruction of the articulation, and associated mobility problems and pain. Fortunately, there are many causes of joint pain, and rheumatoid arthritis is not the most common. However, it is very important to know about the warning signs and symptoms to be able to detect this problem as early as possible.

Early detection and early start of treatment are associated with a better quality of life and slow progression of the disease. But before diving into the signs and symptoms, let us discuss what causes rheumatoid arthritis.

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Causes of rheumatoid arthritis

The exact cause of rheumatoid arthritis is unknown, mainly because there are too many factors playing an important role at the same time. There is a genetic predisposition, but also hormonal, immunologic, and even infectious factors contributing to the development of this degenerative disease. Other lifestyle factors may also affect, as we will list further:

Genetic predisposition

Rheumatoid arthritis is not a genetic disease, but genes play an important role, and account for around 50% of the risk. Certain genes that encode proteins for leukocytes confers a particular risk, according to European studies, and juvenile idiopathic arthritis that affects young people and it is markedly influenced by genetics.

Infectious triggers

In many cases, certain infections become a trigger to the immune reaction that initiates rheumatoid arthritis. Epstein-Barr virus infection and infections with Mycoplasma organisms or rubella may trigger rheumatoid arthritis in susceptible individuals.

Immune problems

The visual concept of immune system and defense

Rheumatoid arthritis is an immune problem. Immune complex start to form against the structures of the articulations, and wear them down in the wrong assumption that they are foreign objects or bacteria. Patients with autoimmune problems and chronic inflammatory processes are at a higher risk of developing rheumatoid arthritis, as well.

Hormonal problems

It appears that hormones play an important role in the development of rheumatoid arthritis. The majority of patients with this disease are females, and studies have found that the symptoms are significantly improved during pregnancy with a recurrence after birth. It is also reduced when women take oral contraceptives. Moreover, certain studies have linked hyperprolactinemia with a higher risk of rheumatoid arthritis.

Lifestyle risk factors

Any lifestyle factor that increases or promotes inflammation is a potential risk factor for the development of rheumatoid arthritis. Tobacco use is the most important lifestyle risk factor, but an inflammatory dietary pattern may also influence. Note that they are not direct triggers, but they may contribute to the development and aggravate the symptoms of rheumatoid arthritis when it is already present.

Symptoms and warning signs

As mentioned at the beginning of this article, the prognosis of rheumatoid arthritis is better in patients who receive an early diagnosis and treatment. Thus, it is very helpful to take note of warning signs and symptoms that may help us detect rheumatoid arthritis during an early phase of the disease.

Reddened and swollen joints

Rheumatoid arthritis is an autoimmune disease that triggers inflammation in the articulations. That’s why one of its features during acute episodes is having reddened and swollen joints, which is noticeable for the patient and the people around him. Reddened and swollen joints is a key symptom to differentiate rheumatoid arthritis from osteoarthritis and other causes of joint pain. Another inflammatory symptom is a warm sensation in the articulation during acute episodes.

Joint stiffness

Patients with rheumatoid arthritis experience a reduction in the range of motion in the affected articulations, usually those of the elbows, knees, and ankles, but it is also very noticeable in the fingers, hands, wrists, and feet. Joint stiffness is worse during the daytime, and especially after waking up. That is because there is a prolonged absence of movement during the night, and you need to move around the articulation once again to recover its proper lubrication.

You may also feel stiffness after standing up from watching a movie or staying immobile for a while. Morning stiffness is a key symptom of rheumatoid arthritis, but it is not an automatic diagnosis. If you experience this type of joint stiffness for 2 weeks or more, talk to your doctor and ask him about your symptoms.

Joint pain

It is very important to understand when joint pain is caused by rheumatoid arthritis or another health problem. It is not sudden or intermittent joint pain. Rheumatoid arthritis often features a persistent pain that involves many different articulations at the same time. It is symmetric joint pain, which means that if your left wrist is hurting, your right wrist is hurting as well.

The severity of pain is variable according to the stage of the disease and the times of acute flare-up episodes. As time passes, pain in rheumatoid arthritis becomes a cause of physical limitation, but not performing movements makes it worse by promoting stiffness. Thus, advanced patients may require steroid anti-inflammatories to control pain and improve their symptoms.

Muscle weakness

As a consequence of joint pain, patients with rheumatoid arthritis will also describe a reduction of the joint function and perceived muscle weakness. This symptom affects the quality of life of patients, especially those in more advanced stages of the disease, and compromises their ability to work. There is a significant reduction in muscle mass, but this reduction does not correlate to the symptoms of muscle weakness, which are usually more pronounced still. Thus, the reason is not only muscle atrophy but also intrinsic cell dysfunction that plays an important role in reducing the functional capacity of the skeletal muscle.

Joint deformities

Muscle atrophy, tendon destruction, and inflammatory wear down of the joints cause a series of joint deformities that affect patients with rheumatoid arthritis and become more noticeable as the disease advances. The earliest deformities in rheumatoid arthritis are often seen in the hands and fingers. There is a deviation of the fingers towards the ulna, which is known as ulnar deviation, and patients may also display a swan-neck deformity and hammertoes. This type of deformities provides important data to the physician because they are characteristic of rheumatoid arthritis patients.

Anemia

Patients with rheumatoid arthritis may also have different hematologic problems, including anemia. This type of anemia is called anemia of chronic disease or anemia of chronic inflammation. It is often asymptomatic and typically caused by an iron deficiency. Around half of patients with rheumatoid arthritis are expected to develop this type of anemia, and other hematologic problems may also arise, including thrombocytosis and leukocytosis (a higher count of platelets or leukocytes, respectively).

Fatigue

The majority of patients with rheumatoid arthritis suffer from some form of fatigue, often chronic fatigue that is associated with acute flare-up episodes. This symptom is not only physical but also features mental exhaustion and constant weariness. The difference between fatigue and normal tiredness is that patients may wake up from a restful night feeling overwhelmingly tired, a sensation that does not easily go away.

Around 80% of patients with rheumatoid arthritis and other rheumatic diseases suffer from chronic fatigue, and half of them may experience very severe symptoms, which are made even worse during acute episodes. This symptom has a significant burden on their quality of life, and it is often associated with depression, poor sleep, and other medical conditions such as obesity and metabolic disease.

Is there any cure for rheumatoid arthritis?

Similar to other forms of chronic disease, rheumatoid arthritis does not have a single risk factor, its cause has not been clearly established, and a cure has not been provided yet. There are many different trials using targeted therapies for rheumatoid arthritis, but one of the major obstacles to finding an everlasting cure is that we don’t know the entire mechanism of disease.

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However, it is possible to prevent rheumatoid arthritis, treat its symptoms and slow down the progression of the disease. We do that by detecting rheumatoid arthritis early in the course of the disease, controlling environmental factors that contribute to the progression of the disease, and using medications to reduce the rate of immune reactions against the joint tissue. Rheumatoid arthritis patients may also require a psychological assessment to cope with the diagnosis and reduce symptoms of anxiety and depression that may trigger acute flare-up episodes.