Rheumatoid arthritis may begin at any age, but the most common age range during which onset begins is the twenties to fifties. Morning stiffness is a hallmark symptom of RA. People with RA often report having a half hour or more of stiffness in the morning. The same symptoms frequently occur after short periods of inactivity such as driving or sitting. For older people, symptoms of weakness or falling may be more common.
For the majority of people, RA begins insidiously, emerging over a period of weeks to months. Typically, a person can only approximately recall when his or her arthritis problems began. Some first notice joint symptoms such as stiffness,joint swelling or pain, puffy hands, or diffuse aches and pains in the muscles. For others, the first problems are systemic symptoms such as fatigue or malaise.
A minority of people with RA experience a sudden onset of severe pain and joint swelling over the course of a few days. Some patients develop their arthritis over an intermediate period of time. Older patients sometimes present with polymyalgia rheumatica (PMR) and progress to RA. PMR is characterized by severe stiffness and aching of the shoulders and hips. I often think of PMR as a limited case of RA. Although PMR is a fairly common disease, only a small percentage of these patients develop RA.
A very few patients have a “palindromic” onset of disease. Palindromic rheumatism is characterized be short, intense episodes of arthritis that typically involve only one or two areas of the body, such as one hand or one foot. These episodes are very painful, but last only a day or two and get better even without treatment. In between episodes, the person is completely free of symptoms or signs of arthritis.This disorder may go on for years, may resolve spontaneously, or may progress into RA or other diseases. It is frequently misdiagnosed as gout.
Gout
A disease characterized by increased blood levels of uric acid; it produces pain and inflammation in the joints, particularly in the foot, ankle, and knee.
Early in the course of RA, the small joints of the fingers, wrists, and toes are involved. Large joint involvement typically develops later in the course of the illness. RA is typically a “symmetrical” arthritis, meaning that the right and left sides of the body are affected fairly equally. This is almost always the case in long-standing arthritis, but the symmetry may not be so obvious early in the course of the disease. People with RA sometimes say things such as “Only my right hand is involved,” but upon examination a physician will usually find that both hands are affected; the confusion arises because the findings in the other hand may be more subtle and easier to ignore. The dominant hand generally has more severe symptoms, probably because it is used more frequently. Paralysis is a major exception to this general finding. Individuals who are weak or paralyzed on one side of the body, perhaps because of a stroke or other neurological problem, typically have much milder arthritis symptoms on that side, presumably because they no longer use that side of their body very much. Muscle atrophy and weakness around affected joints is a common early finding of RA.
For a fortunate few, RA may spontaneously get better. For the majority of patients who visit arthritis clinics, however, the disease gets worse if it isn't treated in an appropriate and timely fashion. For some patients, severe joint damage can occur within a few years; other individuals may experience a much slower progression of their disease.
As a generalization, people who develop RA early in life have a faster and more severe course. Those who develop their RA later in life tend to have a slower progression of their disease.
People who develop RA early in life tend to have a faster and more severe course. Those who develop their RA later in life tend to have a slower progression of their disease.
If you develop RA symptoms such as joint pain, swelling, and fatigue, you should see your primary care physician as soon as possible. If the diagnosis is uncertain, you should ask for referral to a rheumatologist. Early diagnosis and treatment are the best course of action to minimize the damage that this disease can cause.
It has been quite a roller coaster ride for me these past 17 years; from the initial shock of my diagnosis to finding drugs that work. I've probably tried over 15 different medications.Some would work for a while but then the swelling in my hands would get worse so we would have to try something else. The pain in my feet went away after a very short time and I've never been bothered with that again. I can honestly say that my arthritis has never stopped me from doing any of the activities I love for very long. I am an avid skier, hiker and I'm even playing tennis again. I am responding so well to my medication that I hardly feel I have arthritis. Initially, my flare ups left my hands quite deformed, but now it's really hardly noticeable. It's really now just a little inconvenience that I can certainly live with. Of course, who knows what the future may hold but I've just got to keep on doing everything I love to do now and not worry about what may lie ahead.