Early Signs & Symptoms

Reviewed by: HU Medical Review Board

Rheumatoid arthritis, or RA, is an autoimmune and inflammatory disease. Autoimmune diseases (or conditions) may occur when your immune system attacks healthy cells in your body by mistake. RA causes inflammation (painful swelling) in the affected parts of your body.1

In most cases, symptoms of RA come on gradually. You may be experiencing signs of RA for weeks or months before symptoms of RA become bothersome enough to see your doctor. RA symptoms may be different from 1 person to the next.

Early symptoms of rheumatoid arthritis

However, there are early signs and symptoms of the disease. Some of these symptoms are extra-articular (outside the joints). Recognizing these early symptoms is essential to get the treatment you need. Early treatment helps prevent damage to your joints and body that RA can cause over time.1,2

Fatigue or feeling tired

Fatigue is different from feeling tired. Fatigue is described as total exhaustion and can make you lose interest in doing anything. You may find yourself needing more and more sleep. Even after a long night of sleep, you might wake up feeling tired and unrested. Severe fatigue can make you feel like you have lost control of your life, as you cannot plan when you are tired.3

Fatigue is a nearly universal RA symptom, with up to 80 percent of people with the condition reporting feeling this way.4

Numbness and tingling in the hands

Numbness and tingling in the hands is a common early symptom of RA. To understand why this happens, you first have to understand the parts and function of the wrist.

The bones of your wrist are called carpal bones. The carpal bones and a ligament form a tunnel in your wrist. A nerve and tendons run through this tunnel. The nerve supplies sensation and feeling to the thumb side of your hand. If this nerve becomes compressed within that tunnel, numbness in your thumb and fingers can occur. This nerve compression also leads to wrist pain and is known as carpal tunnel syndrome (CTS). CTS is a common early symptom of RA.5

Joint pain, swelling and stiffness

Joint pain tightness, and stiffness are the most common symptoms of RA. Joints in the hands, wrists, feet, and knees are usually affected first. Over time, RA may affect other joints, including the shoulders, hips, and elbows.

In some cases, RA may affect many joints at the same time on both sides of the body. Joint stiffness is usually worse after resting the joint, especially in the morning.2,6

In the early stages of RA, small joints tend to be affected more than large joints. For instance, the joints located at the base of the fingers and toes, and the joints located in the middle of the fingers may be affected. In some people, RA may begin with pain in a large joint (shoulder or knee) that moves from 1 joint to another and comes and goes.2

Low-grade fever

A low-grade fever is an early sign of RA and is likely the result of inflammation.2

Weight loss

Unexplained weight loss may be an early sign of RA. Weight loss in RA may be due to weakness and fatigue.2

The challenge of early recognition of RA is that it may be difficult to distinguish from other types of arthritis involving inflammation. Talk to your doctor about any symptoms you are experiencing to make sure you get the treatment you need.

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