What Does Rheumatoid Arthritis Feel Like?

Unless you’re living it, it’s hard to know exactly what having rheumatoid arthritis (RA), a chronic inflammatory disease, is really like. For those who think they may have RA, or those already diagnosed who are concerned about a flare-up, learning about what RA symptoms may actually feel like can be a huge benefit. That’s because recognizing RA symptoms quickly can help you get treatment—or adjust an existing treatment plan—faster, which helps reduce the amount of long-term damage to your body.

Or maybe you came across this article because you’re looking to better empathize with a loved one who has RA. Educating yourself about RA (for example, it’s not the same as osteoarthritis, contrary to popular belief!) can assist you to better support those with this diagnosis.

Keep reading to learn more about what RA symptoms may feel like, from common aches to advanced complications, and to get a look at how these differ during periods of remission.

Physical Symptoms of RA

Rheumatoid arthritis is an autoimmune inflammatory condition, which helps explain the symptoms it causes. “With an autoimmune inflammatory condition, this means that a patient’s immune system—for many different reasons—might actually start attacking the host,” says Alireza Meysami, M.D., a rheumatologist at Henry Ford Medical Center in Detroit, MI. That attack results in inflammation throughout the body, which leads to the hallmark signs of RA you may experience.

“In the case of RA, the joint is the most common place where inflammation can get involved,” Dr. Meysami says. Usually, it’s the small joints of the hands, wrists, and feet that are impacted. That said, RA may affect other joints in the body, too.

These are the common RA symptoms that affect the joints—and what they may actually feel like:

Pain

“There is a large spectrum of pain that people with RA may feel, and it’s very subjective,” says rheumatologist Mahsa Tehrani, M.D., co-founder of Arthritis and Rheumatology Clinical Center of Northern Virginia in Vienna. For example, she says, “throbbing” and “aching” are words some may use to describe RA pain. Pain can range from a mild, nagging feeling to severe, debilitating pain, depending on how advanced the disease is and other factors.

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Swelling

Due to the inflammation in the joints, you may also experience painful swelling in those areas, Dr. Meysami says. For example, you may notice a puffiness in your fingers or hands, making it hard to do things like making a fist. Redness often accompanies swelling, too.

Stiffness

Another common sign of RA is stiffness of the joints, particularly in the morning, Dr. Tehrani says, where you may feel like it is more difficult to move your joints. Stiffness usually improves somewhat as you start to move and loosen up those joints throughout your day, she says. That said, the stiffness can return anytime throughout the day where you are inactive for about 45 minutes to an hour, Dr. Meysami says, so it’s important to give yourself extra time to warm up after rest periods.

Put together all of these symptoms and it can lead to a reduced range of motion and function, Dr. Meysami says. “Patients will have problems with their grip, such as problems opening bottles or turning doorknobs, sometimes dressing themselves or tying shoes, or even walking,” he says. And again, most of these symptoms are worse in the morning when stiffness is at its peak. "Some people like to run their joints under warm water, massage them, or take anti-inflammatory medications to help with this,” he suggests.

Joint symptoms aren’t the only ones people with RA have to deal with. RA is a systemic condition, meaning it affects systems throughout the body. The result of this full-on body attack? Fatigue, another extremely common RA symptom, with one in six people with rheumatoid arthritis experiencing severe fatigue, according to a 2020 review in RMD Open. The inflammation throughout the body takes a toll on energy levels in people with RA, resulting in extreme exhaustion for some that makes it difficult to keep up with daily tasks, per the National Institutes of Health (NIH).

What Advanced RA Symptoms Feel Like

When RA progresses—typically due to being left untreated or under-treated for too long—symptoms become more severe.

“The major issue is what we call permanent bone damage or erosion,” Dr. Meysami says. Bone erosion occurs around the impacted joints when inflammation eventually leads to breakdown of the bone surface, according to a recent study in the Journal of Musculoskeletal and Neuronal Interactions.

“The damage to the bone results in permanent pain, which can get worse when it is cold or there is a change in humidity or barometric pressure, and it can result in disability, loss of function, and an inability to go to work,” Dr. Meysami says. The pain may present as a severe throbbing and come with swelling and stiffness, sometimes leading to deformities in the hands or affected area. Taking RA medications, such as disease-modifying antirheumatic drugs (DMARDs), can help reduce the pain from erosions, even if they can’t fully be healed, according to recent research.

Other systems of the body that may experience symptoms or complications, particularly if the RA is advanced, include the skin (manifesting as nodules or painful rashes, for example), eyes (feelings of dryness, blurred vision, or light sensitivity), and mouth (feelings of dryness), according to the Arthritis Foundation.

RA in Remission: Does It Feel Different?

Once your RA is under control with medical treatment, you may enter a period of remission in which your symptoms are well-managed. “The goal is to have no pain when the disease is truly in remission,” Dr. Tehrani says.

That said, the definition of “remission” that researchers and doctors use may vary, according to the Arthritis Foundation. Many rheumatologists will consider you to be in remission if you have the following:

• One or fewer swollen joints

• One or fewer tender joints

• Self-assessment that your arthritis activity is a 1 or less on a scale of 1-10

• A C-reactive protein blood test showing little to no inflammation levels

Typically, meeting these criteria means a major difference in how you feel versus before you were in remission. For example, those whose RA symptoms were debilitating enough to prevent them from working typically find that being in remission results in their ability to return to doing their job and other activities, Dr. Meysami says. “Some people may not even be able to tell they have RA as long as they are taking their medications, but if they don’t, it’s like day and night.”

Unfortunately, 100% reduction in pain isn’t possible for everyone with RA. “The damage to the joints from inflammation that has already occurred might cause achy or nagging pain to remain, but the patient will still feel the difference in remission,” Dr. Meysami says.

When to See a Doctor

With RA, early detection and treatment is key in order to help reduce the amount of damage done to your joints. So when should you see a doctor about symptoms? “As soon as RA is suspected, since early diagnosis and treatment yields better long-term outcomes,” says Dr. Tehrani. And if you already have an RA diagnosis, any persisting severe symptoms or worsening symptoms despite treatment should be discussed ASAP with your doctor—they can work with you to adjust your treatment plan to help better get your RA under control.

If any of the aforementioned symptoms sound like aches that have been nagging you, now is the time to have them checked out by your health care provider. Doing some imaging and blood tests is the only way to know for sure whether it’s RA—and to get a jump on whatever treatment you need.