8 Sneaky Signs You May Have Rheumatoid Arthritis

by Tracy Middleton Health Writer

“Young” and “arthritis” aren’t two words you’d expect together. But rheumatoid arthritis (RA)is a young person’s condition, usually showing up between the ages of 30 and 50.

Unlike osteoarthritis, which afflicts mostly seniors and is caused by a lifetime of wear and tear, rheumatoid arthritis is an autoimmune disease that causes a person’s immune system to attack the joints by mistake. This relentless assault causes the lining of the joints (called the synovium) to become inflamed, which limits movement and causes pain and swelling.

There is no cure, but over-the-counter and prescription meds can help curb the inflammation and ease the pain. While OTC medication can ease light joint pain, it’s no substitute for early and aggressive targeted treatments from your doctor.

Woman holding ankle in pain

Why You Need to Know the Signs of RA Now

Early diagnosis is essential, because left unchecked, RA inflammation can wear away cartilage and bone, making the joint unstable, says Stan Cohen, M.D., MACR, a Dallas-based rheumatologist and past president of the American College of Rheumatology.

Problem is, a 2016 survey found that it takes people with rheumatoid arthritis four years and visits to at least three different physicians, on average, to get a proper diagnosis. Women have a higher risk (1 in 12 women vs 1 in 20 men), as do people who smoke, are obese, or have a family history. But there are other RA symptoms that are less well-known. If you notice any of the following, it’s best to check with your doctor to see if you’re at risk.

Woman holding both ankles

Sneaky Symptom #1: Your Pain Mirrors Itself

“Rheumatoid arthritis is usually symmetrical,” says Dr. Cohen. Meaning, if one knee or elbow is affected, the same joint on the other side will probably feel creaky, too. Osteoarthritis tends to show up just on one side.

RA most often affects joints in the hands, feet, wrists, elbows, knees, and ankles, according to the Arthritis Foundation, so be on the lookout for pain that hits these areas on both sides of your body.

Young woman in bed holding shoulder in pain

Sneaky Symptom #2: You Ache More in the Morning

Joint stiffness from rheumatoid arthritis is usually at its worst when you wake up. The same is true for pain from osteoarthritis, which often flares after long periods of inactivity, but the ouch from osteoarthritis tends to go away within a half an hour or so, while RA pain may last for hours—even most of the day.

“The fluid around the joint is full of inflammatory agents,” explains Dr. Cohen. “It can take a long time for them to dissipate.”

Young woman in bed looking at thermometer

Sneaky Symptom #3: You Regularly Run a Low-Grade Fever

The same inflammatory substances that cause joints to swell can also trigger a fever, says Dr. Cohen. The fever will hover in the 99- to 100-degree Fahrenheit range. If your head is hotter, it’s more likely a sign of an unrelated infection. Remember to mention unexplained fevers to your doctor.

Woman putting in eye drops

Sneaky Symptom #4: Your Mouth and Eyes Are Dry

People who suffer from rheumatoid arthritis are also at risk for Sjogren’s syndrome, a related autoimmune disorder that causes dry eyes and mouth, according to the American College of Rheumatology.

The glands that produce tears and saliva become damaged by the same inflammation that causes joints to swell, says Dr. Cohen. Prescription drops can lubricate eyes, he adds, while drinking water and chewing gum can ease the discomfort from an arid mouth.

Woman laying head down on table in train car
Abbie Bernet

Sneaky Symptom #5: Your Tank Is on E

Up to 80 percent of people with rheumatoid arthritis feel somewhat run down, and more than 50 percent have high levels of fatigue, says the Arthritis Foundation.

Even when people are in clinical remission, overwhelming tiredness can linger, according to a study in BMJ. Inactivity and high levels of inflammation can definitely kick your fatigue into overdrive, says Dr. Cohen, but the fatigue may actually be the result of related factors like depression, obesity, and poor-sleep.

Woman's feet on scale

Sneaky Symptom #6: You’ve Lost Weight

When joint pain flares, the needle on the scale may fall. “Inflammatory agents like cytokines can suppress hunger,” says Dr. Cohen, adding that he typically sees patients lose 5 to 15 pounds. Plus, you may be less motivated to prepare meals because of lower energy levels.

Young woman out of breath holding chest

Sneaky Symptom #7: You’re Short of Breath

People with RA have significantly higher risk for cardiovascular disease than the general population. In fact, it’s a leading cause of death among people with the condition, causing almost a third of all RA-related fatalities.

Once again, inflammation is to blame. “Research has shown that inflammation plays a role in arteriosclerosis, or the thickening and stiffening of the arteries, and plaque formation,” says Dr. Cohen.

If your stiff joints are accompanied by shortness of breath or chest pain, see a doctor right away.

Sad man on couch with head in hand
Nik Shuliahin

Sneaky Symptom #8: You Feel Down

Being in constant pain can ruin your mood, but recent research suggests the link between depression and rheumatoid arthritis may have deeper roots.

One study found people with symptoms of depression have 31 percent higher levels of C-reactive protein—a marker of inflammation—than those with no depressive symptoms.

The upshot? There’s also strong evidence that treating rheumatoid arthritis may also help ease mood imbalances.

RA Diagnosis: Eustice, C. (n.d.). "The Influence of Rheumatoid Arthritis on Your Cricoarytenoid Joint."http://arthritis.about.com/od/othercond/a/cricoarytenoid_joint_utd.htm

RA Symptoms: Arthritis Foundation.(n.d.)https://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/what-is-rheumatoid-arthritis.php

Tracy Middleton
Meet Our Writer
Tracy Middleton

Tracy Middleton is an award-winning writer, editor, and content strategist. She has more than 20 years’ experience covering health and wellness for publications including Women’s Health, Men’s Health, Cosmopolitan, Reader’s Digest, and Cancer Today. When she’s not wordsmithing, you can find her at the gym, on her yoga mat, or baking with her two daughters.