14 Arthritis Symptoms You’re Probably Ignoring
Got a few annoying aches and pains? Maybe they're just signs of age—or arthritis symptoms. Here's how to tell.
What is the differences between rheumatoid and osteoarthritis?
Joint pain, swelling, and stiffness—they’re all classic arthritis symptoms. However, there are some subtle early signs of arthritis that may seem insignificant, but can indicate the onset of the inflammatory condition. Do you know what to look for?
First, it’s important to understand the difference between the two main types of arthritis. Rheumatoid arthritis (RA) can be diagnosed at any age (here’s why millennials especially should be concerned about rheumatoid arthritis), even in children. This autoimmune disease triggers inflammation that causes joint pain, stiffness, swelling, and limited movement of the joints, according to the American College of Rheumatology. RA also can impact organs beyond the joints. (Be sure you’re avoiding these inflammation-inducing foods.)
Osteoarthritis (OA) has similar symptoms to RA like stiffness and joint pain, but it’s brought on by the breakdown of joint cartilage between the bones. OA generally develops later in life, after a lifetime of wear and tear, and the symptoms are limited to the joints.
Rheumatologist Arundathi Jayatilleke, MD, is an associate professor of medicine at the Lewis Katz School of Medicine at Temple University in Philadelphia. We asked her to tell us which early signs of RA to watch out for.
Fatigue is usually one of the first rheumatoid arthritis symptoms. It can begin weeks or months before other symptoms appear, and is often accompanied by “not feeling right” or mild depression. “It’s just a general feeling of not having very much energy,” says Dr. Jayatilleke, “Like you might have had a virus or flu.” Sometimes this is just a reaction to the raised inflammation levels in your body, but occasionally it could indicate an underlying problem associated with RA. “Sometimes in RA you get anemia,” says Dr. Jayatilleke, “So that can contribute to the fatigue. It might be something picked up on in a blood test.”
Between 40 percent and 80 percent of RA patients report feelings of fatigue. According to a study in Rheumatology, high fatigue levels are most often due to the pain and depression that accompany RA and not because of the inflammation itself. (Check out these other causes of fatigue, too.)
If you have a persistent low-grade fever, accompanied by some of the other early symptoms of RA, this might indicate the beginnings of the disease. Low-grade fevers are around 37 to 38 degrees C or 99 to 100 degrees F, according to the Johns Hopkins Arthritis Center. “It’s usually not high or spiking fevers, but they’ll feel a little bit warm,” explains Dr. Jayatilleke. Unexplained fever, especially if it persists, is a reason to seek medical attention. Higher fevers could suggest an infection, especially if you’re taking biologics or immunosuppressive medicines to treat RA.
Poor appetite and weight loss
“Having uncontrolled inflammation can suppress your appetite,” Dr. Jayatilleke says. “Weight loss is usually not very drastic, but patients may notice that they don’t have quite the appetite for food and thus start losing weight.” And there’s another reason that early RA might result in losing some weight. The increased inflammation can impact metabolism and trigger the breakdown of muscle mass, leading to weight loss. (Watch out for the foods that may contribute to RA inflammation.)
Dry eyes and mouth
Problems with the eyes are a common side effect of RA, and the symptoms may show before the classic arthritis symptoms kick in. RA can cause the surface of the eye to become inflamed (episcleritis). Usually, it’s just a mild redness and irritation at first. Another eye symptom of RA can be a reduced tear fluid—called Sjögren’s syndrome, where your eyes, mouth, and other ares of your body dry out. Dr. Jayatilleke says that “people will notice that have a gritty sensation in the eye, or feel like there’s some dust stuck in it. They’re not producing as much tear fluid.” (Check out these other causes of red eyes and how to treat them.)
“Many people with RA experience morning stiffness: When they wake up in the morning they feel like they can’t move,” Dr. Jayatilleke says. “And some people don’t realize this is a sign of arthritis. They think this is part of growing old.” Lack of movement causes the joint to seize up. Stiffness can also happen after napping or sitting and it may interfere with sleep.
Another of the early rheumatoid arthritis symptoms is stiffness in minor joints that isn’t caused by activity. Dr. Jayatilleke explains that this usually starts in the small joints, maybe in the hands or the wrists, and then progresses to the other joints. There may also be some mild joint inflammation. (In addition to consulting your doctor, you may find home remedies that help with RA.)
Typically, you think of heart attack when you think of chest pain, but there are many other conditions that can trigger chest pain. Rheumatoid arthritis can cause pericarditis, which is inflammation of the tissue that lines the chest cavity and surrounding the heart. This can lead to chest pain and difficulty breathing. Dr Jayatilleke explains, “Some RA patients get inflammation of the lining of the lungs, so it hurts when you take a deep breath.” However, she points out that this is not a very common early sign. More often it comes on after other symptoms. Occasionally, the lining of the heart can get inflamed. Any unexplained chest pains can be serious. Get medical advice immediately if you have them.
Classic RA symptoms
Following any early signs, more classic rheumatoid arthritis symptoms will appear. These might be the first ones to catch your attention. Swollen joints can put pressure on the nerves, causing numbness and tingling. Carpal tunnel syndrome is caused by pressure on the nerves in the wrist, and is commonly associated with RA. You also may notice cracking or squeaking noises when you move swollen joints.
Inflammation of the joints also can damage tendons and ligaments, reducing your range of movement. Eventually, you might find you can’t bend or straighten your limbs or back, although exercise and physical therapy can help. (Here are some suggestions for beating back the pain of arthritis.)
Because osteoarthritis is caused by wear and tear over the years, the damage is usually localized to your joints. The early symptoms of OA are generally the more classic arthritis problems, like pain, swelling, stiffness, and a loss of flexibility. (Here’s how to protect your knees from unnecessary damage.)
Grating sensation and bone spurs
The spongy cartilage in your joints cushions bones as you bend, move, walk, and grasp things. As cartilage wears down, the bones can begin to grate and grind against each other, causing pain. Worn cartilage can also encourage the growth of bone spurs, potentially deforming joints.
“Often people will report this cracking or popping sensation, a kind of cracking sound in their knees or cracking in their joints,” reports Dr. Jayatilleke. When joints lose their cushion of cartilage, they make sounds because of the change in roughness of the joint surface.
Swollen joints and stiffness
Joint swelling in OA is caused by excess synovial fluid, the lubricating fluid in your joints. Again, this isn’t usually painful, but it can limit your range of movement of the affected joints, such as the fingers or wrist. Read more about how OA targets your joints.
Pain triggered by activity
“People with OA usually find that their pain is worse with activity and improves with rest,” says Dr. Jayatilleke, “As opposed to people with RA who find that their stiffness is worse in the morning.” Morning stiffness often lasts for an hour or longer in people who have RA and is often the first sign of the disease.
Do popping joints or knee pain mean I’ll develop arthritis?
“Everybody asks that question!” says Dr. Jayatilleke. “If there’s no pain, then we usually tell people not to worry.” Cracking your knuckles might drive people mad, but it won’t cause arthritis. And there’s no definite link between knee pain and developing arthritis later in life either.
Seeking medical help early
Early detection enables you to seek expert treatment earlier. (If you don’t have a primary care doctor, here’s how to choose a good one.) Early intervention may help prevent joint damage in the case of OA—but catching RA early is vital. “The longer that you have untreated inflammation, the more effect it has on your entire system,” explains Dr. Jayatilleke. “There’s evidence that untreated inflammation can lead to a risk of cardiovascular disease, heart attacks, and strokes, which is very serious. It’s important is to make sure that people who have persistent symptoms aren’t ignoring things that could be signs of a larger systemic problem like RA,” she says.
- American College of Rheumatology: “Rheumatoid Arthritis”
- Centers for Disease Control and Prevention: “Osteoarthritis”
- Arundathi Jayatilleke, MD, rheumatologist, associate professor of medicine at the Lewis Katz School of Medicine at Temple University, Philadelphia
- Rheumatology: “Fatigue in rheumatoid arthritis reflects pain, not disease activity”
- Johns Hopkins Arthritis Center: “Rheumatoid Arthritis Signs and Symptoms”
- The Journal of Rheumatology: “Rheumatoid Cachexia: What Is It and Why Is It Important?”
- Johns Hopkins Medicine: “Episcleritis”
- U.S. National Library of Medicine: “Sjogren's Syndrome”
- UpToDate: “Patient education: Rheumatoid arthritis symptoms and diagnosis (Beyond the Basics)”
- National Institute of Neurological Disorders and Stroke: “Carpal Tunnel Syndrome Fact Sheet”
- Cleveland Clinic: “Osteoarthritis”
- Library of Congress: “What causes the noise when you crack a joint?”
- Arthritis Foundation: “Causes of Inflammatory Joint Pain”
- Harvard Health: “Explain the pain – Is it osteoarthritis or rheumatoid arthritis?”