With 1.3 million Americans living with rheumatoid arthritis (RA), you probably know someone who has the condition. Specifically, you probably know a woman living with RA, given that we are up to three times more likely to have it than men. And the fact that women (still) handle more household tasks than men — things like bending down to clean or pick up dirty laundry, or standing while washing dishes — only makes matters worse, because you’re never quite sure if your achy joints are caused by your everyday activities, or are a sign of something more serious.
My mother lived with RA for close to 40 years after she was diagnosed with it in her 30s. This is normal — RA typically affects people between the ages of 30 and 60. I grew up constantly hearing about arthritis (or “Arthur Itis” as my grandmother — who had osteoarthritis — would say) and didn’t really understand it beyond the fact that sometimes my mother would be so sore that she wasn’t able to play with us. She actually was diagnosed with RA after taking her mother to her rheumatologist appointment. After listing some of her symptoms, the doctor brought her back in for an official screening. Up until this point, she had assumed that the stiffness, swelling and pain in her joints was the result of being a busy mom.
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If, at some point, you’ve wondered whether the discomfort you’re experiencing was just the regular wear and tear on your body or the signs of something more serious, you’re not alone. In fact, RA isn’t caused by overuse of joints — that’s osteoarthritis. RA is actually the result of an autoimmune disorder, though we don’t yet know precisely what causes it. And as of now, there is no cure for RA. So what RA symptoms women should be on the lookout for? SheKnows spoke with experts to find out, as well as when to talk to your doctor about them.
Pain, stiffness and swelling in and around your joints
The symptoms of RA depend, to some extent, on how far the condition has progressed. According to Dr. Kevin Deane, a rheumatologist with UCHealth Rheumatology Clinic-Anschutz Medical Campus, as well as an associate professor of medicine and the William P. Arend Chair for Rheumatology Research at the University of Colorado Anschutz Medical Campus, the most common symptoms at the onset of RA are pain, stiffness and a feeling of swelling in and around the joints. “Often these symptoms are worse in the morning after sleep, get better with movement and are symmetric — i.e. fairly equal on both sides of the body. For example, in the right and left hand,” he tells SheKnows. “For many people, the first joints involved in RA are the joints in the fingers and wrists, although many other joints can also be involved.”
The primary areas affected by RA joint inflammation are:
Hands (fingers and knuckles)
If you’ve noticed that you have the same type of pain or discomfort at the same place on both sides of your body, it could be a sign of RA, according to the Rheumatoid Arthritis Support Network. However, the levels of pain on different sides of your body aren’t necessarily going to be the same. So if both of your shoulders hurt, the pain in your left shoulder may be significantly worse.
RA can also cause flu-like symptoms — likely a result of the elevations of the body’s inflammation, according to Deane. These include the usual suspects like body aches, fatigue and a low-grade temperature. Of course, it could also be the actual flu, but if you’re experiencing any of these symptoms along with joint pain, swelling or stiffness, it may be time to talk to a doctor.
Joint redness and warmth
In addition to being painful, stiff or swollen, the joints of someone with RA could also look red in appearance and feel warm to the touch, according to the Rheumatoid Arthritis Support Network. The redness is a result of the widening of the skin’s capillaries caused by inflammation within the joint capsule, making the joints more visible. It’s possible to notice warmth around your joints without the redness, so it’s important to pay attention to all aspects of your symptoms.
One of the most noticeable symptoms of RA are deformed joints. According to the Johns Hopkins Arthritis Center, people with RA could develop deformed joints in their hands and/or feet. RA-induced deformities are typically found in the metacarpophalangeal joints (MCP joints) and proximal interphalangeal joints (PIP joints) — the small joints that allow your fingers to bend. My mother had a deformity in her pointer finger, which prompted many children over the years to ask about her “witch’s finger.” Deformities could also form in a person’s elbows and toes (like hammer toe).
Carpal tunnel syndrome
Though we usually associate carpal tunnel syndrome with typing too much, it can also be a symptom of RA, according to Dr. Giuseppe Aragona, a family medicine physician at Prescription Doctor. The Johns Hopkins Arthritis Center notes that carpal tunnel syndrome sometimes occurs in patients with RA as a result of compression of a peripheral nerve by inflamed edematous tissue.
Shortness of breath
Believe it or not, RA can also be behind a variety of lung conditions that makes it difficult to breathe. For example, Aragona says that this includes pleurisy, which he describes as “a sharp pain in the chest, caused by inflammation in the lungs.” And it doesn’t end there. According to the Mayo Clinic, sometimes the lung symptoms show up before the achy joints, and can take the form of scarring within the lungs, lung nodules or a small airway obstruction. If you’re experiencing any unexplained breathing problems, you’re going to want to talk to your doctor about it ASAP.
When to see your doctor
Because so many of the symptoms associated with RA could be caused by something else, it can make it tricky to diagnose, as well as make it difficult to know when you need to talk to a doctor about them.
“Not every ache and pain in and around the joints is RA, as there are multiple things that can cause those symptoms ranging from things like over-exercise, sprains or [other] forms of arthritis such as ‘osteoarthritis,’” Deane explains. “Not all of these need immediate medical attention and unfortunately, telling each of these types of things apart can be difficult.”
However, Deane does point out that a general rule regarding RA is that if someone has pain, stiffness and swelling in and around their joints that lasts for more than three to five days — especially if those symptoms are on both sides of their body and/or are worse in the morning — then it is reasonable to talk with their health care provider. At least that way a health care provider can ask more questions to help sort out what may be going on, and perhaps most importantly, examine the joints to see if signs of inflammation are present. In addition, a health care provider can take X-rays and perform blood tests that can help make a diagnosis of RA, or identify other types of arthritis. In most cases, if it does appear to be RA, a person will be referred to a rheumatologist to confirm the diagnosis and then start specialized treatment.
“The health-care field is increasingly aware, identifying RA early and starting appropriate treatment [that] can avoid joint damage and keep an individual as healthy as possible,” Deane says. “As such, in general, health care providers aim to identify someone with RA within a few weeks of onset of their symptoms.”
The bottom line is that you should keep an eye out for these symptoms — including those that are less obvious — and talk to your doctor if you think something’s up.
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