Rheumatoid arthritis (RA) is an autoimmune disorder, a dysfunction of the immune system. The purpose of a healthy immune system is to protect the body from infection. For those diagnosed with rheumatoid arthritis, the immune system becomes overactive and attacks the joints, specifically the synovial lining of affected joints, causing pain and stiffness.
The exact causes of rheumatoid arthritis are still not clear, but the condition has been studied extensively. Research shows that genetic and environmental conditions trigger the disease. Not everyone with the genetic predisposition for RA will develop the condition. There are current theories that suggest a virus, trauma or infection triggers the onset of the condition in a percentage of those who are genetically susceptible. Unfortunately, those who develop rheumatoid arthritis may end up with health problems that extend beyond painfully damaged joints.
1. Joint Pain
Rheumatoid arthritis causes pain in the joints. The condition typically affects the small joints of the feet and hands, but can affect any joint in the body. The pain associated with rheumatoid arthritis is symmetrical. This means that both sides of the body are typically affected. For example, if there is pain felt in the left elbow, similar pain will be experienced on the right side.
As mentioned earlier, rheumatoid arthritis is caused by the immune system attacking the synovium of the joint. This is the tissue around the joint responsible for providing nutrients and maintaining lubrication. The initial pain of RA is caused by the inflammatory reaction caused by the overactive immune system attacking the synovium. The resulting swelling of the area stretches the pain receptors in the soft tissues. The stretching of pain receptors causes pain.
2. Joint Swelling
Pain is only one of the many signs or symptoms associated with rheumatoid arthritis. Those who experience RA symptoms may also notice that the affected joints are inflamed and swollen. The swelling of the joints is a direct result of the autoimmune response.
When the synovia are assaulted by the immune system, There is an increase of synovial fluid that accumulates in the affected area. The immune system response, and the irritation, will trigger an increase in blood flow to the affected joints. The joints may become red and warm to the touch as a result. If the inflammation of the synovial membrane is not addressed, the damage to the joint will progress.
3. Joint Weakness
The increase in inflammation, pain, swelling and conversion of surrounding tissues to pannus, can result in the stiffening and weakening of the joints affected by rheumatoid arthritis.
Regular low impact exercise can help to keep joints strong and protect them from further damage. Exercise will do more than keep joints strong and flexible. Exercise is important to the management of RA symptoms because it will also keep the body flexible, alleviate pain and stiffness, improve the quality of sleep and build endurance. An exercise program that includes strengthening, aerobic activity and stretching is recommended to minimize joint weakness.
4. Lumps or Nodules
About 25 percent of those diagnosed with rheumatoid arthritis will develop rheumatoid nodules under their skin. These nodules will typically appear on the base, or near the base of an arthritic joint.
Nodules can range in shape and size. They are typically pea-sized, but can be as large as a walnut. These lumps most commonly appear around the joints of the fingers, forearms, elbows, the back of the heal or the knees. Nodules can feel doughy or firm.
Rheumatic nodules are not dangerous, but there are treatment options available for those who find the lumps bothersome, including surgery.
5. Hand Swelling
While nodules are not as common with RA, hand swelling is a common occurrence. For many people diagnosed with rheumatoid arthritis, the hands are often the first area to experience symptoms.
The swelling is caused by the build-up of synovial fluid. The swollen hands can be tender or painful, and the swelling may impact the range of motion or hand strength.
The swelling may not be limited to affected fingers. In some cases the entire hand can swell, giving the hand a similar appearance to a boxing glove. The swelling can be severe enough to prevent the patient from touching their fingers to their palms.
6. Dry Mouth
Saliva production is necessary to maintain healthy function of the mouth. One of the many frustrating symptoms of rheumatoid arthritis is a dry mouth. A dry mouth can be an indication of a coexisting autoimmune disorder (Sjogren’s syndrome) or a side effect of several RA medications.
Symptoms of a dry mouth (xerostomia) include irritation of the tongue and gums, the mouth may become red and shiny, or the saliva may feel sticky or thick. There may also be changes in the way food tastes or a change in perceived food texture in the mouth.
Anyone experiencing dry mouth symptoms should be sure to stay adequately hydrated and avoid drinking caffeine. Some find chewing sugar-free gum to be helpful.
7. Physical Deformity
The inflammation that occurs because of RA can cause joint damage and lead to physical deformities of the affected joints. When joint inflammation forms an abnormal layer of fibrous tissue (pannus), the pannus releases substances that erode bone, destroy cartilage and damage the surrounding ligaments. Severe deformities can cause the loss of joint function.
Once rheumatoid arthritis deforms a joint, treatment includes exercise and splinting. For severe deformities of the hand, an occupational therapist can often design an exercise program and splints to slow the progression. To correct severe joint deformities, joint replacement surgery may be necessary to restore mobility.
8. Pins and Needles
Hand numbness can also be a symptom of rheumatoid arthritis. This numbness is often described as a pins and needles sensation, or tingling. This troublesome sensation can be a result of inflamed tissue putting pressure on sensitive nerves. It is not unusual to feel the tingling sensation in the elbows, wrists and ankles. Damage to the nerves can also cause pins and needles.
Sometimes, this symptom is not directly related to the onset of rheumatoid arthritis, but a complication of the condition. Roughly five percent of the time, these tingling sensations in the hand are caused by a common complication of rheumatoid arthritis, carpal tunnel syndrome.
