Rheumatoid arthritis is an autoimmune disease that attacks the joints. Although it shares some symptoms with osteoarthritis, the type of arthritis that usually occurs in older people due to wear and tear on joints, there are some key differences.
Rheumatoid arthritis can attack at any age, can come on rapidly, and may be accompanied by other symptoms, such as fatigue.
Do you have RA?
But RA can be tough to diagnose. Symptoms can mimic other illnesses, or they may flare, then fade, only to flare again somewhere else. Lab tests aren’t perfect—you can test negative for RA factors and still have it. And X-rays don’t show signs until later on.
Here are some tricky rheumatoid arthritis symptoms and hints that they’re due to RA and not some other condition.
Hard to heal injuries
This is more common in younger people, says Lisa A. Mandl, MD, MPH, assistant attending rheumatologist at Hospital for Special Surgery in New York City.
One day a patient is playing soccer and the next day her knee is swollen, she says. “I have seen people who have had two arthroscopic surgeries and extensive physical therapy in their knee and they have rheumatoid arthritis.”
Numbness or tingling in the hands
What happens is that the swelling in the arm compresses the nerves going into the hands. The sensation is often worse at night.
If you go to a doctor with these symptoms and don’t have (or tell him or her about) other RA symptoms, you may be diagnosed only with carpal tunnel syndrome.
Women often stop wearing heels and head to a podiatrist due to the pain.
Some people with RA may also develop pain in the heel because of plantar fasciitis, a common foot disorder caused by swelling of the tissue at the bottom of the foot, near the heel.
This can happen even in the early stages of RA, but it’s unlikely to be the only symptom.
Most people with dry eyes head to an eye doctor to find out the cause, but Dr. Mandl recommends telling your doctor—even an eye doctor or other specialist—about additional symptoms you’re having in any part of the body.
Pairs of achy joints
This achiness can also be misdiagnosed as fibromyalgia or chronic fatigue syndrome (fatigue is another symptom of RA).
RA joint pain is not fleeting; it usually lasts longer than a week. It can also be symmetrical, meaning both hands, feet, knees, or ankles will be affected at the same time.
Again, this is also a common problem in osteoarthritis, which can cause pain after long periods of inactivity, like sleeping.
The difference between the two is that osteoarthritis pain usually subsides in about a half hour. Stiffness from rheumatoid arthritis will last much longer, possibly for a good chunk of the day.
The right kind of exercise can help alleviate stiffness for people with RA and osteoarthritis pain.
The symptom can be mistaken for a meniscus tear, a knee joint injury that’s common in sports, and which can also lead to cysts.
These are firm lumps that grow under the skin near the affected joints. They often appear at the back of the elbows, and sometimes people get them in the eyes.
They’re more common in people who have advanced rheumatoid arthritis, but occasionally show up earlier, says Dr. Mandl.
The nodules can at times mimic gout, another form of arthritis.