by Stacey Cahn, Special to CreakyJoints
You're waking up in pain, unable to move, and wondering whether it's going to be one of those bad days.
Morning stiffness that lasts for at least an hour is a classic symptom of rheumatoid arthritis but it's not the only one. The symptoms for RA can vary. In some cases, they can develop over a period of years while others may advance quickly.
Still, you may watch your symptoms come or "flare" and go, and then return again, but not necessarily in the same way or to the same part of the body. Symptoms of RA may also be signs of other conditions including osteoarthritis and Lyme Disease and autoimmune diseases such as fibromyalgia, gout and lupus. Joint inflammations caused by infections can also be mistaken as RA.
Confusing? Yes. Exasperating. Absolutely.
Symptoms of RA may include:
- Stiff joints especially in the morning or after long periods of not moving. The stiffness, in and near the joints, can last for hours.
- Swollen joints in the wrist, ankles, knees or elbows but especially the smaller ones in the hands and feet. Swelling or fluid around three joints at the same time. At least one of these joints involves a finger, hand or wrist. These joints may feel tender or warm. As the disease advances, you may notice these symptoms in your shoulders and hips.
- Symmetric Arthritis or arthritis in the same joints on both sides of the body such as the hands, knees, ankles or feet. This is common in most cases.
- Nodules or lumps under the skin on your arms. These bumps or rheumatoid nodules are usually in pressure points such as the elbows or shoulders, knees and ankles.
- Fatigue, Fever and weight loss or feelings like you have the flu, a feeling which flares and fades.
These symptoms may sound hauntingly familiar but it doesn’t mean you have rheumatoid arthritis. RA can be complicated to diagnose.
If you and your doctor suspect you have RA, the first step is to look for an elevated erythrocyte sedimentation rate (ESR, or “sed rate”) which suggests inflammation somewhere in the body. There are other common blood tests for the so-called “rheumatoid factor” but you can test negative for RA and still have it. Crescendo Bioscience’s Vectra DA tests 12 key proteins or bio-markers associated with RA to come up with a single score to help doctors and patients determine their next steps. X-rays may not confirm signs of RA unless it shows a change in bone or cartilage, and that's not likely in the early phase of the disease. RA affects the lining of your joints; the painful swelling can eventually lead to bone erosion and joint deformity.
Additional tests may be ordered to help confirm or rule out RA. According to the American College of Rheumatology, it can take several months after noticing the first symptoms of RA to confirm a diagnosis.
What You Should Do
If you suspect you have RA, see a rheumatologist or talk to your primary care doctor, and make sure to schedule periodic visits. Again, you may not get immediate answers. Your doctor should take a series of steps to either diagnose or rule out the disease.