How quickly does rheumatoid arthritis progress?


Twelve early signs of rheumatoid arthritis

The main symptoms of RA are joint pain and stiffness. Before these symptoms occur, a person may experience some early warning signs.

Some of these early warning signs relate to how a person feels overall, while others are specific to the joints. The symptoms that affect a person’s joints are more likely to indicate RA, particularly if more than one joint or both sides of the body are affected.

Spotting these warning signs can help people seek treatment at the earliest possible opportunity. The early warning signs of RA include:

1. Fatigue

Before experiencing any other symptoms, a person with RA may feel extremely tired and lack energy. They may also feel depressed.

Feelings of fatigue may affect:

  • everyday activities
  • relationships
  • sex drive
  • productivity at work

Feeling fatigued may be due to the body’s reaction to inflammation in the joints.

2. Slight fever

Inflammation associated with RA may cause people to feel unwell and feverish. They may have a slightly raised temperature, which is an early sign that sometimes accompanies fatigue. It may precede any noticeable effects on the joints.

3. Weight loss

A third early warning sign of RA is unexplained weight loss, which is possibly an indirect effect of inflammation.

When someone is feeling feverish and fatigued, they may lose their appetite, which can cause them to lose weight.

4. Stiffness

Share on PinterestPersistent stiffness, tenderness, and pain in joints may be an early sign of rheumatoid arthritis.

Another early sign of RA is joint stiffness. Stiffness may occur in one or two small joints, often in the fingers. It can come on slowly but may last for several days.

In addition to the stiffness that affects specific joints, a general feeling of stiffness in the body may be an early sign of RA.

This type of stiffness usually affects a person after they have been still for a long time. This symptom is the cause of morning stiffness, a characteristic complaint of patients with RA.

5. Joint tenderness

Joint tenderness that affects the hands and feet is a typical early sign of RA.

In the hands, the joint in the middle and at the base of the fingers may feel tender when pressed or during movement.

In the feet, the joints at the base of the toes may be tender. This soreness may cause people to walk on their heels or lift their toes up as they walk.

6. Joint pain

Joint pain in the fingers, wrists, and feet is a sign of RA. Inflammation makes the lining of the joint thicker and also causes the production of extra joint fluid.

Both of these factors put pressure on the capsule that surrounds the joint and irritate the nerve endings that it contains, causing pain.

7. Joint swelling

Joints that look swollen in the hands and feet is a typical sign of RA. Joint swelling tends to be more apparent as RA progresses, but subtle swelling may be an early sign.

8. Joint redness

Inflammation in the joints may give them a red appearance. Discoloration of the skin around the joints in the hands and feet is a sign of RA.

Redness occurs because the inflammation causes the blood vessels in the surrounding skin to widen. Wider vessels allow more blood to flow into this area, giving the skin a red appearance.

9. Joint warmth

Joint warmth is caused by inflammation and may be present before redness or swelling occurs. This can be an early sign of RA.

10. Numbness and tingling

Numbness and tingling affecting the hands and feet may be an early sign of RA. These symptoms are caused by inflammation in the joints that can cause nerve compression, resulting in loss of sensation.

11. Decrease in range of motion

In the early stages of RA, a person may notice they are having trouble bending their wrist back and forth.

As the disease progresses, damage to the joints can affect ligaments and tendons, making it hard to bend and straighten them.

12. Joints affected on both sides

It is common for people affected by RA to experience symptoms in the same joints on both sides of the body. While this symmetry is typical, it is not the case for everyone with the condition.

Question: I was diagnosed with rheumatoid arthritis (RA) three months ago, so learning to recognize an arthritis flare is new to me. I realize the length of a flare can vary, but how long does a flare last for most people? Months? Years?
Answer: People usually know a flare of an inflammatory disease like RA, psoriatic arthritis, or ankylosing spondylitis is getting under way when morning stiffness increases. That is, they wake up in the morning feeling their joints are stiffer than usual, and it takes longer until the joints loosen up sufficiently for daily activities. With bad flares, morning stiffness and fatigue may last all day and greatly interfere with people’s lives. To the question “how long does a flare last?” the answer is that they can persist for weeks or months unless there is a change in treatment.
Usually your symptoms are reliable indicators of an arthritis flare, so it is important to keep tabs on them, as well as what you are doing to treat your arthritis.
Changes in blood work may also indicate an increase in inflammation. For example, both the erythrocyte sedimentation (“sed”) rate and the blood level of C-reactive protein may rise. Although these test results don’t change only when there is an arthritis flare, they may provide supporting evidence of worsened disease activity. These numbers are helpful for your doctor to track improvement of the disease flare after treatment.
It’s crucial to suppress inflammation during flares, especially so soon after your diagnosis, when initial damage to your joints can occur. How long it takes to suppress a flare depends on the medications you take. One strategy for severe flares is to control symptoms quickly with low-dose prednisone, which can improve symptoms within days, while simultaneously starting methotrexate and other medications designed to suppress disease activity within weeks or months.
John H. Stone, MD, MPH
Director, Clinical Rheumatology
Massachusetts General Hospital
Boston, Massachusetts

Tremor, and Rheumatoid arthritis

Diseases related with Tremor and Rheumatoid arthritis

In the following list you will find some of the most common rare diseases related to Tremor and Rheumatoid arthritis that can help you solving undiagnosed cases.


Autosomal dominant dopa-responsive dystonia (DYT5a) is a rare neurometabolic disorder characterized by childhood-onset dystonia that shows a dramatic and sustained response to low doses of levodopa (L-dopa) and that may be associated with parkinsonism at an older age.

AUTOSOMAL DOMINANT DOPA-RESPONSIVE DYSTONIA Is also known as hpd with marked diurnal fluctuation|gtpch1-deficient dopa-responsive dystonia|gtpch1-deficient drd|dyt5a|hereditary progressive dystonia with marked diurnal fluctuation|autosomal dominant segawa syndrome

Related symptoms:

  • Intellectual disability
  • Hearing impairment
  • Scoliosis
  • Ataxia
  • Hypertension




DYSTONIA, DOPA-RESPONSIVE; DRD Is also known as dystonia, progressive, with diurnal variation|dystonia 5|segawa syndrome, autosomal dominant|dystonia, dopa-responsive, autosomal dominant|dopa-responsive dystonia, autosomal dominant|dystonia-parkinsonism with diurnal fluctuation|dyt5

Related symptoms:

  • Intellectual disability
  • Hearing impairment
  • Scoliosis
  • Nystagmus
  • Spasticity




Juvenile Huntington disease (JHD) is a form of Huntington disease (HD; see this term), characterized by onset of signs and symptoms before 20 years of age.

JUVENILE HUNTINGTON DISEASE Is also known as huntington chorea|jhd|juvenile huntington chorea

Related symptoms:

  • Seizures
  • Ataxia
  • Cognitive impairment
  • Anemia
  • Delayed speech and language development



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Familial amyloid polyneuropathy (FAP) or transthyretin (TTR) amyloid polyneuropathy is a progressive sensorimotor and autonomic neuropathy of adulthood onset. Weight loss and cardiac involvement are frequent; ocular or renal complications may also occur.

ATTRV30M AMYLOIDOSIS Is also known as familial amyloid polyneuropathy type i|ttr amyloid neuropathy|attrv30m-related amyloidosis|hereditary amyloidosis, transthyretin-related|transthyretin amyloid polyneuropathy|familial amyloid polyneuropathy, portuguese-swedish-japanese type|fap|amyloid pol

Related symptoms:

  • Seizures
  • Hearing impairment
  • Ataxia
  • Nystagmus
  • Sensorineural hearing impairment


More info about ATTRV30M AMYLOIDOSIS


VELOCARDIOFACIAL SYNDROME Is also known as chromosome 22q11.2 deletion syndrome|shprintzen vcf syndrome|vcf syndrome|vcfs

Related symptoms:

  • Intellectual disability
  • Seizures
  • Global developmental delay
  • Short stature
  • Generalized hypotonia




DiGeorge syndrome (DGS) comprises hypocalcemia arising from parathyroid hypoplasia, thymic hypoplasia, and outflow tract defects of the heart. Disturbance of cervical neural crest migration into the derivatives of the pharyngeal arches and pouches can account for the phenotype. Most cases result from a deletion of chromosome 22q11.2 (the DiGeorge syndrome chromosome region, or DGCR). Several genes are lost including the putative transcription factor TUPLE1 which is expressed in the appropriate distribution. This deletion may present with a variety of phenotypes: Shprintzen, or velocardiofacial, syndrome (VCFS ); conotruncal anomaly face (or Takao syndrome); and isolated outflow tract defects of the heart including tetralogy of Fallot, truncus arteriosus, and interrupted aortic arch. A collective acronym CATCH22 has been proposed for these differing presentations. A small number of cases of DGS have defects in other chromosomes, notably 10p13 (see {601362}). In the mouse, a transgenic Hox A3 (Hox 1.5) knockout produces a phenotype similar to DGS as do the teratogens retinoic acid and alcohol.

DIGEORGE SYNDROME; DGS Is also known as hypoplasia of thymus and parathyroids|chromosome 22q11.2 deletion syndrome|third and fourth pharyngeal pouch syndrome

Related symptoms:

  • Intellectual disability
  • Seizures
  • Global developmental delay
  • Short stature
  • Hearing impairment




Systemic-onset juvenile idiopathic arthritis is marked by the severity of the extra-articular manifestations (fever, cutaneous eruptions) and by an equal sex ratio.

SYSTEMIC-ONSET JUVENILE IDIOPATHIC ARTHRITIS Is also known as systemic-onset jia|systemic juvenile rheumatoid arthritis|still disease|systemic polyarthritis

Related symptoms:

  • Visual impairment
  • Hepatomegaly
  • Fever
  • Splenomegaly
  • Visual loss




Progressive pseudorheumatoid arthropathy (dysplasia) of childhood (PPAC; PPD) presents as spondyloepiphyseal dysplasia (SED) tarda with progressive arthropathy and is described as a specific autosomal recessive subtype of SED.

PROGRESSIVE PSEUDORHEUMATOID ARTHROPATHY OF CHILDHOOD Is also known as progressive pseudorheumatoid arthropathy of childhood|ppd|spondyloepiphyseal dysplasia tarda-progressive arthropathy syndrome|sedt-pa|spondyloepiphyseal dysplasia tarda with progressive arthropathy|progressive pseudorheumatoid dysplasia

Related symptoms:

  • Short stature
  • Scoliosis
  • Muscle weakness
  • Pain
  • Flexion contracture




Peripheral neuropathy-myopathy-hoarseness-hearing loss syndrome is a rare, syndromic genetic deafness characterized by a combination of muscle weakness, chronic neuropathic and myopathic features, hoarseness and sensorineural hearing loss. A wide range of disease onset and severity has been reported even within the same family.

PERIPHERAL NEUROPATHY-MYOPATHY-HOARSENESS-HEARING LOSS SYNDROME Is also known as peripheral neuropathy-myopathy-hoarseness-deafness syndrome

Related symptoms:

  • Hearing impairment
  • Sensorineural hearing impairment
  • Muscle weakness
  • Peripheral neuropathy
  • Tremor




Nephronophthisis is an autosomal recessive cystic kidney disease characterized by onset of end-stage renal failure in the first 3 decades of life. The disorder is often associated with extrarenal manifestations, including liver fibrosis, retinal degeneration, and central nervous system abnormalities (summary by O’Toole et al., 2010).For a general phenotypic description and a discussion of genetic heterogeneity of nephronophthisis, see NPHP1 (OMIM ).

Related symptoms:

  • Intellectual disability
  • Seizures
  • Hearing impairment
  • Sensorineural hearing impairment
  • Hypertension



Top 5 symptoms//phenotypes associated to Tremor and Rheumatoid arthritis

Symptoms // Phenotype % cases
Hearing impairment Common – Between 50% and 80% cases
Arthritis Common – Between 50% and 80% cases
Intellectual disability Uncommon – Between 30% and 50% cases
Scoliosis Uncommon – Between 30% and 50% cases
Seizures Uncommon – Between 30% and 50% cases

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Other less frequent symptoms

Patients with Tremor and Rheumatoid arthritis. may also develop some of the following symptoms:

Uncommon Symptoms – Between 30% and 50% cases

Anxiety Fever Behavioral abnormality Obsessive-compulsive behavior Juvenile rheumatoid arthritis Hypertension Depressivity Hypothyroidism Rigidity Dementia Hydrocephalus Autoimmunity Gait disturbance Cognitive impairment Ataxia Muscle weakness Delayed speech and language development Anemia Schizophrenia Gait ataxia Chorea Bradykinesia Short stature Sensorineural hearing impairment

Rare Symptoms – Less than 30% cases

Abnormality of the foot Bifid uvula Gliosis Spina bifida Arteria lusoria Joint swelling Sacral meningocele Right aortic arch with mirror image branching Paranoia Bulbous nose Hemolytic anemia Renal agenesis Hypocalcemia Primary amenorrhea Specific learning disability Renal dysplasia Neuronal loss in central nervous system Amenorrhea Tetralogy of Fallot Low posterior hairline Purpura Aplasia of the thymus Abnormality of the kidney Cardiomyopathy Pain Peripheral demyelination Flexion contracture Global developmental delay Microcephaly Abnormal facial shape Cleft palate High palate Ventricular septal defect Short neck Hypoplasia of the corpus callosum Atrial septal defect Hallucinations Immunodeficiency Recurrent infections Abnormality of cardiovascular system morphology Thrombocytopenia Visual impairment Retrognathia Peripheral neuropathy Arnold-Chiari malformation Blepharophimosis Abnormality of the pinna Renal insufficiency Umbilical hernia Areflexia Obesity Hyporeflexia Posteriorly rotated ears Arthralgia Inguinal hernia Abnormal heart morphology Patent ductus arteriosus Bicuspid aortic valve Conotruncal defect Falls Truncus arteriosus Spasticity Myelomeningocele Hyperreflexia Babinski sign Hypertonia Dystonia Difficulty walking Paresis of extensor muscles of the big toe Seborrheic dermatitis Irritability Aplasia of the uterus Abnormality of movement Paraplegia Graves disease Nystagmus Abnormality of the substantia nigra Involuntary movements Postural tremor Sleep disturbance Parkinsonism Abnormality of extrapyramidal motor function Horizontal nystagmus Torticollis Pes cavus Brisk reflexes Transient hyperphenylalaninemia Lower limb hyperreflexia Impaired vibration sensation in the lower limbs Limb dystonia Generalized dystonia Focal dystonia Progressive flexion contractures Decreased CSF homovanillic acid Abnormal cerebellum morphology Meningocele Hypoparathyroidism Psoriasiform dermatitis Talipes equinovarus Vitiligo Dysphagia Unilateral renal agenesis Cerebellar atrophy Retinal vascular tortuosity Hyperactivity Duodenal stenosis Weight loss Fatigue Aggressive behavior Mental deterioration Cholelithiasis Nasal speech Acne Dysarthria Inflammation of the large intestine Autoimmune hemolytic anemia Interrupted aortic arch Autoimmune thrombocytopenia Perimembranous ventricular septal defect Posterior embryotoxon Bipolar affective disorder Impaired T cell function Right aortic arch Microphthalmia Ptosis Narrow mouth Giant platelets Low-set ears Hydronephrosis Telecanthus Unilateral lung agenesis Unilateral primary pulmonary dysgenesis Psychotic episodes Strabismus Velopharyngeal insufficiency Vascular ring Platybasia Micrognathia Congenital conductive hearing impairment Mood swings Central nervous system degeneration Neoplasm Hypertelorism Perineal fistula Cleft lip Abdominal pain Craniosynostosis Metaphyseal widening Decreased cervical spine mobility Sclerotic vertebral endplates Enlarged epiphyses Methylmalonic acidemia Flattened epiphysis Synovitis Abnormality of the knee Arthropathy Spondyloepiphyseal dysplasia Genu varum Enlargement of the proximal femoral epiphysis Short long bone Coxa vara Abnormal form of the vertebral bodies Osteoarthritis Interphalangeal joint contracture of finger Waddling gait Platyspondyly Camptodactyly of finger Joint stiffness Enlarged interphalangeal joints Morbus Scheuermann Skeletal dysplasia Renal cyst Renal corticomedullary cysts Chronic pancreatitis Pancreatic cysts Kinetic tremor Tubular atrophy Gout Arachnoid cyst Nephronophthisis Pancreatitis Retinal degeneration Enlarged metacarpophalangeal joints Stage 5 chronic kidney disease Dilated cardiomyopathy Vocal cord paresis Progressive peripheral neuropathy Mildly elevated creatine phosphokinase Hoarse voice Distal amyotrophy Distal muscle weakness Myopathy Camptodactyly Kyphoscoliosis Attention deficit hyperactivity disorder Amblyopia Abnormality of the middle ear Perisylvian polymicrogyria Alcoholism Femoral hernia Hypoplasia of the thymus Anterior segment developmental abnormality Tetany Sclerocornea Exotropia Broad thumb Vascular tortuosity Short palpebral fissure Coarctation of aorta High, narrow palate Iris coloboma Polymicrogyria Astigmatism Generalized tonic-clonic seizures Microtia Short philtrum Abnormality of the thymus Esophoria Osteoporosis Lymphadenopathy Severe short stature Kyphosis Serositis Anterior uveitis Elevated C-reactive protein level Uveitis Pericarditis Elevated erythrocyte sedimentation rate Pleural effusion Pulmonary artery atresia Accommodative esotropia Myalgia Hepatosplenomegaly Visual loss Splenomegaly Hepatomegaly Type I truncus arteriosus Parathyroid agenesis Parathyroid hypoplasia Decreased circulating parathyroid hormone level Skin rash Hypospadias Abnormality of the endocrine system Dilated fourth ventricle Clumsiness Hyperkinesis Incoordination Slurred speech Personality changes Akinesia Hypokinesia Muscle fibrillation Bronchitis Cerebellar vermis atrophy Restlessness Upper limb undergrowth Head tremor Chronic bronchitis Testicular atrophy Progressive neurologic deterioration Congestive heart failure Paresthesia Malabsorption Facial palsy Constipation Arrhythmia Headache Diarrhea Mania Vomiting Oral motor hypotonia Frequent temper tantrums Suicidal ideation Neuronal loss in basal ganglia Abnormal involuntary eye movements Broad-based gait Type II diabetes mellitus Nephropathy Parkinsonism with favorable response to dopaminergic medication Motor delay Encephalopathy Hyperlordosis Abnormal pyramidal sign Spastic paraplegia Confusion Cerebral palsy Dysphonia Spastic diplegia Gaze-evoked nystagmus Resting tremor Hyperactive deep tendon reflexes Upper motor neuron dysfunction Torsion dystonia Oromandibular dystonia Generalized-onset seizure Cough Brain atrophy Progressive cerebellar ataxia Neurodegeneration Infertility Abnormality of eye movement Abnormality of the cerebral white matter Diabetes mellitus Writer’s cramp Myoclonus Ventriculomegaly Fixed facial expression Obsessive-compulsive trait Infantile encephalopathy Axial dystonia Peripheral axonal neuropathy Polyneuropathy Echolalia Open mouth Generalized hypotonia Muscular hypotonia Cataract Intellectual disability, severe Absent speech Hernia Conductive hearing impairment Congenital cataract Pulmonic stenosis Anal atresia Dysmetria Vesicoureteral reflux Underdeveloped nasal alae Psychosis Multicystic kidney dysplasia Cardiac amyloidosis Basal ganglia calcification Pierre-Robin sequence Delusions Hearing abnormality Anal stenosis Submucous cleft hard palate Axonal loss Abnormality of the ear Narrow palpebral fissure Myopathic facies Hypoplasia of the brainstem Apathy Dysdiadochokinesis Abnormality of the hand Holoprosencephaly Amyloid deposition in the vitreous humor Vitreous floaters Coma Malnutrition Urinary incontinence Migraine Hypotension Bilateral sensorineural hearing impairment Cardiomegaly Hemiparesis Vasculitis Abnormal autonomic nervous system physiology Paraparesis Spastic paraparesis Atrioventricular block Cachexia Cerebral hemorrhage Impotence Aphasia Orthostatic hypotension due to autonomic dysfunction Stroke-like episode Psychomotor deterioration Urinary retention Sensory ataxia Abnormal renal physiology Myelopathy Constrictive median neuropathy Multiple myeloma Axonal degeneration Restrictive cardiomyopathy Increased CSF protein Syringomyelia Amyloidosis Decreased number of peripheral myelinated nerve fibers Orthostatic hypotension Tubular basement membrane disintegration

If you liked this article maybe you will also find interesting the following in-depth articles about other rare diseases, like Myopia and Encephalitis, related diseases and genetic alterations Hepatomegaly and Azoospermia, related diseases and genetic alterations

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Bruce’s Rheumatoid Arthritis story
Sandra’s Rheumatoid Arthritis story
Jan’s Rheumatoid Arthritis story

This is Bruce’s onset of Rheumatoid Arthritis story, in his own words.

When I was 5 years old I was diagnosed with Rheumatic fever: high fever, couldn’t walk, had swollen joints and spent 2 wks in the hospital! After that it had left me with a heart murmur, but as I grew into my early teens I’d outgrown it; I guess staying active and playing sports really helped! Had my sickness in childhood, because as I became a young adult I was the most fit in my family, took after my mom by not smoking and eating good, played sports, went into the Navy at 23; did 6 years.

Up until I was 45 years, I still played softball; that’s when I tore my Achilles tendon. Shortly after that I started experiencing physical problems, my neck and back hurt and I had weakness in my hands and arms, tremor in my right hand/arm! A doctor told me I might have Parkinson’s, but that was negative. Had MRI of back/neck, showed I had spondylosis of cervical, thoracic & lumbar. I would get fatigued and muscle pain, then my hand would tremor.

Though I had a bone scan too, they told me all the arthritis in my multiple joints was minor and I had no vertebrae pinching nerves. So I even had one doctor tell me I probably had a bipolar problem that’s why I had a tremor, even though I had told them I got a tremor after I would use my hands & arms a lot lifting or physical work. This all went on 8 years ago. A doctor had given me Lithium, which made my hand shake more, so I left him and went to neurologist, he had brain scan done, that was normal. He took me off Lithium and after more test said at times my neck may be pushing on nerve roots. I went to a rheumatologist finally and she did blood panel and check my Rheumatoid factor, C – reactive protein, Sed Rate, but nothing showed. I went on seeing her and despite my mother having 2 autoimmune Diseases ( RA and Myasthenia Gravis ) and all my joint pain, morning stiffness, fatigue and having her take 3 tubes of fluid out of my left knee, she still didn’t want to diagnose me with RA.

But last summer after being hospitalized with Pericarditis and having an MRI on my right hip due to pain in it, sent me back to her. After she heard why I was in the hospital, she then tells me there was a new test her lab could send out, it was the Anti-Mutated Citrullinated Vimentin (anti-MCV). I had this test last Sept. 2010, and was finally diagnosed Jan. 2011 with RA. I am on methotrexate pills along with 6 NSAID pills per day. So after 8 years of doctors & tests, I finally get my diagnosis!

Too bad I’m already having damages done. Don’t know why doctors don’t go with your symptoms and family genes more; I have autoimmune diseases all in my family – mom has Myasthenia Gravis, her mom died of Tuberculosis, my great aunt died of Lou Gehrig’s disease, I lost a little sister to Leukemia and my brother has Spina Bifida. Last year, I had to have that sore right hip replaced, after I tried physical therapy; x-rays had showed some arthritis, it got so bad I could hardly walk on it. Went to my orthopedic surgeon that I had seen for it before, he & I decided that it was too painful and not functioning well enough, so had it removed. I’m walking without my cane now, but I do get pain in that leg muscle, tendons. I’m driving again, at least short trips, hurts my back and I stiffen up if I sit too long!

This is Sandra’s onset of Rheumatoid Arthritis story, in her own words.

It took a while to discover the correct diagnosis for why I had been feeling badly with malaise, body aches, fatigue, cognitive difficulties, depression, and anxiety. I had several early indications of rheumatoid disease, but they became obvious only in hindsight.

The first was minor. Occasionally, I would have difficulty pouring tea or emptying a teakettle or pot. My wrist would feel weak and weird. So I would put the pot down and I would think to myself, “There’s something wrong there. One of these days I will have to get it checked out.” I chuckled at the non-specificity and transience of the symptom. Either I’d be brushed off, since it was intermittent, or I’d have to get images, etc., which would take time and probably be inconclusive. File that for another day.

The second was awakening with stiff and tingling wrists and hands most mornings. I attributed it to overuse, and thought it weird that both wrists hurt, even though I use my dominant right hand much more than my left. I’d been treated for carpal tunnel syndrome years ago, and thought I should try sleeping with braces, since it helped before. I also thought it might be neuropathy. My endocrinologist said that sometimes happens.

The third indication was even less specific, an area of stiffness and discomfort on the bottom outside of my right ankle. Although I remember turning my ankle months previously, it seemed to be fine at the time. Yet, the discomfort of the ankle was getting slowly worse, not better. At that time, I had no idea that RA could cause ankle inflammation leading to tendon injury. Again, it was something I was going to have to get checked out, one of these days.

Then last August I had a severe allergic reaction, followed by a respiratory infection. Since I have asthma and pulmonary hypertension, I was not surprised when I was out of commission. I took care of myself, stayed home from work, and took the antibiotic the doctor prescribed. A few days later, my Achilles tendon was alarmingly tight. Since one of the possible antibiotic side effects was tendon rupture, I immediately saw a doctor, who changed the antibiotic just in case, and referred me to a podiatrist. He diagnosed plantar fasciitis, and gave me a splint to wear at night.

When my respiratory infection went away, I still felt lousy. I had enough experience to take it easy, but I was not bouncing back. I had been treated for depression in the past, and thought it had returned. I just could not get going. Everything was more of an effort than it should be, and I hurt all over. I’d seen the commercials about “depression hurts,” so I attributed it to that. My psychiatrist changed and increased my antidepressants and I stayed out of work.

The night splint took care of the plantar fasciitis, but my ankle had gotten worse. When conservative measures did not work, I was scheduled for surgery to repair tendon damage. Although I was not looking forward to it, at least it would give me some time to pull myself together. I still hurt, and I was still tired, and I was not well. (Later, I learned the term malaise—an indefinite feeling of debility or lack of health often indicative of or accompanying the onset of an illness.)

After foot surgery, my left knee hurt, but I thought it was because of the additional stress from not using my right leg. When my right knee swelled, I thought it was bursitis, and just moved the icepack from my ankle to my knee. I knew I had wear and tear on my joints. I tried to address the persistent pain, so I became diligent about cycling rest and activities, and exercising, but not too much. Last fall, I told both my psychiatrist and internist about the problems I was having, and then made an appointment with a rheumatologist. When the time came, I almost cancelled the rheumatology appointment, because I thought that I would be told that I had osteoarthritis and fibromyalgia, and I’d have wasted my time and the doctor’s.

The rheumatologist listened to my complaints of increasing pain and difficulty. He examined my muscles and joints. He thought I might have Lyme disease, and sent me for blood tests—seven vials! The initial Lyme test came back positive, so I started antibiotics. I was pleased, because although it is a difficult infection, Lyme usually responds to antibiotic therapy. When I returned to the doctor a month later, he told me that the more specific Lyme test had been run twice, and both results were negative, so I should stop the antibiotic. However, he wanted me to have another test rerun again in a different lab—anti-CCP. My initial test was a strong positive result at 60, and the second test came back even higher at 67. Later that week, the rheumatologist called to tell me I had Rheumatoid Arthritis.

At that point, I knew very little about rheumatoid disease, but I knew it was not good. I felt better, though, knowing there was a medical reason for my symptoms, and they were not all in my head.

On the internet, I found an article on Rheumatoid Arthritis Clinical Presentation by Alan K. Matsumoto, M.D. at The Johns Hopkins Arthritis Center: “The typical case of rheumatoid arthritis begins insidiously, with the slow development of signs and symptoms over weeks to months. Often the patient first notices stiffness in one or more joints, usually accompanied by pain on movement and by tenderness in the joint… Nonspecific systemic symptoms primarily fatigue, malaise, and depression, may commonly precede other symptoms of the disease by weeks to months. Patients complain of severe fatigue 4 to 6 hours after wakening.”

Finding this information made me feel validated (read: not crazy). Reading RA Warrior has the same effect. I love the analogy of the spear actually being a pen. With hair color and sunscreen, I am putting it off as long as I can, but I, too, aspire to be like an elephant eventually—grey and wrinkled.

My sincere thanks.

This is Jan’s onset of Rheumatoid Arthritis story, in her own words.

I am writing this just before the one year anniversary of my diagnosis. WHOOPEE! My story begins with ongoing pain in my neck which was causing numbness in my forearm and fingers. After seeing a nurse practitioner with no response I then traveled to the chiropractor. After a few sessions with him I began to feel worse. I started to have swelling in the wrists, fingers, ankles and knees. He suggested I see my family doctor to have blood work done. He was correct in assuming I had RA

All of the tests came back positive, so off to the rheumatologist I went. The first plan of attack was Nabumetone and a very low dose of prednisone, which did seem to relieve some swelling. The only problem with this treatment was I reacted to prednisone with most of the side effects. Next in line was Plaquenil, this drug was the best, in a few weeks I had no flares and my energy was gaining.

Within a few months I ended up in the ER with them checking for heart troubles, (after all the testing there is, I’m pleased to report no heart issues). Turns out I am severely allergic to Plaquenil, which my rheumy and GP had never heard off. My GP had to put me on Zoloft and clonazepam to counter act the terrible side effects. During this time my swelling returned and the fatigue worsened. I am now on 10mg of methotrexate a week and folic acid daily. So far so good other than my thinning hair that is. I feel lucky my RA is not the worst, but boy do I not wish this on anyone. As I tell my family, every day is a new experience!! Thank you for the web site, I have learned so much from reading all the stories. I will be interested to see if anyone has had the complications with medications that I have.

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Diagnosed with arthritis in your 30s


Image copyright Science Photo Library

  • Common condition causing pain and inflammation in joints; affects about 10m people in the UK, of all ages
  • Two most common types – osteoarthritis, which can be caused by injury or other joint-related conditions, and affects the cartilage lining of the joints; rheumatoid arthritis which occurs when the body’s immune system targets affected joints, which leads to pain and swelling
  • Another, less common type is psoriatic arthritis which between one and two in every five people with the skin condition psoriasis will develop
  • The pain, swelling and stiffness associated with psoriatic arthritis can affect any joint in the body, but often affects the hands, feet, knees, neck, spine and elbows
  • Symptoms vary depending on the type of arthritis, but include joint pain, tenderness and stiffness, inflammation in and around the joints, restricted movement of the joints, weakness and muscle wasting
  • No cure for arthritis but treatments can slow down the condition including painkillers, anti-inflammatory drugs, and in severe cases, surgery
  • More information from Arthritis Research UK and Arthritis Care

Source: NHS Choices

I should stress that, a) I am not a doctor, b) Humira does not, I am told, work for everyone and c) it can have side effects. I still combine the fortnightly injections with a very small dose of methotrexate which helps with inflammation, taken in tablet form, and that combination means I need to have regular blood tests to make sure my liver is not being adversely affected. My immune system is slightly less robust as a result of Humira, so that needs watching, and I have had cellulitis – a troublesome infection.

On a day-to-day basis now though I barely suffer arthritic pain any more. I can get washed and dressed without having to think about awkward hand and wrist movements, I can play a loud chord on the piano and risk only upsetting the neighbours, and I can even take on a round of golf, still with eye-wateringly high scores, obviously, but no longer with a medical excuse for them.

So the next time the chancellor pops in to a TV or radio studio and I am there to greet him, I can promise him a relaxed and grimace-free hello. Viewers and listeners may choose to wince, depending on their political persuasions, but for me it will be an enjoyably painless encounter.

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