From the Guidelines
Common symptoms of rheumatoid arthritis include joint pain, swelling, stiffness, and warmth, particularly in the small joints of the hands and feet, as well as morning stiffness lasting more than an hour, fatigue, low-grade fever, and general malaise. These symptoms typically occur symmetrically, affecting both sides of the body simultaneously 1. Patients may also experience fatigue, low-grade fever, and general malaise. As the disease progresses, joints can become deformed, with visible nodules developing under the skin near affected joints. Range of motion becomes limited, and patients may notice weakness in the affected areas. Some individuals experience symptoms beyond the joints, including dry eyes and mouth, chest pain with breathing, or numbness and tingling in extremities.
Key Symptoms
- Joint pain and swelling, especially in the hands and feet
- Morning stiffness lasting more than an hour
- Fatigue, low-grade fever, and general malaise
- Deformed joints with visible nodules
- Limited range of motion and weakness in affected areas
- Dry eyes and mouth, chest pain with breathing, or numbness and tingling in extremities
These symptoms result from the autoimmune nature of rheumatoid arthritis, where the immune system mistakenly attacks the synovial membrane lining the joints, causing inflammation and eventual joint damage 1. Symptoms often fluctuate with periods of flares and remission, and early recognition is crucial for prompt treatment to prevent permanent joint damage. The 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis emphasizes the importance of early treatment and a treat-to-target approach to manage the disease and improve patient outcomes 1.
From the Research
Common Symptoms of Rheumatoid Arthritis
The provided studies do not directly address the common symptoms of rheumatoid arthritis. However, they discuss the treatment and management of the disease, which can be used to infer the symptoms.
- The studies mention the use of disease-modifying antirheumatic drugs (DMARDs) such as methotrexate, sulfasalazine, and hydroxychloroquine to treat rheumatoid arthritis 2, 3, 4, 5, 6.
- They also discuss the efficacy of combination therapy compared to monotherapy in reducing disease activity and improving functional outcomes 2, 4, 5, 6.
- The studies mention the use of outcome measures such as the disease activity score (DAS) and the American College of Rheumatology (ACR) criteria to assess the response to treatment 5, 6.
- The symptoms of rheumatoid arthritis can be inferred to include joint pain, swelling, and stiffness, as well as fatigue and other systemic symptoms, based on the use of these outcome measures.
Treatment Outcomes
The studies provide evidence for the efficacy of combination therapy in treating rheumatoid arthritis, with the triple combination of methotrexate, sulfasalazine, and hydroxychloroquine being the most effective 2, 6.
- The study by 2 found that 77% of patients treated with the triple combination achieved a 50% improvement in composite symptoms of arthritis at 9 months, compared to 33% of patients treated with methotrexate alone and 40% of patients treated with sulfasalazine and hydroxychloroquine.
- The study by 6 found that 78% of patients treated with the triple combination achieved an ACR 20% response at 2 years, compared to 60% of patients treated with methotrexate and hydroxychloroquine and 49% of patients treated with methotrexate and sulfasalazine.