Man gripping wrist in hand while experiencing early symptoms of rheumatoid arthritis in hands

Early Symptoms of Rheumatoid Arthritis in Hands

Medically reviewed on March 7, 2024 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

Rheumatoid arthritis (RA) affects roughly 18 million people worldwide, with 55 percent of those diagnoses given to individuals who are older than 55 years old. [1] Characterized by achy, swelling joints, the chronic inflammatory and autoimmune disease attacks the body’s healthy cells and can significantly impact one’s quality of life. [2]

Oftentimes, rheumatoid arthritis develops slowly, with RA symptoms spreading from the hands to other areas of the body as the disease progresses. [2]

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Signs of Early Rheumatoid Arthritis

Primarily, rheumatoid arthritis is an autoimmune disease in which the body’s immune cells attack and damage the cartilage around the joints. This connective tissue is two to four millimeters thick and provides a smooth, lubricated surface for the bones to move and ease friction. It also has a limited capacity to heal and repair itself. [3]

The uncontrolled, immune inflammatory response damages the cartilage and, eventually, the bone underneath. [4] RA inflammation leads to partial or permanent disability in most people. Further, rheumatoid arthritis also damages the synovial membranes, or lining of the joints. These membranes produce fluid, which nourishes and lubricates the joints. Synovitis, or inflammation of the synovial membrane, can further the destruction of the joint and worsen the accompanying symptoms. [5]

Early rheumatoid arthritis—which is characterized by symptoms that have persisted for no more than three months—typically affects only the smaller joints in the [2]:

  • Fingers and hands
  • Toes and feet

What differentiates rheumatoid arthritis from other types of this disease, like osteoarthritis vs. arthritis, is its symmetry. In other words, it affects the joints on both sides of the body. For example, if your right fingers feel pain, so too will your fingers on your left hand. [6]

The disease typically develops in people aged 30 to 60; although it can affect people of any age—even children. [6]

All that said, early symptoms of rheumatoid arthritis in hands and feet include [6]:

  • Joint pain – Persistent discomfort in the affected joints
  • Joint swelling – Swelling around the joints, leading to a feeling of warmth and tenderness
  • Morning joint stiffness – Stiffness lasting more than 30 minutes, especially in the morning
  • Rheumatoid nodules – Firm bumps or nodules beneath the skin, often over pressure points or joints
  • Reduced range of motion – Decreased ability to move the affected joints through their full range of motion

The inflammatory nature of rheumatoid arthritis not only can result in joint pain and stiffness but also can trigger a systemic response in the body. The chronic pain can lead to fatigue, which goes beyond mere tiredness and can be overwhelming. The constant discomfort and limited mobility due to joint pain can also make even simple tasks challenging for an RA patient. [6]

As the disease progresses, it’s not uncommon for RA symptoms to dissipate and then arise again. During remission, people may be completely asymptomatic. Factors that may trigger a resurgence include [6]:

  • Weather changes
  • Feelings of stress
  • Diet changes
  • Infections
  • Decreased physical activity

Risk Factors of Rheumatoid Arthritis

  • Family history – Understanding your family's medical history is crucial in assessing your risk for rheumatoid arthritis, raising the question: is arthritis hereditary? A rheumatologist can evaluate the presence of any genetic predispositions, offering insights into potential hereditary factors influencing the development of this condition. This knowledge aids in creating a personalized risk profile for informed decision-making and proactive management.
  • Sex – Your assigned gender at birth plays a role in the susceptibility to rheumatoid arthritis, with women and people assigned female at birth (AFAB) being more commonly affected. A rheumatologist can discuss the gender-specific aspects of the disease and consider hormonal influences or imbalances that may be relevant to you.
  • Lifestyle habits – Lifestyle choices significantly impact the risk of developing rheumatoid arthritis. A rheumatologist can delve into your daily habits, including diet, physical activity, and stress management. Namely, smoking is a likely risk factor for rheumatoid arthritis and may even worsen your symptoms if you’re already experiencing early rheumatoid arthritis. Collaboratively, you can explore lifestyle modifications that may mitigate risk factors and promote your joint health.
  • Health status – A rheumatologist considers factors such as existing medical conditions, immune system status, and overall well-being. In particular, obesity may play a role in rheumatoid arthritis due to its link to chronic inflammation. Extra weight can also add pressure to the joints and worsen your symptoms.

The Importance of Early Detection of Rheumatoid Arthritis

If you’re newly experiencing joint pain and stiffness that has persisted for several weeks to several months, it’s time to visit a healthcare provider.

Joint damage is often irreversible and your body cannot fully heal damage to the cartilage, lining, and bones. It’s critical to diagnose the disease as early as possible to [7]:

  • Prevent the erosion of the joints
  • Prevent the progression of the damage
  • Increase your chances of going into remission

Namely, during the initial diagnosis, your healthcare provider will assess your symptoms to differentiate it from other types of arthritis, such as undifferentiated inflammatory arthritis, which will affect your treatment plan. Additionally, if diagnosis is delayed, more aggressive therapy may be required. [7]

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On the other hand, early treatment—when diagnosed properly—may have a curative effect on some people.

Diagnosing Rheumatoid Arthritis

Diagnosing rheumatoid arthritis requires a comprehensive evaluation considering various factors. One crucial aspect is clinical symptoms, such as joint pain, swelling, and morning stiffness. However, these symptoms can indicate other conditions, making it essential to rely on a combination of clinical assessments and specific diagnostic tests. [6, 7]

To verify your diagnosis, the American College of Rheumatology (ACR) provides several criteria to further consider, including [8]:

  • Duration of the symptoms – Symptoms persisting six weeks or longer may indicate chronic inflammation
  • The number of affected joints – Pain and swelling in two or more joints may point towards rheumatoid arthritis

A healthcare provider will also order various tests. Your healthcare provider will likely conduct a blood test to assess your levels of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies. Tested antibodies may also include erythrocyte sedimentation rate (ESR), which can indicate RA inflammation, and C-reactive protein (CRP). [6, 7, 9]

Elevated levels of these antibodies in the blood may suggest that you have rheumatoid arthritis, although not everyone with the disease has positive results. [6, 7, 9]

Imaging studies like X-rays and magnetic resonance imaging (MRI) scans can also help assess joint damage and provide additional insights into how to customize your treatment plan. [7]

Managing Rheumatoid Arthritis

If you believe you may have rheumatoid arthritis, it’s critical to get a diagnosis within the first two years of experiencing your symptoms. During this window, there is a likelihood that you can prevent long-term joint damage. [6]

Initially, you may be prescribed a type of drug to ease joint pain, swelling, and inflammation. This may include [6]:

  • Non-steroidal anti-inflammatory drugs (NSAIDs) – NSAIDs are often prescribed initially. They help alleviate joint pain, relieve swelling, and reduce inflammation to improve your symptoms. These drugs include ibuprofen, naproxen, and aspirin, as well as COX-2 inhibitors like celecoxib.
  • Corticosteroids – Corticosteroids may be part of the treatment plan to address severe symptoms. These drugs help control inflammation quickly and can be administered orally or through injections, offering prompt relief. These include prednisone and cortisone.
  • Disease-modifying antirheumatic drugs (DMARDs) – DMARDs are pivotal in managing rheumatoid arthritis. These drugs, such as methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide (Arava®), work to slow down the progression of the disease, preserving joint function and preventing long-term damage. JAK inhibitors may also be prescribed to patients who don’t initially respond to methotrexate.
  • Biologics – If you fail to respond to the drugs listed above, your healthcare provider may prescribe biologics to tackle inflammation at a cellular level. These drugs typically have rapid effects and include etanercept, infliximab, and adalimumab, among others.

Additionally, making a few lifestyle changes may help to alleviate your symptoms. For example, eliminating unhealthy fats, salts, and processed carbs from your diet may help to reduce some inflammation within the joints. If you’re carrying extra weight, your healthcare provider may also recommend that you adopt a weight loss plan to ease the amount of pressure being put on your joints. [6]

If chronic inflammation caused by rheumatoid arthritis leads to severe joint damage, surgery may be necessary, particularly in the knees and hips. [6]

Seek Answers Sooner With Everlywell

The signs and symptoms of rheumatoid arthritis may be subtle at first, affecting only your fingers and toes. However, as the disease develops it can cause severe damage to your joints and bones that can impact your mobility.

If you’re experiencing pain or swelling of the joints, make an appointment with an Everlywell healthcare provider through our virtual care visits. They’re discreet and convenient, allowing you to log on from the comfort of your own home to discuss your symptoms one-on-one.

Once our healthcare providers have assessed your situation, they can provide you with recommendations regarding changes to your lifestyle, particularly if you’re looking to lose weight to help manage your symptoms. Because at Everlywell, we’re with you every step of the way.

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Osteoarthritis vs. Arthritis: How Are They Different?

Is Arthritis Hereditary? Genetics and Potential Causes

Does Chicken Cause Inflammation?

References

  1. World Health Organization: WHO, World Health Organization: WHO. Rheumatoid arthritis. Published June 28, 2023. Medical Citation URL. Accessed February 4, 2024.
    2. Rheumatoid arthritis - Symptoms and causes - Mayo Clinic. Mayo Clinic. Published January 25, 2023. Medical Citation URL. Accessed February 4, 2024. Fox AM, Bedi A, Rodeo SA. The basic science of articular cartilage: structure, composition, and function. Sports Health. 2009;1(6):461-468. doi:10.1177/1941738109350438. Medical Citation URL. Accessed February 4, 2024. Rannou F, François M, Corvol MT, Berenbaum F. Cartilage breakdown in rheumatoid arthritis. Joint Bone Spine. 2006;73(1):29-36. doi:10.1016/j.jbspin.2004.12.013. Medical Citation URL. Accessed February 4, 2024. Ostrowska M, Maśliński W, Prochorec‐Sobieszek M, Nieciecki M, Sudoł‐Szopińska I. Cartilage and bone damage in rheumatoid arthritis. Reumatologia. 2018;56(2):111-120. doi:10.5114/reum.2018.75523. Medical Citation URL. Accessed February 4, 2024. Professional CCM. Rheumatoid arthritis. Cleveland Clinic. Last reviewed February 18, 2022. Medical Citation URL. Accessed February 4, 2024. Rheumatoid Arthritis: Early diagnosis and treatment outcomes. PubMed. Published 2011. Medical Citation URL. Accessed February 4, 2024. Rheumatoid arthritis. American College of Rheumatology. Medical Citation URL. Accessed February 4, 2024.
  2. Gr P, Dihingia P, Jha A, Gadgade A, Agarwal D. Rheumatoid Arthritis Co-relation with Anti-CCP Antibodies with special reference to its Prevalence in Asymptomatic First-Degree Relatives. Mediterranean Journal of Rheumatology. 2022;33(1):42. doi:10.31138/mjr.33.1.42. Medical Citation URL. Accessed February 4, 2024.
Jordan Stachel, M.S., RDN, CPT is most fulfilled when guiding others towards making stepwise, sustainable changes that add up to big results over time. Jordan works with a wide variety of individuals, ranging in age from children to the elderly, with an assortment of concerns and clinical conditions, and has written for publications such as Innerbody. She helps individuals optimize overall health and/or manage disease states using personalized medical nutrition therapy techniques.
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