Rheumatoid arthritis causes joint pain, stiffness, and swelling. Other symptoms throughout your body include fever, fatigue, and nodules under your skin. Rare symptoms can affect your eyes, mouth, and lungs.

Rheumatoid arthritis (RA) is an autoimmune disease. When someone has RA, their immune system mistakenly attacks the joints as well as other organs and tissues.

As the name of the disease suggests, the most common symptoms of RA involve your joints. (Arthritis means “inflammation of the joints.”) Additional symptoms are due to the widespread effects of an overactive immune system.

While joint symptoms are most common, other symptoms may occur less frequently or indicate more advanced disease.

The primary symptom of RA is joint pain and swelling. Symptoms usually begin in the smaller joints. RA typically starts in the fingers (knuckles) and wrists. Other joints commonly affected by RA include:

Affected joints may feel warm and spongy to the touch.

Joint damage from RA is usually symmetrical. This means that if your left hand is affected, your right hand will be as well.

Symmetrical symptoms are one of the things that distinguish RA from osteoarthritis (OA). Since OA is due to physical wear and tear on joints, it’s less likely to be symmetrical. OA is the type of arthritis most people associate with aging or an injury that occurred years before.

What does rheumatoid arthritis pain feel like?

People often describe joint pain from RA as:

  • intense
  • sharp
  • throbbing
  • burning
  • gnawing

Prolonged stiffness upon waking is another symptom that can help distinguish RA from other forms of arthritis. This stiffness usually lasts 1 to 2 hours after waking. (OA stiffness is brief upon waking and worsens throughout the day.)

Research suggests that morning stiffness may often be the first symptom of RA, appearing before other clinical signs.

You may also experience stiffness after other long periods of inactivity, such as sitting.

Inflammation from RA can lead to weakness and general fatigue. People describe it as overwhelming exhaustion that affects the whole body — more severe than typical tiredness. RA fatigue can affect your mood and reduce your motivation.

RA inflammation can also affect red blood cell production, leading to anemia. Fatigue is a hallmark symptom of anemia.

However, fatigue isn’t unique to RA. Without other RA symptoms, fatigue may likely be due to a different condition.

Many people with RA experience a low grade fever (under 100°F or 38ºC) for several hours after waking up. An increase in body temperature is part of your body’s typical response to inflammation. RA may also affect your metabolic rate, which affects your body temperature.

Like with fatigue, many other health conditions can cause fever, even the common cold. A doctor usually doesn’t suspect RA until joint symptoms appear.

Rheumatoid nodules are hard, flesh-colored lumps that may appear under the skin of the arms. They can range from pea-sized to walnut-sized. They may be either movable or firmly connected to tendons under the skin and tend to occur at points of pressure, like the elbows or heels.

Rheumatoid nodules are a symptom of advanced RA. They’re the most common RA symptom outside of the joints.

Rheumatoid arthritis flares

People with RA often experience periods where symptoms suddenly appear or worsen. These are called flares.

They’ll also experience periods of remission, when symptoms don’t affect them as much.

According to a 2020 study, about 8.7% of people with RA also have Sjögren disease. This is a condition where your immune system attacks the salivary glands and tear ducts. It can cause:

  • dry or gritty sensations in the eyes, mouth, and throat
  • cracked or peeling lips
  • difficulty talking or swallowing
  • dental damage

Some people with RA also experience other discomfort in their eyes, including:

  • burning
  • itching
  • light sensitivity

Some people with severe or advanced RA may develop heart and lung complications, such as:

These can cause severe tightness or sharp pain in the chest when breathing. Seek immediate medical help if you experience any of these symptoms with RA.

The Arthritis Foundation recommends seeing a doctor if you experience joint pain, swelling, or stiffness that lasts 3 days or more or if you’ve had several episodes of joint pain in the last month. A primary care doctor may refer you to a rheumatologist for a diagnosis.

If you already have an RA diagnosis but find that your symptoms are bothering you even with treatment, your doctor can consider your symptoms and adjust your treatment plan.

Various treatments are available to help you manage RA symptoms, including:

You can also make several lifestyle changes to help manage symptoms and reduce the frequency and severity of flares. Experts recommend:

Joint pain, swelling, and stiffness are the primary symptoms of RA. However, widespread inflammation can affect other parts of the body, such as the skin, lungs, and circulatory system. Other common symptoms include rheumatoid nodules, fatigue, and fever.

If you experience joint pain for several days, talk with a doctor. They can determine if RA is the cause of your symptoms and get you started on a plan to help manage them.

If you’re looking to connect with other people to share experiences of RA symptoms, resources like Healthline’s Bezzy RA offer an online safe space for community, peer and expert guidance, and support.