The symptoms and signs: Joint stiffness, particularly in the hands and feet, in the mornings when getting up from bed. A telling sign can be that the stiffness is experienced in either both hands or both feet - not just one. Stiffness that lasts for over an hour, or pain and swelling that persists for more than a month or so may also be indicative of rheumatoid arthritis.



Early symptoms may also include fever, excessive tiredness or nodules under the skin - these feel like pea-size lumps. Other possible symptoms are anemia, fluid collecting on the ankles or behind the knee and loss of appetite. In children, a pink rash may follow the characteristic swollen joints and there may be shaking chills.

Why the condition is painful: Cartilage does not cause pain (it has no nerves to transmit pain signals), so it is thought that irritation of other tissues in and around the joint affected is the cause of the joint pain typical of rheumatoid arthritis. However,the relationship between joint pain and cartilage destruction is still not fully understood.

The irritation in the joint may be caused by 'chemical messengers' such as prostaglandin E2 that have been found to be associated with the disease process. For this reason, administration of non-steroidal anti-inflammatory drugs (NSAIDs) helps as it inhibits production of prostaglandin.

Joint pain that is similar to that caused by rheumatoid arthritis can be caused by a number of other conditions. Among these are chronic fatigue syndrome, fibromyalgia and even bunions. Only a doctor can identify the cause accurately, as similar symptoms can result from other autoimmune-related conditions from other kinds of arthritis to serious conditions such as cancer.

Other factors: The disease is more common in older people, though it can occur at any age, even in children (Still's disease). Studies have suggested that a high body mass index, particularly in women, may increase the risk of contracting the disease. Also, obesity places a greater strain on joints and may contribute to the breakdown of joint tissue in rheumatoid arthritis. Overweight people are also at greater risk from other forms of arthritis.

Self-care: This can be managed by adopting a regime that includes the following -

Balancing exercise sessions with periods of rest

Eating healthy foods

Caring for your emotional health during times of stress

Protecting your joints during everyday tasks

Applying local treatments for joint pain

Adopting healthy habits in general

All these factors can reduce the need for medication.

Exercise: Consult your physical therapist or doctor to help you formulate an exercise program that uses the full motion range of your joints and strengthens muscle. Plan for plenty of rest between exercises but keep up a daily program even if you don't feel like it - your mood should improve, joint pain lessen and you should sleep better.

Although some discomfort is to be expected this should only last for a short time after exercise - any new joint pain or other sharp pains need to be referred to your doctor for advice on how to proceed.

Although rheumatoid arthritis is not a condition to take lightly, it can be controlled to some degree. Early diagnosis helps reduce loss of mobility and joint pain caused by the disease in advanced form, so the best advice this article can give is to see your doctor immediately if you suspect you have the symptoms of rheumatoid arthritis, especially if you experience stiffness and joint pain.

All advice in this article is given in good faith but does not pretend to replace the diagnosis or professional advice of a qualified medical doctor.