Rheumatoid Arthritis Symptoms: A Patient's Journey

Rheumatoid Arthritis

Hello, doctor.
I would like to inquire about the symptoms of rheumatoid arthritis.
At the beginning of this year, I started experiencing pain in my knee joint and consulted a rheumatologist who performed a physical examination and said everything was fine.
Later, I visited an orthopedic doctor who suggested it was likely just inflammation and prescribed medication for me.
However, I experienced side effects of palpitations, so I did not take the medication.
As a result, the joint pain persists, and recently I have also experienced symptoms of numbness and weakness in my hands and feet.
The numbness in my hands extends from my entire arm to my fingers, while the numbness in my feet extends from my thighs to my toes.
Occasionally, my palms, fingers, and toes also experience pain.
Thank you, doctor, for patiently reading my concerns.

Ms. Li, 20~29 year old female. Ask Date: 2023/06/27

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your question.
I believe that after the onset of joint symptoms followed by neurological symptoms, it is advisable to: 1.
Return to the rheumatology department for a reevaluation by the physician.
Rheumatic diseases can present with both joint and neurological symptoms, which may raise the physician's awareness.
2.
You may also consider consulting a neurologist to assess the type of neurological issue.
Neurologists have experience with certain neurological symptoms that may be related to rheumatic diseases, so their evaluation can also be beneficial.
The Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare, is concerned about your well-being.

Reply Date: 2023/06/27

More Info

Rheumatoid Arthritis (RA) is a chronic autoimmune disorder characterized by inflammation of the joints, which can lead to pain, swelling, and eventual joint damage. Understanding the symptoms and the patient's journey through diagnosis and treatment is crucial for effective management of the disease.

In your case, the onset of knee pain earlier this year, followed by numbness and weakness in your hands and feet, raises several important considerations. RA often presents with symmetrical joint pain, which means that if one knee is affected, the other knee is likely to be affected as well. The pain can be accompanied by morning stiffness, which typically lasts for more than 30 minutes. In contrast, osteoarthritis (OA) usually presents with pain that worsens with activity and improves with rest.

The symptoms you describe, including numbness and weakness in your limbs, could indicate nerve involvement, which is not uncommon in RA due to inflammation affecting nearby nerves or even systemic effects of the disease. Peripheral neuropathy can occur in RA patients, often due to inflammation or as a side effect of medications. It is essential to differentiate whether these symptoms are directly related to RA or if they might be due to other conditions, such as carpal tunnel syndrome or even a herniated disc affecting nerve roots.

Regarding your treatment journey, it is understandable to feel overwhelmed, especially when medications cause side effects like palpitations. It is crucial to communicate these side effects to your healthcare provider, as they may be able to adjust your medication regimen or suggest alternatives that are more tolerable. Disease-modifying antirheumatic drugs (DMARDs) are often used in RA to slow disease progression and reduce joint damage. Methotrexate is a common first-line treatment, but there are other options available if side effects are intolerable.

In addition to medication, physical therapy can be beneficial for maintaining joint function and reducing pain. Gentle exercises, stretching, and strengthening can help improve mobility and reduce stiffness. Occupational therapy may also assist in adapting daily activities to minimize strain on affected joints.

It is also important to monitor your symptoms closely. Keeping a symptom diary can help you and your healthcare provider identify patterns, triggers, and the effectiveness of treatments. Regular follow-ups with your rheumatologist are essential for adjusting treatment plans based on your evolving symptoms.

Lastly, consider seeking support from patient advocacy groups or counseling services. Living with a chronic condition like RA can be emotionally taxing, and connecting with others who share similar experiences can provide comfort and practical advice.

In summary, RA is a complex disease that requires a multifaceted approach to management. Open communication with your healthcare team, a proactive approach to symptom management, and support from peers can significantly enhance your quality of life. If you continue to experience significant symptoms or side effects from medications, do not hesitate to reach out to your healthcare provider for further evaluation and adjustment of your treatment plan.

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