Rheumatoid Arthritis: What It Is, Causes, and Early Signs

When people hear the word arthritis, they often think of something that happens as we get older, or a wear-and-tear condition that comes from years of use. Rheumatoid arthritis, or RA, is very different. RA is an autoimmune disease, which means it can affect people at any age and it does not just involve the joints.

In a healthy body, the immune system acts like a well-trained security team. Its job is to recognize real threats, such as viruses and bacteria, and protect the body from them. With RA, that system gets confused. Instead of defending the body, it mistakenly attacks healthy tissue, especially the joints, as if they were dangerous.

The main target in RA is the synovium, the thin lining inside the joints that allows them to move smoothly. When the immune system attacks this lining over time, it becomes inflamed and thickened. This ongoing inflammation can damage the cartilage, bone, and ligaments that support the joint, leading to pain, stiffness, and loss of function.

What Actually Causes Rheumatoid Arthritis?

The short answer is that we do not know one single cause of rheumatoid arthritis. What we do know is that RA develops when a combination of factors come together and push the immune system off track.

Genetics play a role. If a close family member, such as a parent, sibling, aunt, or grandparent, has RA, your risk is higher. Certain genes, including HLA-DR4, can increase susceptibility. That said, having these genes does not mean you will definitely develop RA. Many people carry them and never do.

Environmental exposures also matter. Smoking is one of the strongest and most preventable risk factors for RA. Other contributors include chronic gum disease, viral or bacterial infections, air pollution, exposure to silica dust, and changes in the balance of bacteria in the gut.

RA is more common in women, who are about two to three times more likely to develop the disease than men. Symptoms can also change during pregnancy, sometimes improving and sometimes flaring, which is one reason hormones are thought to play a role.

When these genetic, environmental, and hormonal factors overlap, the immune system may begin attacking the body’s own tissues. Blood tests, including rheumatoid factor and anti-CCP antibodies, help doctors identify whether RA is present, along with symptoms, exam findings, and imaging.

Early Signs: Don’t Ignore These

Rheumatoid arthritis can be hard to recognize at first. Early on, it often feels vague, like you are run down, coming down with something, or just not quite yourself. Still, there are some early warning signs that are worth paying attention to.

One of the biggest red flags is morning stiffness that lasts longer than an hour. Joints may feel swollen, warm, and tender, often affecting both sides of the body in a similar pattern. This is especially common in the small joints of the hands, particularly the middle and base joints of the fingers, not the tips, as well as the wrists.

Fatigue is another hallmark symptom. Many people describe it as bone deep exhaustion that does not improve, even after a full night of sleep. Low-grade fevers and flu-like symptoms without an actual infection are also common.

Unlike osteoarthritis, pain from rheumatoid arthritis often improves with movement and gets worse with rest. This difference can be an important clue early on.

Some people develop small, firm lumps under the skin called rheumatoid nodules, most often near the elbows or fingers. These usually appear later in the disease, not at the very beginning.

Unfortunately, many people brush off these early symptoms, assuming they have pushed themselves too hard, slept wrong, or are simply getting older. By the time joints are visibly swollen or begin to change shape, the disease may have been active for months or even years.

This is why early diagnosis matters so much. When rheumatoid arthritis is identified and treated early, modern therapies, including biologics and JAK inhibitors, can often bring the disease into remission and help prevent permanent joint damage.

Arthritis in Children (Juvenile Idiopathic Arthritis)

Arthritis does not only affect adults. Children can also develop an autoimmune form of arthritis called juvenile idiopathic arthritis, or JIA.

Like rheumatoid arthritis, JIA occurs when the immune system mistakenly attacks healthy joint tissue. This leads to ongoing inflammation, stiffness, and pain. While the underlying process is similar, the way JIA shows up in children can look very different.

Kids often have a hard time describing what they are feeling, which can make JIA challenging to recognize early. Warning signs may include persistent joint swelling, morning stiffness, limping, unexplained fevers, low energy, or a child favoring one joint and avoiding using it. Because these symptoms can come and go, JIA is sometimes mistaken for growing pains or a minor injury.

Early diagnosis is especially important in children. Ongoing inflammation can interfere with normal growth and joint development if it is not treated. The encouraging news is that with the right care, most children with JIA are able to stay active, keep up with school, and live healthy, full lives.

The Bottom Line

If you are waking up stiff, feeling unusually exhausted, or noticing swelling in your knuckles or wrists, especially on both sides of the body, do not ignore it or try to push through. These symptoms are worth getting checked out by a rheumatologist.

Rheumatoid arthritis is not a minor inconvenience, and it can affect people at any age. The good news is that when RA is identified early, treatment can significantly reduce symptoms, protect the joints, and in many cases, help people achieve remission over time..