How does rheumatoid arthritis usually begin?

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Rheumatoid arthritis typically begins with a gradual onset, most commonly attacking the joints of the hands and feet in a symmetrical pattern before potentially spreading to the wrists, knees, or shoulders.1

Early symptoms often include pain and stiffness in one or more small joints, which are generally followed by swelling and heat. These physical signs may be accompanied by muscle pain, fatigue, muscle weakness, and weight loss. In some cases, individuals may experience coldness, numbness, or tingling in the hands and feet before more prominent symptoms appear, which can indicate compression of the vasomotor nerve. Because these early symptoms can resemble other conditions, diagnosis is often confirmed through blood tests—such as those for rheumatoid factor—and imaging.1