Around middle age, it’s normal to start to notice changes in your body — things that are suddenly there that were never there before. But sometimes those things are hard to explain. Why am I so tired all the time? Where did this fever come from? What’s with the stiffness every morning? If you’re suspecting rheumatoid arthritis (RA), you’re not alone, especially if you’re a woman. RA, which causes pain, swelling, stiffness as well as limited motion and function in the joints, often starts in middle age and is most common in older people, affecting more than 1.3 million Americans. 75% of these are women! But kids and young adults can get it, too. Rheumatoid arthritis or osteoarthritis? Unlike osteoarthritis, which is a common form of arthritis that typically comes with age, RA is an autoimmune disease. Your immune system (which normally protects against invaders) attacks your healthy tissues, which in turn affects your joints. No one knows what causes RA, but genes, environment and hormones may all play a role. So how can you know for sure if it’s RA? There are some common signs and symptoms to look out for: Stiffness. This can happen with any joint, but most often, it affects the small joints in the hands and feet and is worse in the morning. If it lasts for 30 minutes or more (for a period of six weeks or more), it’s likely RA. (Osteoarthritis usually does not cause prolonged morning stiffness). Redness, swelling, tenderness or pain. In the early stages of RA, you may not notice redness or swelling, but you could have some tenderness or pain in the joints. This is caused by inflammation, which can affect the organs, such as the eyes or lungs, as well as the joints. Limited motion. You may notice that your joints don’t function as well and you can’t move the way you used to.Also, if more than one joint, or the same joint on both sides of your body, is affected, it could be RA. Loss of energy or fatigue. RA can cause pain that wakes you up at night, disrupting your sleep cycle and making you drowsy during the day. Inflammation from RA can also make you feel tired, since your body is constantly working to fight its own autoimmune response. In fact, fatigue can be one of the first RA symptoms you experience. Low-grade fever. If you have RA, your body may identify an inflamed joint as foreign or infected, and your immune system may become hyperactive to fight it. Your body will produce specific cytokines, which include a molecule that causes fevers. Loss of appetite. This is one of the body’s natural reactions to inflammation. Many people with RA lose weight and muscle, so it’s important to work with your doctor to get the nutrition you need each day. Symptoms that come and go. Symptoms may slowly increase in intensity, or they may ebb and flow. A period of increased symptoms is called a flare, and it can last for days or even months. If you have ongoing inflammation, it could cause problems in other parts of the body: Dry, red or sensitive eyes. RA causes inflammation in your body, which can affect your eyes’ ability to function normally. Dry mouth and irritated or infected gums. Inflammation can wreak havoc on your mouth, too, increasing the risk of infection and irritation. Firm lumps (called rheumatoid nodules). These grow beneath the skin over bony areas, such as the elbows and hands. Inflamed or scarred lungs, which can causeshortness of breath Inflamed blood vessels that can lead to damage in the nerves, skin and other organs How is RA diagnosed? It’s important to diagnose and treat RA early in its course because ongoing high levels of inflammation in untreated RA can do serious damage to your joints. Delaying treatment can cause disabling and irreversible arthritis. To start, your family doctor or a rheumatologist (a doctor who focuses on the joints, bones and muscles) can take a look at your symptoms to determine if it may be RA. But often, it’s not easy to diagnose, since the symptoms are similar to other types of joint disease and can sometimes take time to develop. Your doctor will ask about your personal and family medical history and do a physical exam to look for tenderness, swelling, warmth and painful or limited movement in your joints, as well as other signs, such as fever. You may also have some x-rays or blood tests taken. This will help your doctor determine the amount of inflammation or damage in your joints and other areas of the body. How is RA treated? If RA is the diagnosis, your doctor may suggest medicine, lifestyle changes and/or surgery to help with your symptoms. These can provide pain relief, reduce swelling and inflammation, and keep your condition from getting worse. Sometimes alternative therapies, such as special diets or vitamins, can also help. Ask your doctor what’s best for you.