Rheumatoid arthritis isn't your grandmother's arthritis

For Stacy Courtnay, it all started with her stilettos. When she began experiencing intense foot pain twenty years ago, she attributed it to frequently wearing the towering, skinny-heeled shoes.

"I bought all new shoes, and I was wearing flats. Nothing was getting better," she remembers. "It truly was like ice picks or like somebody beating my feet."

It was a podiatrist who first mentioned rheumatoid arthritis, but she brushed it off, assuming she was too young for such a diagnosis. But the pain soon spread to her shoulders and wrists, and within months, the 23-year-old newlywed was relying on her husband to carry her and assist with simple tasks like brushing her hair and drinking from a cup. 

When she finally saw a rheumatologist, it was confirmed: Courtnay was diagnosed with rheumatoid arthritis shortly after her 24th birthday, just about four months after first exhibiting symptoms.

"Your first thought, which everybody says, 'you're too young,' you know? And everybody says, 'I thought this only happened to old people.' And so that was my first thought too, like, how could this be happening? How could my body turn on me like this?" Courtnay, now 44, says. "Like, I'm so healthy. I've exercised. I do everything right. And how could my body do this to me?"

There are more than 100 forms of arthritis and related diseases, according to the Arthritis Foundation, and rheumatoid arthritis and osteoarthritis are two of the most common. The Centers for Disease Control and Prevention reports arthritis affects 58.5 million Americans. 

Rheumatoid arthritis, or RA, is an autoimmune disorder in which the immune system, which protects the body against viruses and bacteria, becomes active against the body's own healthy tissues. It can affect people at nearly any age. RA often affects joints symmetrically — for instance, a patient will experience pain in both feet or both hands.

The Arthritis Foundation estimates 1.3 million people in the U.S. have RA. It's twice as common in women than men.

"Rheumatoid arthritis is a primarily inflammatory condition, so what I hear from my patients with rheumatoid arthritis is when they wake up in the morning, their joints feel very stiff, sometimes swollen. They have pain and tenderness, explains Dr. Ashira Blazer, assistant professor and academic rheumatologist for the Hospital for Special Surgery in New York City. "It improves with movement or putting the hands particularly under hot water, and this stiffness lasts for over 30 minutes, sometimes up to an hour or two or longer."

Osteoarthritis, or OA, is the type most people know simply as arthritis. It's caused by degenerative wear and tear on the joints. Over time, the cartilage or meniscus becomes damaged, leading to joint injury and pain.

"OA does more classically happen in older adults, but we're seeing it happen younger and younger for a couple reasons. Osteoarthritis is one of these conditions that goes along with overall difficulty with metabolism. So, the more that we see things like obesity, diabetes, hypertension, metabolic syndrome, we're also seeing OA," says Dr. Blazer. "Just as those conditions are happening in people younger and younger, OA is happening in younger and younger people."

Arthritis is also a leading cause of work disability in the U.S., with annual costs for medical care and lost earnings of $303.5 billion, the CDC reports. 

Jen, 45, who asked CBS News not to use her last name for privacy reasons, says her RA diagnosis has kept her from pursuing her dream of running her own production company. She still works full time as a video editor, but with RA, she couldn't put in the additional hours necessary to build the business on the side.

"Seventy hours a week does not mix with rheumatoid arthritis. I'm still employed. I still support my family. But I had to pull back on additional work, additional things I was striving for in my career," she said. "[RA] definitely played a role in how much additional I can push myself outside of my job for my career."

Courtnay left her job shortly before having her first child. She was often leaving work early or missing days, and the pain and fatigue of RA necessitated daily naps. She feels fortunate she and her husband could afford for her to quit her job.

"It was a blessing that I was able to stay home. People in that much pain, like, sometimes they don't have a choice, and they still have to go to work. And I don't know how I physically could have gone to work if I was having to do that, financially."

Both women share their frustration with the unpredictability of RA. Many patients can be fine one day but have debilitating pain the next. When Courtnay's son was young, there were times she was in so much pain, all she could do was lie on the floor and cry.

"When my son was younger, and he's at the age where I'm supposed to be outside playing and running football with him, and you know, I'm like, nope. One, I'm either in pain, or two, I'm in bed. [There's] lots of events that I've missed out on. Like if my husband and I had a birthday party for friends or something and we're supposed to go to dinner, I mean, there are many nights where I'm like, all right, you go, I'm staying home," she says.

Jen echoes those sentiments. 

"There are certain days that I can't wear nice shoes because my feet hurt so much. And then other days I could go for a run and be fine," she says. "There are days that I am totally fine. And there are other days I can't open my bottle of water, and I have to ask my 11-year-old to do it because it hurts so bad."

Rheumatoid arthritis patients are also susceptible to other medical conditions, including cardiovascular disease, lymphoma, and other autoimmune illnesses such as Sjögren's syndrome, a condition that causes dry eyes and mouth.

Dr. Blazer stresses that if people suspect their pain could be rheumatoid arthritis, they should be seen by their physician as quickly as possible. 

"If you catch it early and you get on adequate therapy early, you're more likely to protect your joints from any sort of injury. You're less likely to end up with those long-term comorbidities we worry about, like cardiovascular disease. So, early detection is the key, and if you're concerned, definitely go see someone."