Rheumatoid arthritis (RA) is a type of arthritis that causes painful, swollen, and stiff joints. This is because RA involves the immune system, which mistakenly attacks your body’s own tissues. In addition to the joints, symptoms of RA include:
- fatigue, particularly during the day
- unintended weight loss
But beyond the typical arthritis symptoms, RA can also cause unusual and unexpected symptoms like difficulty breathing and dry eyes. This is because RA can spread to other organs in your body, such as the:
It can also affect your blood vessels and nervous system. Sometimes the drugs your doctor prescribes cause known side effects. If you are facing a new RA diagnosis, learning how RA affects your body can help your treatment plans.
It’s important to report any new symptoms early to your doctor so they can help you manage your condition.
Read on to find out what “uncommon” symptoms you want to look for. They may also reflect how the disease is progressing.
Heart and blood
Inflammation from RA can spread and damage your heart, heart lining, and blood vessels. Atherosclerosis, which is damage, and plaque and cholesterol buildup, in the blood vessels, can lead to heart attacks and stroke. Research shows that people with RA have a 60 percent higher risk for heart attacks after a year of living with the disease.
Atherosclerosis usually doesn’t have symptoms until it becomes very serious. Most people don’t know they have this condition until they experience a heart attack or stroke. In some cases, you may feel chest pain or restriction.
Talk to your doctor about your risk for heart and blood vessel inflammation. You can manage certain risk factors such as weight, diet, and medication.
Some medications such as disease-modifying anti-rheumatic drugs (DMARDs) and methotrexate can lower your cardiovascular risk. Nonsteroidal anti-inflammatory drugs (NSAIDs) may increase this risk.
Inflammation can also affect the lining of your lungs and cause scarring. One in 10 people with RA will develop interstitial lung disease (ILD), a life-threatening condition that can cause heart failure. Inflammation in the lungs can also cause other complications such as bronchitis, pleurisy, or small growths in the lungs (intrapulmonary nodules).
Inflammation in the lungs usually doesn’t have symptoms until the later stages. But scarring in the lungs can eventually cause shortness of breath and decreased oxygen in the blood.
Some lung diseases are treatable with anti-inflammatory medications. But if a condition like ILD develops and is severe, your doctor may put you on a waiting list for a lung transplant.
Talk to your doctor if you have trouble breathing, especially during exercise or physical activity.
The eye conditions that may be caused by RA include:
- scleritis, inflammation in the white of the eye
- uveitis, inflammation in between the retina and the white of the eye
- Sjögren’s syndrome, which also causes dry mouth
Your immune system, in this case, attacks your glands that produce saliva and tears, causing dryness and tissue scarring. This also affects the mouth and increases your risk for ulcers.
Dry mouth increases your risk for oral bacterial infections that may lead to tooth decay and gum disease.
Medications can also affect your eyes and mouth. Corticosteroids and hydroxychloroquine can affect your vision, while methotrexate can cause dry mouth and mouth sores.
Other than dry eyes and redness that doesn’t go away with eye drops, inflammation can cause symptoms of blurred vision and sensitivity to light. It’s important to tell your doctor about any eye symptoms. The Arthritis Foundation advises people with RA to get yearly eye checkups. Untreated uveitis can cause blindness.
For dry mouth, medications can be helpful in increasing saliva production.
Neuropathy in RA has several mechanisms, including vasculitis resulting in inchemia to the nerve and pain (monocuritis multiplex). Sensory symptoms may develop as carpal tunnel syndrome. Carpal tunnel can affect how you grip objects and your ability to use devices or type on the computer.
Nerve compression results in numbness or tingling in your limbs. In carpal tunnel syndrome, the numbness runs from the wrist up the forearm. You may also experience decreased grip strength.
Talk to your doctor if you are experiencing any numbness or tingling.
Chronic inflammation can cause your bones to become thin and brittle. This loss of bone density, or osteoporosis, increases your risk for bone fractures. Studies show that bone loss in people with RA occurs mostly around the affected joints. If you are on corticosteroids for RA, this medication can also thin your bones.
Loss of bone density doesn’t often have symptoms until the later stages. Early signs of brittle bones may appear as weak nails or back pain.
You can also take steps to prevent bone thinning with a high-calcium diet, vitamin D, and weight-bearing exercises. Also talk to your doctor if you’re concerned about your bone health.
Skin and nails
Vasculitis can cause skin rashes and ulcers on the legs or around the nails. Skin rashes will look like small red dots. This condition usually develops after you’ve had RA for a long time.
Symptoms include small red dots on the skin, or in severe cases, ulcers around the fingernails and on the legs. Vasculitis is very serious if not treated, but can be controlled with RA medications.
Treating skin rashes involves treating the underlying inflammation with corticosteroids, NSAIDs, or DMARDs. These medications can also cause other side effects such as easy bruising, sun sensitivity, or thinning of the skin.
Sometimes flu-like symptoms aren’t the flu, but RA. With RA, your immune system is attacking tissue in your joints, and so you may experience some of the general symptoms of inflammation throughout your body. This can feel like the flu, with fatigue, a low-grade fever, and loss of appetite.
You may feel the typical symptoms of illness such as high temperature, sweating, and loss of appetite. Most people also feel fatigue and experience general weight loss as a result of not eating, and from the inflammatory process itself. It’s also possible to get post-viral arthritis after a viral illness. A virus can intensify the pain in swollen joints for several weeks or months.
RA doesn’t just affect the joints. As a systemic disease, RA can spread to other parts of your body and cause symptoms that you may not associate with RA.
Talk to your doctor about any new symptoms you’re experiencing. You may be able to manage or resolve some of the symptoms by adjusting your medication. Other conditions, such as lung diseases, have better treatment options when diagnosed early. Early treatment increases your outlook and quality of life.