Rheumatoid arthritis (RA) is an autoimmune condition that causes chronic inflammation. With RA, your immune system attacks your body’s tissues and causes painful swelling of the joints. Without treatment, RA can cause severely deformed joints.
The most obvious signs are in the hands and feet. Imaging tests like X-ray, computed tomography (CT) scan, and magnetic resonance imaging (MRI) help doctors assess the severity of joint damage.
RA can also affect other parts of the body, including skin, blood vessels, eyes, and lungs. People with RA may also battle fatigue and general weakness.
Keep reading to learn more about how RA affects the body.
One of the distinguishing features of RA can be seen in the hands. Swelling of the knuckle joints and wrists leads to severe pain and stiffness, especially in the morning. Chronic inflammation can cause the fingers to twist in an outward direction. This can take a toll on fine motor skills. In advanced cases of RA, the hands can become disfigured and interfere with quality of life.
Nonsurgical treatments involve medications, injections, and splinting. Splinting helps support the joints but shouldn’t be worn for too long, as it leads to muscle deterioration. If these treatments don’t work, you may need surgery.
Ankle and heel
More than 90 percent of people with RA develop symptoms in the foot and ankle. Inflammation causes damage to the ligaments and tissues that support your bones. This causes the ankle and back of the foot to move out of alignment. If the ankle and heel can’t move properly, it can be difficult to walk, especially on uneven surfaces, hills, and stairs. Inflammation of the ankle and heel cause pain on the outside of the foot. Besides your standard RA treatment, you can also get an insert to minimize pressure or use an ankle brace to support your joints.
Middle of the foot
As the ligaments and cartilage of the foot continue to deteriorate, the arch of the foot can collapse. With flat foot, the shape of the entire foot begins to shift. Some people with RA develop large, bony bumps, corns, or calluses on the ball of the foot. These can be painful and make it very difficult to find comfortable footwear. Special shoe inserts can help improve the arch.
Front of the foot
When the arch falls, it puts pressure on the toes and the front of the foot starts to point outward. Toes become twisted and may cross over each other, especially the big toe. Many people with RA develop bunions, calluses, or claw toes. The combination of problems from the ankle to the toes causes pain throughout the foot. Over time, people with RA may be inclined to avoid standing or walking. In severe cases, surgery can help correct this by fusing the affected bones.
Severe damage can cause the toes to take the shape of claws. The small toes take on a prominent appearance as they bend upward and then point downward at the middle joints. Sometimes, toes curl under the foot. Added pressure on the toes can cause skin ulcers and calluses. In time, claw toes can become rigid and unable to flex inside a shoe. Claw toe is a progressive condition.
In the early stages, you can wear soft shoes and stretch your toes into a normal position. Toe exercises, such as using your toes to pick up marbles, may also help. In the later stages when your toes are fixed, you can use a special pad or shoes to accommodate your toes.
When your big toe bends toward the second toe, it causes a bump to form on the joint at the base of the big toe. This is known as a bunion. Because the foot must carry the body’s weight when you walk, bunions can be very painful. A bunion can also form on the outside of the little toe. This is called a “bunionette” or “tailor’s bunion.” The misshapen area in front of the foot makes it difficult to find shoes that are wide enough at the front. Home treatments for bunions include wearing wider shoes, avoiding high-heels, and applying ice packs to reduce swelling. Surgery can also help correct bunions in severe cases.
RA can also attack the joints of the knees, causing inflammation. This also makes it difficult to bend or straighten the knee. Imaging tests like X-rays and MRI can clearly show the extent of the damage. Typically, there’s a loss of joint space due to damaged cartilage and an outgrowth of bone, known as bone spurs or osteophytes. In advanced cases, bones can grow together and fuse. Treating knee arthritis involves medications and lifestyle modifications, such as physical therapy and assistive devices like a cane or knee sleeve.
Some people with RA, particularly those with more severe disease, form rheumatoid nodules. These are small, firm lumps that develop under the skin, usually near joints that are inflamed. The nodules can be small, or as large as a walnut. No treatment is required. Certain medications can help reduce the size of larger nodules that are bothersome. In some cases, they can be surgically removed. Usually, the nodules are painless and pose no risk.
While joints are the most obvious sign of RA, this disease can also cause inflammation in other parts of the body, too.
RA inflammation can also affect:
- eyes (scleritis)
These complications are more likely in very advanced cases of RA. While there’s no cure for RA, medication, assistive devices, surgery, and other treatments can ease symptoms and improve quality of life.