Rheumatoid Arthritis (RA) Symptoms and Complications

Rheumatoid arthritis (RA) symptoms are different for each person who has this long-term disease.

Some people have long periods with few or no symptoms. Others feel it for months at a time in an uptick of disease activity called a flare. 

Most people have persistent problems with episodes of worsening disease. New and earlier treatment is changing the overall picture, though. More people are having low disease activity or even remission.

RA Symptoms in Your Joints

RA almost always affects your joints. It may take a few weeks or months for the first signs to show. The inflammation it causes results in classic symptoms like:

  • Stiffness. The joint is harder to use and doesn't move as well as it should. It’s especially common in the morning. While many people with other forms of arthritis have stiff joints in the morning, it takes people with rheumatoid arthritis more than an hour (sometimes several hours) before their joints feel loose.
  • Swelling. Fluid in the joint makes it puffy and tender.
  • Pain. Inflammation inside a joint makes it hurt whether you’re moving it or not. Over time, it causes damage and pain. 
  • Redness and warmth. The joints may be warmer and show color changes related to the inflammation.

What Joints Does RA Affect?

RA usually starts in the hands, but it can affect any joint, including your:

  • Elbows
  • Feet
  • Hips
  • Jaw
  • Knees
  • Neck
  • Shoulders
  • Wrists

If you have RA, you’ll notice a symmetrical pattern. It shows up in the same joints on both sides of your body, like both wrists or both hips.

It doesn’t happen often, but RA can also affect a joint in your voice box. It can make your voice hoarse.

Whole-Body Symptoms

Rheumatoid arthritis symptoms can go beyond your joints. You could also feel:

  • Fatigue
  • Muscle aches
  • Poor appetite
  • Bad all over (your doctor may call this malaise)
  • Depression

Extreme fatigue could be a sign of anemia, or a lack of healthy red blood cells. Your doctor will test for this as part of your RA diagnosis.

Depression could also cause some of these symptoms. A chronic disease like RA can be hard to live with. Talk to your doctor if you think RA has you down.

Continued

Symptoms That Affect Your Skin

Some people with RA also get rheumatoid nodules. These are bumps under the skin. Most of the time they aren’t painful and move easily when you touch them.

Most often they appear on your elbows, but they might show up on other bony areas like:

  • The underside of your forearm
  • The back of your head
  • The base of your spine
  • Your Achilles tendon
  • Tendons in your hand

What RA Does to Your Heart and Lungs

RA can damage your lungs or inflame the lining around them. This is called pleurisy. This may not cause symptoms. But you might notice shortness of breath. Your doctor can treat it with drugs that ease the inflammation in the lungs.

Likewise, RA can inflame the lining around your heart (called pericarditis) or your heart muscle (called myocarditis). You probably wouldn’t notice symptoms from that. There’s a chance you could feel shortness of breath or chest pain. If you do, call your doctor. It can also raise your odds of heart failure, atrial fibrillation, and stroke.

RA And Your Eyes

The most common problems are:

Cataracts: A clouding of the lens in your eye that affects your vision

Dry eye syndrome: Whether it’s medications or damage to your tear glands, your eyes can’t make a healthy tear film.

Scleritis: Inflammation and redness in the white part of your eye

Other Body Parts RA Can Affect

Bones: The chemicals that cause inflammation can also take a bite out of your bones. It often affects your hips and spine. Sometimes it’s a byproduct of years of treating RA with steroids.

Liver and kidneys: It’s rare for RA to affect these organs. But the drugs that treat it can. Nonsteroidal anti-inflammatory drugs (NSAIDs) and are bad for both. Cyclosporine can cause kidney disease. Methotrexate can damage your liver.

Immune system: The medications you take can slow it down. This makes you more likely to get infections.

Mucous membranes: You might be more likely to get a condition called Sjogren’s syndrome that dries out moist places in your body like your eyes, mouth, and inside your nose.

Continued

Muscles: When inflammation stops you from moving your joints, the attached muscles can get weak. Or you could get a condition called myositis that weakens them. The medications you take for RA can also be to blame. 

Nerves: RA causes symptoms that range from numbness and tingling to paralysis and sudden death. It can result from joint damage that RA causes, the disease process itself, or medications that treat it.

Blood vessels: RA can cause inflammation of your blood vessels. It shows up as spots on the skin that look like ulcers.

WebMD Medical Reference Reviewed by David Zelman, MD on April 21, 2018

Sources

SOURCES: 

Ching D. British Journal of Rheumatology, November 1992. 

eMedicine.com: "Rheumatoid Arthritis-Symptoms." 

Kelly, C. Bailliere's Clinical Rheumatology, February 1993.

Klippel, J. Primer on the Rheumatic Diseases, 12th edition, Arthritis Foundation, 2001. 

Lee, D., Weinblatt, M. Lancet, 2001. 

Masi, A. American Journal of Medicine, Dec. 30, 1983. 

Venables, P. UpToDate topic: "Clinical Features of Rheumatoid Arthritis," Jan. 20, 2005.

Johns Hopkins Arthritis Center: “Rheumatoid Arthritis Signs & Symptoms.”

Mayo Clinic: “Anemia: Symptoms & causes,” “Pleurisy: Symptoms & causes.”

Arthritis Foundation: “More Than Just Joints: How Rheumatoid Arthritis Affects the Rest of Your Body,” “Rheumatoid Arthritis Symptoms.”

UpToDate: “Overview of the systemic and nonarticular manifestations of rheumatoid arthritis,” “Patient education: Rheumatoid arthritis symptoms and diagnosis (Beyond the Basics).”

National Eye Institute: “Facts About Cataract.”

American Academy of Ophthalmology: “What Is Scleritis?”

Clinical Rheumatology: “Beyond the joints: neurological involvement in rheumatoid arthritis.”

© 2018 WebMD, LLC. All rights reserved.

Pagination