New rash? Blurry vision? Chest pain? Improve your awareness about these possibly troublesome signs and more.
Rheumatoid arthritis is a chronic, autoimmune disease that occurs when the body’s immune system mistakenly attacks its own joints and tissues, causing pain and inflammation. But the inflammation caused by RA can also damage your heart, lungs, and blood vessels, leading to serious complications. So, if you have RA, it’s important to be aware of which symptoms to look out for so you can avoid lasting damage and disability later on. These include:
Joint pain and swelling. RA can affect any joint in the body, but it most commonly strikes the hands (including the knuckles and the middle joints of the fingers), wrists, feet, and knees, says David Pisetsky, MD, PhD, a professor of medicine and immunology and chief of rheumatology at Duke University Medical Center in Durham, North Carolina, and president of the U.S. Bone and Joint Initiative. Affected joints can be warm, achy, stiff, and tender to the touch. But if pain and other symptoms in affected joints persist, despite treatment, it might be a sign of a complication.
“RA therapy directly targets inflamed joints, so if joint pain is persistent despite treatment, call your doctor,” Dr. Pisetsky says. “There is also a special concern if one joint is far, far more painful or swollen than the others and gets red or tender when touched.” This could signal an infection, and you should reach out to your rheumatologist if this occurs, he stresses.
Fatigue. “Extreme fatigue is a hallmark of RA,” Pisetsky says. However, if your joints get better but you haven’t gotten better in terms of pain and fatigue, it could be a sign you have depression, a common complication of rheumatoid arthritis, he adds. Talk with your doctor about a referral to a mental health specialist if your pain and fatigue persist even after starting RA treatment.
Persistent cough. The inflammation that comes with rheumatoid arthritis also affects other parts of the body, including your lungs. In fact, RA-related lung complications are among the most common manifestations of RA outside of the joints, according to the Arthritis Foundation.
“RA can involve the lungs and cause chest tightness and coughing,” Pisetsky says. “If you are on biologics to treat RA, there is also concern about infection, which can cause a persistent cough.” A cough that lasts longer than a week should be evaluated by a healthcare professional, especially if it’s accompanied by fever and you feel sick, he adds. A persistent cough and shortness of breath could also be a sign of interstitial lung disease, another common complication of RA that causes inflammation and scarring in the lungs, which can make it difficult to breathe.
Chest pain or shortness of breath. People with rheumatoid arthritis are more likely to develop heart disease, according to the Arthritis Foundation. “If you have RA and experience chest pain or shortness of breath, get it checked out,” Pisetsky advises. It could be a sign of a heart attack or heart disease. To lower your risk for heart disease, he recommends maintaining a healthy weight, quitting smoking, and keeping cholesterol and blood pressure down.
Numbness or trouble with balance. Although it is less common today, due to improved treatment, RA can affect the spine, causing “numbness and/or balance issues,” Pisetsky notes. But these can also be symptoms of diabetic nerve damage. As people with RA are at increased risk for diabetes, this can be an all-too-common complication. Proper treatment of both RA and diabetes can help.
Skin rash. A rash could be a drug reaction, or it could be a sign that the disease is progressing outside of the joints, says Eric Matteson, MD, chair of rheumatology and a professor of medicine at the Mayo Clinic in Rochester, Minnesota.
Red eyes, blurry vision, or eye pain. These symptoms can indicate inflammation in the eye, and they need attention, Dr. Matteson says. Another potential RA-related eye risk is retinal detachment. When the retina detaches, it’s lifted from its normal position. This is considered an emergency because, if it’s not promptly treated, it can lead to permanent vision loss, according to the National Eye Institute.
The Bottom Line
“The better your RA is controlled, the less likely these signs are to occur,” Matteson says. “But identifying them early can also help stave off long-term consequences in and outside of the joints.”