There’s more than joint pain to watch out for.
Painful, swollen joints are a hallmark of rheumatoid arthritis. But for people with RA, it’s not the only thing to watch out for.
A result of the body’s immune system attacking its own tissues, rheumatoid arthritis requires more than just managing the pain. Other symptoms that might even seem unrelated to the condition may pose a threat.
“This is a disease process, not just something that happens in the joints,” rheumatologist Joan Bathon, MD, says. “It can be in all your tissues, causing problems wherever inflammation occurs,” says Bathon, who is chief of the rheumatology department at New York-Presbyterian Hospital/Columbia University Medical Center.
People with more severe rheumatoid arthritis are more likely to have other complications. But it can also happen in milder cases.
Here are the top 10 symptoms rheumatoid arthritis patients should never ignore.
1. Shortness of breath or chest pain
Because rheumatoid arthritis can affect the blood vessels and muscle of the heart, people with the condition are at a greater risk for heart attacks and heart failure.
“Chest pains or shortness of breath are big red flags,” says rheumatologist Brian Mandell, MD, PhD, of Cleveland Clinic’s Arthritis and Musculoskeletal Center.
If you’re getting winded easily, you could also have a lung infection. Or you could have some form of interstitial lung disease, which causes lungs to become inflamed and scarred, Mandell says. Fluid might also be surrounding the lungs, which would require drugs and drainage to treat.
Seek medical attention immediately if you’re having these problems, even if you’ve never had heart or lung issues before.
2. Numbness or tingling
Rheumatoid arthritis can cause connective tissues in the hand or foot to become inflamed and push up against a nerve causing numbness and tingling. As a result, you might experience weakness or clumsiness, or even nerve damage.
This type of swelling can happen in tissues throughout the body. But it most commonly occurs around the wrist area, causing carpal tunnel syndrome, Mandell says.
If you experience numbness or tingling, you need to be evaluated by your rheumatologist or another health care provider as soon as possible to determine the cause.
3. Inability to move or raise your hand or foot
Compared to numbness or tingling, suddenly not being able to raise or move a hand or foot is a much more severe complication to result from rheumatoid arthritis.
It’s also a much more rare occurrence, involving damage to nerves that are connected to muscles.
“It’s like having a heart attack for the nerves,” Bathon says.
Seek emergency treatment for this symptom. Bathon says not doing so could lead to permanent paralysis.
4. Spots on or around your fingertips
Little red or black spots on or around the fingernails may mean that the tissue in those areas has died from inflamed small blood vessels.
Although very uncommon, the spots can signal an advanced form of inflammation, says Bathon, who suggests promptly seeing a rheumatologist.
If the symptom goes untreated, it may ultimately lead to losing fingers or toes.
5. Red, inflamed eyes
Blood vessels in the eyes are another common target of rheumatoid arthritis, especially among people with more serious forms of the disease.
If the outer layer of your eye feels dry or irritated, eye drops can usually treat the problem, Mandell says.
However, sudden severe pain and redness of the eyes could mean deeper parts of the eye are affected. That’s a very serious complication, so see a doctor immediately if that happens, Mandell says.
6. Tummy troubles
If you take a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen or naproxen to treat your rheumatoid arthritis, you are at risk for stomach problems.
These drugs can cause stomach ulcers, which could in turn make the stomach bleed or form a hole in its wall.
When taking an NSAID, report any tummy pain, black or bloody bowel movements, or nausea to your doctor.
7. High fever and other signs of infection
Another problem from rheumatoid arthritis treatment is infection related to biologic drugs such as Cimzia, Enbrel, Humira, Remicade, and Simponi.
The most telling sign of an infection is high fever (greater than 101 or 102 degrees Fahrenheit), Bathon says. Others are an unexplained cough, or an area of the skin that is extremely hot, red, swollen, or more painful than usual.
This type of infection can spread very quickly and is usually tough to control since rheumatoid arthritis patients have compromised immune systems to begin with. That gives them a lower tolerance for fever, Bathon says.
If you suspect an infection, see a doctor immediately, even if it means a trip to the ER, she says.
8. Feeling blah
Symptoms that just make you feel not well could also signify infection. So don’t ignore your body when it’s telling you something isn’t right, Mandell says.
Specifically, things like loss of energy, night sweats, sudden weight loss, unexplained fatigue, or a low-grade fever might mean it’s time to re-evaluate your treatment regimen.
Be sure to discuss any of these symptoms with your doctor.
9. Bone fracture
A bone fracture in someone with rheumatoid arthritis may reveal underlying osteoporosis, especially among women.
Because of its inflammatory nature, rheumatoid arthritis can cause bone loss. On top of that, the risks of fracture can skyrocket if you’re taking prednisone, a common treatment for rheumatoid arthritis.
In addition to exercising and following a diet rich in calcium and Vitamin D, people with rheumatoid arthritis should consider having a bone density test to detect osteoporosis soon after their RA diagnosis.