If not treated properly, rheumatoid arthritis (RA) will cause steadily worse problems, ranging from lifestyle disruptions to severe joint damage and other health conditions.

Lifestyle Disruption

Sleep

Pain from RA may wake patients several times during the night, preventing them from getting a full night's rest. In addition, several RA drugs can cause insomnia.

Disability

Joint damage and pain may make you unable to work or to perform normal everyday tasks like getting dressed or using a computer mouse or keyboard. One study found that more than a quarter of women with RA stopped working within four years of their diagnosis.

Psychological problems

The stress of RA and the lifestyle changes it can cause lead to loss of self-esteem, feelings of helplessness, and even clinical depression or anxiety disorders.

Anemia

Anemia is a low level of red blood cells in the body. It causes fatigue, weakness, and dizziness. Widespread inflammation caused by RA affects the body's production of red blood cells, which makes anemia very common among RA patients; as many as 60 percent of them are anemic. Studies also show that patients with untreated anemia are more likely to have serious joint damage from RA.

Rheumatoid Lung

Rheumatoid lung refers to a group of lung conditions commonly found in RA patients: pleural effusions (fluid in the chest cavity), pulmonary fibrosis (scarring of the lungs), nodules (lumps of tissue) forming in the lungs, and pulmonary hypertension (high blood pressure in the lungs). It is not known why RA leads to these problems. Symptoms of rheumatoid lung include shortness of breath, chest pain, and persistent cough.

Heart Inflammation

RA sometimes causes inflammation in and around the heart in addition to the joints. Both pericarditis (inflammation of the membrane surrounding the heart) and myocarditis (inflammation of the heart muscle itself) can lead to congestive heart failure, a serious condition in which the heart cannot adequately pump blood to the rest of the body.

Joint Destruction

As RA inflammation progresses, it begins to destroy the cartilage and bone around the joints. This causes deformities and loss of motion. In severe cases, the bones may grow together, fusing and immobilizing the joint. This damage is permanent and irreversible, except by total joint replacement surgery, which is not possible on all joints.

Sjögren's Syndrome

Sjögren's syndrome is an autoimmune disease commonly linked to RA, in which the white blood cells destroy moisture-producing glands, such as the salivary and tear glands. It is most prevalent in women and is characterized by symptoms of dry eyes and mouth (see RA Symptoms section), which can cause problems with swallowing and talking. Sjogren’s can also cause digestive and neurological problems.

Osteoporosis

Osteoporosis is a loss of bone density, which makes fractures more likely. It is a concern for RA sufferers for a number of reasons. First, the two diseases share risk factors—older women and smokers are at high risk for both RA and osteoporosis. Second, corticosteroids commonly used for RA can cause osteoporosis. Third, studies suggest that RA itself may cause loss of bone density in the joints it affects. A diet rich in calcium and vitamin D (or taking calcium and vitamin D supplements if recommended by a doctor) can help ward off osteoporosis.