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 severely damage joints.
There are many ways that rheumatoid arthritis can appear, but some of the most recognized signs are in the hands and feet. However, many different joints can be affected, with varying severity.
Imaging tests, like X-ray, computed tomography (CT) scan, and magnetic resonance imaging (MRI) help doctors take a close look at your joints and assess any damage.
RA can also affect other parts of the body, including skin, blood vessels, eyes, and lungs. People with RA may deal with fatigue and general weakness as well.
Keep reading to learn more about how RA affects the body.
One of the first noticeable 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 permanently change shape and interfere with quality of life.
With proper treatment, RA symptoms can be managed. Treatments focus on reducing the inflammation to prevent joint damage.
For hands and fingers, these may include medications, injections, and splinting. Splinting helps support the joints but shouldn’t be worn for too long because it may lead 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, which can then cause 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 can result in malalignment causing pain on the outside of the foot.
In addition to your regular RA treatment, you can also get an insert to minimize pressure or use an ankle brace to support your joints.
Middle of the foot
Over time, the ligaments and cartilage of the foot can deteriorate, leading to the collapse of the arch of the foot. 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.
Over time, foot pain may cause people with RA to avoid standing or walking. In severe cases, surgery can help correct this by fusing the affected bones.
If inflammation isn’t properly controlled, severe joint 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 stuck in position and unable to flex inside a shoe.
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. If your toes are fixed, try using a special pad or shoes to accommodate them.
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. Wearing bunion pads can help to ease discomfort.
Surgery can also help correct bunions in severe cases.
RA can also attack the joints of the knees, causing inflammation. This makes it difficult to bend or straighten the knee. Doctors use imaging tests, like X-rays and MRI, to see any possible joint 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.
Some people with RA, particularly those with more advanced or poorly controlled RA, 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. Treatment isn’t required, but certain medications can help reduce the size of larger nodules if they’re bothersome. In some cases, they can be surgically removed. Usually, the nodules are painless and pose no risk.
Any joint in the body can be affected by RA. Hips, elbows, sternum, shoulders, and spine are all sites where inflammation can arise, leading to pain, deformity, and dysfunction.
If you’re diagnosed with RA, you should mention any focus of pain to your doctor, so you can begin treatment appropriate for the condition.
While the most obvious signs of RA are found in the joints, it can cause inflammation in other parts of the body, too.
RA inflammation can also affect:
- eyes (scleritis)
These complications are less common and more likely to be seen in very advanced cases of RA. Medication, assistive devices, surgery, and other treatments can ease symptoms and help you live with less discomfort.
Not everyone with RA will experience all of these symptoms. Each person’s condition can affect their body differently. Often, people with RA may even experience periods where their symptoms stop, called remission.
In addition to medication treatments, there are also diet and lifestyle changes that can make a positive impact on managing your condition.