Effects of Rheumatoid Arthritis on the Body

RA is a progressive autoimmune disease that mainly affects your joints. According to the American College of Rheumatology (ACR), over 1.3 million people in the United States live with RA.

Anyone can get RA, but it generally begins between ages 30 and 50 years old. It also tends to affect women nearly three times more often than men.

The exact cause of RA is unknown. Factors that may play a role include:

• genetics
• hormonal changes
• infections
• environmental factors, such as exposure to air pollution
• lifestyle choices, such as smoking

One of the first signs of RA is inflammation of the smaller joints in the hands and feet. Most of the time, symptoms affect both sides of the body at once.

Common symptoms include:

• pain
• swelling
• tenderness
• stiffness which is more pronounced in the morning

Morning RA pain can last for 30 minutes or more but will likely improve with a warm shower.

RA can also cause tingling or burning sensations in the joints. Symptoms may eventually come and go in flare-ups followed by a period of remission. The initial stage of symptoms can last at least 6 weeks.

The pain and discomfort can make it difficult to sleep, resulting in extreme fatigue and a lack of energy. RA inflammation can also cause fatigue.

RA can also result in:

• claw toes
• hammer toes
• bunions

As the disease progresses, it damages and destroys cartilage and bone. Eventually, it weakens the supporting tendons, ligaments, and muscles. This can lead to a limited range of motion or difficulty moving the joints properly. In the long term, joints can become misshapen. Pain may be worse when you wear closed-toe shoes.

Having RA also puts you at greater risk of developing osteoporosis, a weakening of the bones. This in turn can increase your risk of bone fractures and breaks.

Chronic inflammation of the wrists can lead to carpal tunnel syndrome, making it difficult to use your wrists and hands.

Weakened or damaged bones in the neck or cervical spine can cause chronic pain. RA in the cervical spine also increases your risk of spinal cord compression. This may result in pain and weakness in the arms or legs.

A doctor may order X-rays to investigate the extent of your joint and bone damage from RA.

RA can affect the system responsible for making and transporting blood throughout your body, too.

A simple blood test can reveal the presence of antibodies called cyclic citrullinated peptide (CCP) and rheumatoid factor (RF). Not all people with these antibodies develop RA, but they’re two of the many clues doctors use to diagnose the condition. CCP antibodies usually appear before RF and are more specific to RA.

RA increases your risk of anemia. This is because the condition itself or RA medications can cause the decreased production of red blood cells. You may also have a higher risk of blocked or hardened arteries.

In rare cases, RA can lead to inflammation of the sac around the heart (pericarditis), inflammation of the heart muscle (myocarditis), or even congestive heart failure.

Rheumatoid vasculitis, or inflammation of the blood vessels, is another rare but serious complication of RA.

Inflamed blood vessels weaken and either expand or narrow, interfering with blood flow. This can lead to problems with the peripheral nerves, heart, and skin. Early diagnosis is important so that you can begin treatment and reduce permanent tissue damage.

Rheumatoid nodules are hard lumps that appear under the skin, usually near joints. They’re caused by inflammation. They can be bothersome but aren’t usually painful.

Nodules tend to develop at pressure points, such as at the elbows or the areas where your shoes rub against your heels.

In some cases, RA or RA medications can cause rashes. For example, rheumatoid vasculitis is associated with a telltale rash. Hives can also occur in RA.

Between 1 and 4 million people in the United States have the inflammatory disease Sjögren’s disease, according to the National Institute of Neurological Disorders and Stroke.

The ACR states that about half of these individuals also have RA or a different autoimmune disease. “Secondary Sjögren’s disease” is the term that was previously used for cases where a person with a preexisting autoimmune disease was also diagnosed with Sjögren’s.

Sjögren’s causes severe dryness — especially of the eyes. You may notice a burning or gritty feeling. Prolonged dry eyes increase your risk of eye infection or corneal damage. In rare instances, RA can also cause inflammation of the eye (such as uveitis, which affects the eye’s middle layer).

Sjögren’s can also cause a dry mouth and throat, making it difficult to eat or swallow, especially dry foods.

Chronic dry mouth can lead to:

• tooth decay, such as cavities
• gingivitis and other gum diseases
• oral infections

People with Sjögren’s may also experience:

• swollen glands in the face and neck
• dry nasal passages
• dry skin
• vaginal dryness

RA increases the risk of inflammation or scarring of the linings of the lungs (pleurisy) and damage to the lung tissue.

Other respiratory issues include:

• blockage of the lungs’ smallest airways, or bronchiolitis obliterans (popcorn lung)
• fluid in the chest, or pleural effusion
• high blood pressure in the lungs, or pulmonary arterial hypertension
• scarring of the lungs, or pulmonary fibrosis
• rheumatoid nodules on the lungs

Not everyone will have respiratory symptoms. Those who do may experience shortness of breath, wheezing, coughing, and chest pains.

Your immune system acts as an army, protecting you from harmful substances like viruses, bacteria, and toxins. It does this by producing antibodies to attack these invaders.

Occasionally, the immune system mistakenly identifies a healthy part of the body as a foreign invader. When that happens, antibodies attack healthy tissues.

In RA, your immune system attacks your joints. The result is intermittent or chronic inflammation throughout the body.

Autoimmune diseases are chronic, and treatment focuses on slowing progression and easing symptoms.

Did you know?

In some cases, rheumatoid arthritis flare-ups can cause flu-like symptoms such as:

• short-term fever
• sweating
• lack of appetite

Early diagnosis and treatment may help slow the progression of RA. Disease-modifying medications, medications to relieve your symptoms, and lifestyle changes can help you manage its effects and improve your overall quality of life.

Keep your doctor informed of any changes in your RA symptoms. They can advise you on adjusting your treatment plan as necessary.

RA is a chronic inflammatory condition that causes stiff and painful joints, often in your hands, wrists, and knees. A rheumatologist diagnoses and treats diseases that affect the bones, joints, and muscles. They may partner with your primary care doctor to monitor RA progression and prescribe treatments, such as lifestyle changes and medication.

An occupational therapist evaluates your ability to do daily activities and meet your goals. They may adjust your tasks and environment or recommend assistive devices to improve quality of life. A physical therapist teaches exercises to strengthen muscles, maintain range of motion, promote joint stability, and reduce injury risk. They use techniques like cold therapy or massage to ease joint pain.

Dry eye is a common RA symptom. RA is also associated with the inflammatory eye disease uveitis, as well as Sjogren’s disease. Left untreated, these conditions can lead to vision loss. It’s important to visit an ophthalmologist or optometrist for regular eye exams. If you have eye pain or other unusual symptoms, see an ophthalmologist for diagnosis and treatment.

Obesity promotes inflammation and adds stress to your joints, which can aggravate RA symptoms and increase the risk of complications. A well-managed diet may help you lose weight, lower inflammation, and support overall health. A registered dietitian can design a sustainable, balanced diet plan.

Sometimes medication and lifestyle changes alone aren’t enough to relieve pain and maintain function. Over time, inflammation can lead to lasting joint damage. An orthopedic surgeon may repair or remove damaged tissues, fuse joints together for stability, or replace a joint with a prosthesis (artificial joint).

People with RA have increased risk of asthma and chronic obstructive pulmonary disease (COPD), and RA itself can cause lung disease sometimes called rheumatoid lung. All three of these conditions cause breathing difficulties. A pulmonologist diagnoses and treats lung disease. They may prescribe medication and lifestyle changes. They may refer you to a pulmonary rehab for education and support.

RA increases heart disease risk. A cardiologist specializes in diagnosing and treating heart conditions. They may order tests and prescribe treatments, such as lifestyle changes or medication, to protect your heart.

People with RA have increased risk of anxiety and depression. Behavioral health challenges may impact RA symptoms and management. A psychologist, clinical social worker, or licensed counselor treats these conditions with psychotherapy. A psychiatrist can prescribe medication if needed.