Most people with rheumatoid arthritis have tender, swollen joints, but there are other symptoms you may not be as familiar with, such as hearing problems, trouble sleeping, and others.

When you think of rheumatoid arthritis, you usually think of things like swollen, painful joints. But there’s a lot more to rheumatoid arthritis — and some of it may surprise you.

In this article, we take a look at some of the more unusual symptoms that can be associated with rheumatoid arthritis.

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is an autoimmune form of arthritis. This means that your own body fights itself, attacking your joints. The result is often painful, swollen, and even disfigured joints.

RA comes and goes, with periods of remission and flare-ups. Like many autoimmune diseases, this condition might not be limited to the primary symptoms. There are many symptoms you could be having— and ignoring — that are linked to RA.

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Here are 10 surprising symptoms of RA:

People with rheumatoid arthritis report a number of problems with their hearing, from hearing loss to tinnitus. While it’s not completely clear why this happens, evidence points to the body-wide inflammation that’s common with RA.

Some medications are also linked to hearing changes, including some of the medications used to treat RA, including nonsteroidal anti-inflammatory drugs and disease-modifying antirheumatic drugs, which include hydroxychloroquine and methotrexate.

Redness, heat, and inflammation over joints affected by RA are common symptoms of the disease, but some people report other skin problems like rashes, discoloration, and becoming easily bruised.

Common skin reactions associated with RA itself can include:

While these symptoms can be caused by the disease itself, be sure to talk with your doctor if you experience them. They can also be side effects of some of the medications used to treat RA.

Many diseases or infections can cause symptoms like snoring, coughing, and other breathing problems. However, lung diseases like obstructive sleep apnea and interstitial lung disease (ILD), a lung condition that can result in lung damage if not diagnosed early and treated, have been linked to RA.

While these links may be coincidental, research suggests that the inflammation that causes a host of other symptoms with RA might also be the cause of breathing problems.

Numbness, tingling, and even weakness in your arms, legs, hands, and feet are called peripheral neuropathy. This problem appears in a number of chronic conditions, including RA.

There are many reasons why these symptoms may develop, including joint inflammation and pressure on nerves that run through those joints. The numbness, tingling, and weakness are part of rheumatoid neuropathy and are connected with the same mechanism that causes the joint pain and stiffness of RA. Neuropathy can strike in mild cases of RA and advanced cases.

There are lots of reasons that gum disease can develop, but it’s been observed as a common complication in people with RA since the early 1900s. A 2016 study showed that gingivitis, or gum disease, in people with RA, is often caused by the same bacteria that triggers the autoimmune inflammatory response that happens in RA.

Decreased muscle mass is common in people with many types of chronic arthritis, and RA is no exception. Reduced activity due to joint inflammation and pain can lead to loss of muscle mass, as well as increases in body fat, according to a 2018 study.

As this shift happens, increased body fat and lower muscle mass can add to the already significant cardiovascular risk people which people with RA have from the inflammation caused by the disease.

The body-wide inflammation that causes RA isn’t just limited to the joints. Even your eyes can experience symptoms from this condition. Dryness, redness, and swelling can develop, as well as ulcers. Dry eye is the most common eye condition associated with RA.

While these symptoms can sometimes be treated with medications or eye drops, problems like redness might not go away completely.

A lot of chronic conditions lead to disrupted sleep. In RA, this seems to be linked to the severity of the disease and the pain it causes. RA pain may cause sleeplessness, which in turn can increase daytime sleepiness and other sleep problems. A 2023 study found that short sleep duration may be a risk factor for RA diagnosis.

Chronic illnesses and pain have long been linked with depression. Changes in lifestyle, a loss of ability or function, and pain can all contribute to depression.

A 2019 research review pointed to RA causing disruptions to the chemicals and neurotransmitters in the brain. All of these together can lead to emotional and mood disturbances, as well as trouble concentrating and other cognitive issues.

People with RA are about 70% more likely to develop gastrointestinal problems than people without the condition, according to the Arthritis Foundation. These problems are likely due to a number of things, including:

  • medications you’re taking to treat RA
  • other conditions you have alongside RA
  • infections
  • autoimmune complications from RA

A 2019 population-based study found that roughly 20% of people with RA have irritable bowel syndrome, as well as other symptoms like nausea and bloating. Researchers have linked these problems to other immune-related conditions, too.

If you’re experiencing one or more of these symptoms, talk with a doctor about your concerns. If they have reason to believe you have RA, they may order some lab testing and refer you to a specialist.

A rheumatologist will oversee your RA care, but you may speak with other specialists as well to address specific symptoms. Your team of doctors may include orthopedists, physical therapists, pain management specialists, and others.

RA is a chronic disease, and you will manage it throughout your life as you experience flare-ups and periods of remission. It will take a multipronged approach — and a number of healthcare specialists — to help you meet your health needs.

Does rheumatoid arthritis hurt all the time?

Pain associated with RA may come and go or worsen at times depending on your activity level and the amount of inflammation you have. As the disease progresses, your joints change shape and can become painful more frequently.

What is the best pain relief for rheumatoid arthritis?

Pain medications to treat the pain of RA may include:

  • non-steroidal anti-inflammatory drugs (NSAIDs) like:
    • celecoxib
    • diclofenac
    • etoricoxib
    • ibuprofen
    • naproxen
  • steroid medications (glucocorticoids) like prednisolone

What foods are bad for rheumatoid arthritis?

Since RA is an inflammatory condition, you may want to avoid foods that can contribute to inflammation in your body, such as:

  • foods with added sugar
  • processed meats
  • gluten
  • ultra-processed foods like fast foods
  • foods high in salt
  • alcohol

Rheumatoid arthritis is an inflammatory condition, so it may affect many parts of your body and can cause many different symptoms beyond joint pain and swelling. These symptoms range from eye changes to sleep disturbances and digestive problems.

If you have RA, your healthcare team can help treat the many symptoms you experience.

Want more information and support?

For a comprehensive resource and support from a community who knows what you’re going through, download Healthline’s new rheumatoid arthritis app, RA Healthline. The RA Healthline app is available for free on the Apple App Store and Google Play. Downloading the app and getting started is simple.

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