Uncommon RA Symptoms You Can't Afford to Miss

Understanding the Non-Joint Symptoms of Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disorder that primarily affects the joints, causing pain, stiffness, and swelling. However, it can also lead to a variety of symptoms in other parts of the body. These non-joint symptoms are often linked to the abnormal immune response and increased inflammation associated with RA or side effects from treatments.

Skin-Related Symptoms

One common non-joint symptom is the development of rheumatoid nodules. These are firm, typically painless lumps that form under the skin, often on pressure points like the elbows or heels. They affect about 30% of people with RA. Another skin-related issue is Raynaud's syndrome, which affects approximately 10% of individuals with RA. This condition causes blood vessels in the hands or feet to constrict in response to cold or stress, leading to pale, numb, or painful fingers or toes.

Other less common skin symptoms include:

• A rash resembling eczema or psoriasis
• Reddish palms
• Very dry skin
• Sores or ulcers
• Vasculitis, which involves inflammation of blood vessels and can cause a painful rash, fever, and nerve pain

Lung-Related Symptoms and Conditions

RA can also impact the lungs. Pleural effusion, where fluid accumulates around the lungs, occurs in about 5% of RA patients. It may cause chest pain, shortness of breath, and coughing. Interstitial lung disease, which leads to scarring of the lungs, affects about 21% of people with RA and can cause similar symptoms.

Lung nodules, which are noncancerous growths, may be visible on chest X-rays but usually don't cause symptoms. In some cases, a lung biopsy may be necessary to confirm the diagnosis.

Heart-Related Symptoms and Conditions

People with RA have an increased risk of atherosclerosis, a condition where arteries harden, raising the likelihood of heart attacks and strokes. RA can also lead to pericarditis, or inflammation of the sac around the heart. While mild cases may not cause symptoms, severe instances can result in sharp chest pain, fever, shortness of breath, and low blood pressure.

Other potential heart issues include damage to heart valves and irregular heart rhythms.

Eye and Vision Symptoms

Approximately 18% of RA patients experience eye-related symptoms. The most common issue is very dry eyes, often accompanied by dry mouth. Additional symptoms may include:

• Eye redness
• Eye pain
• Blurred vision
• Light sensitivity
• Changes in vision

Nerve-Related Symptoms

Damage to joints can sometimes compress nerves, leading to symptoms such as pain, numbness, and tingling in the hands or feet. This can resemble carpal tunnel syndrome, where pressure on a nerve in the wrist causes discomfort.

Weakened Immune System

Felty syndrome, a rare condition affecting 1% or fewer RA patients, reduces certain immune cells, increasing the risk of infections. It can also cause an enlarged spleen and higher chances of bruising and bleeding.

Bone Health

RA may increase the risk of osteoporosis, a condition that weakens bones and makes them more prone to fractures.

Hearing Impairment

Some RA patients may experience hearing loss over time, potentially due to inflammation in the ear or medication use.

Managing Unusual Symptoms

The approach to managing these symptoms varies depending on their type, severity, and overall health status. Adjustments to regular RA medications or additional therapies, such as eye drops for dry eyes, may be necessary.

A rheumatologist, a specialist in diseases like RA, can help determine the best ways to manage or accommodate any unusual symptoms.

When to Seek Medical Care

Regular checkups are essential for RA patients to monitor for non-joint symptoms. During these visits, healthcare providers can screen for issues through medical history, exams, blood tests, and imaging.

Contact your RA doctor if you experience new or unusual symptoms such as a persistent cough, mild chest pain, shortness of breath, an unusual rash, changes in vision, or hearing issues. For severe symptoms like intense eye pain or sudden chest pain with shortness of breath, seek emergency care immediately.

Summary

While RA primarily affects the joints, it can also lead to various non-joint symptoms impacting the skin, lungs, heart, eyes, and other areas. Working closely with a healthcare provider is crucial for early detection and treatment of these symptoms. Regular checkups and open communication with your doctor can help manage the broader impact of RA on your overall health.