The most common symptoms of rheumatoid arthritis are pretty well known – stiff, painful joints and fatigue.
But Sheetal Patel, MD, a board-certified rheumatologist with Health First, says RA can bring on a wide range of other symptoms, because inflammation caused by the disease affects the entire body. “Your organs are interconnected and they talk to each other,” she says.
The Arthritis Foundation explains that RA occurs when the immune system doesn’t work properly and attacks the lining of the joints, called the synovium.
It commonly affects the hands, knees and ankles, usually the same joint on both sides of the body, such as both hands or both feet. For unknown reasons, more women than men get RA, and it usually develops in middle age. Having a family member with RA increases your odds of developing it, as do some habits and behaviors.
“If you have a genetic predisposition and have made certain lifestyle choices – like smoking – you’re increasing your risk of developing rheumatoid arthritis,” Dr. Patel says.
Symptoms related to RA that might not immediately seem connected include broken bones, heart disease, dry eyes and mouth, other eye problems, hearing loss, skin nodules and trouble breathing.
Broken bones
Dr. Patel says you likely won’t be as mobile if you have RA, since it causes bone loss. “The inflammation you develop reduces your bone-building cells.
“Steroids are regularly prescribed to decrease pain and inflammation, and they thin out your bones over time. We see an increased risk of osteoporosis in RA patients, which often leads to broken bones.”
Heart disease
RA increases the chances of heart disease.
“Pericarditis is a common cardiac complication of RA,” says Dr. Patel. Pericarditis occurs when thin layers of tissue around the heart get inflamed. Patients may feel severe chest pain that’s easy to mistake for a heart attack. This condition usually comes on quickly and can last weeks to months. The main symptom is sharp chest pain.
Dryness
“People with RA can develop secondary Sjogren’s syndrome, which causes dry eyes and mouth,” explains Dr. Patel. It’s called secondary because the disease’s symptoms develop alongside another existing autoimmune disease, such as RA.
Eye problems
“Although not as common, episcleritis and scleritis [two conditions involving inflammation of the eyeball] can develop,” Dr. Patel says. “RA can also cause dry eyes.” Medical News Today lists grittiness, a pulling or pressing sensation in the eyes, discomfort or pain, and sensitivity to light as some of the symptoms of dry eyes.
Hearing loss
The most common type of hearing loss tied to RA is sensorineural hearing loss, which affects anywhere from 25 percent to 75 percent of people with rheumatoid arthritis. The inner ear has tiny hair cells that help you perceive sound. Sensorineural hearing loss happens when those cells in the inner ear get damaged. It’s the most common type of permanent hearing loss.
Two other types of hearing loss are less common in people with RA:
- Conductive hearing loss is when sound has trouble getting through the outer or middle ear and reaching the hearing part of your inner ear, the cochlea.
- Mixed hearing loss means you have symptoms of both sensorineural and conductive hearing loss in the same ear. You may need treatments for both types.
Skin nodules
Skin nodules are very common in people with RA, Dr. Patel says, “About one in four people with RA develops firm, fleshy lumps beneath the skin. These so-called nodules usually occur at bony pressure points on the body, such as the knuckles, elbows and heels.
“While these protrusions are harmless, sometimes they cause pain, limit function or become infected.”
The Arthritis Foundation says that unless the nodule is in a sensitive spot, such as where you hold a pen, treatment may not be necessary. Nodules sometimes disappear on their own or with treatment with disease-modifying antirheumatic drugs.
Trouble breathing
“With RA, the inner part of the lung can become inflamed causing fluid to build up and interfere with your breathing,” cautions Dr. Patel.
Penn Medicine, part of the University of Pennsylvania, says that lung problems related to RA can include blockage of the small airways in the lungs, fluid in the chest, high blood pressure, nodules in the lungs and scarring.
Dr. Patel concludes, “In addition to the issues we’ve outlined, RA can cause mood changes and depression, numbness or tingling in your hands and feet, inflammation of your gums which can lead to periodontal disease, and atrophy of your muscles.
“Having one type of autoimmune disease makes you more susceptible to having another. Even if your symptoms aren’t severe, don’t wait too long to consult with your doctor or medical professional.
“You don’t want to risk irreversible complications. Early treatment is important so that more organs don’t get involved.”
Sheetal Patel, MD is a board-certified rheumatologist who graduated from Ross University School of Medicine located in Bridgetown, Barbados. She has a B.S. in biology from University of Massachusetts. She completed her residency at Henry Ford Hospital in Detroit, and her rheumatology fellowship through a combined program at Henry Ford Hospital and Wayne State University at Detroit Medical Center. Her office is located at Health First Medical Group Gateway, 1223 Gateway Dr., Suite 2H, Melbourne. Call 321-361-5632 for an appointment.
