One of the first signs of RA is inflammation of the smaller joints in the hands and feet. Most of the time, symptoms on one side of the body correspond with symptoms on the other side of the body. Common symptoms include pain, swelling, tenderness, and stiffness, which is more pronounced in the morning. Some patients may feel a tingling or burning sensation. And symptoms can come and go in “flares” followed by a period of remission.
Symptoms can occur in any of the body’s joints, including shoulders, elbows, hips, knees, and ankles. People with RA often develop bunions, claw toes, or hammer toes. As the disease progresses, cartilage and bone are damaged and destroyed. Eventually, supporting tendons, ligaments, and muscles weaken. This can lead to a limited range of motion or difficulty moving the joints properly. In the long term, joints can become deformed.
Having RA also puts you at greater risk of developing osteoporosis, a weakening of the bones. People with osteoporosis are at increased 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. X-rays can illuminate the extent of the damage.
RA can affect the system responsible for making and transporting blood throughout your body. A simple blood test can reveal the presence of an antibody called the rheumatoid factor. Not all people with the antibody develop RA, but it’s one of many clues doctors use to diagnose the condition.
People with RA have an elevated risk for developing anemia. This is due to a decrease red blood cell production. They 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), the heart muscle (myocarditis), or even congestive heart failure.
A rare but serious complication of RA is inflammation of the blood vessels (rheumatoid vasculitis). Inflamed blood vessels weaken and expand or narrow, interfering with blood flow. This can lead to problems with the nerves, skin, heart, and brain.
Skin, Eyes, Mouth
Rheumatoid nodules are hard lumps caused by inflammation that appear under the skin, usually near joints. They can be a troubling, but usually aren’t painful.
As many as four million people in the U.S. have an inflammatory disease called Sjogren’s syndrome, according to the Sjogren’s Syndrome Foundation. About half of those people also have RA or a similar autoimmune disease. When the two diseases are present, it’s called secondary Sjogren’s syndrome.
Sjogren’s causes severe dryness—especially of the eyes. Patients describe it as a burning or gritty feeling. Prolonged dry eyes increase the risk of eye infection or corneal damage. It’s rare, but RA can cause inflammation of the eye.
Sjogren’s can also cause dry mouth and throat, making it difficult to eat or swallow, especially dry foods. Chronic dry mouth can lead to tooth decay, gingivitis, and oral infections. Some people experience swollen glands in the face and neck, dry nasal passages, and dry skin. Women may also feel dryness in their vaginas.