RA Symptoms You Shouldn’t Ignore

Article featured on WebMD, Medically reviewed by Brunilda Nazario, MD

Rheumatoid arthritis can have many symptoms. The most common are stiff, painful joints and fatigue.

But this disease causes inflammation in many body parts, so you may have symptoms that you don’t realize are related to RA. Some are signs of serious complications that put your organs, or even your life, at risk.

If you have any of these symptoms, don’t try to deal with them on your own. Call your doctor right away.

Broken Bones

Both RA and medications to treat it, like steroids, cause your bones to become weaker. You’re more likely to break a bone if you fall. Exercise, especially weight-bearing activity like walking, helps to keep your bones strong.

Chest Pain

RA makes you more likely to get heart disease. Over time, plaque builds up in your arteries. Doctors call this atherosclerosis. This can lead to a heart attack. Chest pain is a common symptom.

RA is a possible cause of a painful heart problem called pericarditis. That’s when thin layers of tissue around your heart get inflamed. You may feel severe chest pain that’s easy to mistake for a heart attack.

Even though your chest pain may not be a heart attack, if you have it, call 911 or go to the emergency room right away.

Dryness

RA sometimes causes dry eyes. This makes you more likely to get an eye infection.

People with RA could get another autoimmune condition called Sjögren’s syndrome. It often leads to dry mouth, nose, eyes, vagina, or skin. Your lips or tongue may dry out, crack, and get infected.

Eye Problems

It’s rare, but RA can cause inflammation in the white part of your eye, called the sclera. The symptoms are mostly redness and eye pain. You might have blurry vision. If you notice these signs, see your doctor.

Work With Your Doctor to Prevent RA Complications

With RA, it’s important to treat more than just your joints. Talk to your doctor to tailor a plan.

Fever

It can be a sign of infection. RA medications like biologics and steroids slow down your immune system. While they ease joint pain and swelling, it’s harder for you to fight off bugs like the flu. RA makes you more likely to get an infection just because the disease wears down your immune system.

Mild fever is also one sign of an RA flare. That’s when inflammation gets out of control. If it gets too high, your doctor will check for infection.

Hearing Loss

There may be a slightly higher risk of hearing loss with RA.

Tinnitus, or ringing in your ears, can be a side effect of treatments like nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs).

Mood Changes

RA is tied to depression, anxiety, and other mood problems. That’s because the disease causes pain, fatigue, and stiffness that make it harder to do the things you enjoy. Depression and anxiety could also come from inflammation.

Some people with RA get fibromyalgia. This illness causes muscle pain and often leads to depression and anxiety. Stress makes all of your symptoms worse.

If your mood changes seem to take over your life, talk to your doctor. Depression and anxiety can become serious if you don’t treat them.

Numbness or Tingling

RA sometimes affects the small nerves in your hands or feet. They might feel numb or like you’re being stuck with pins and needles.

If these tiny blood vessels in your hands or feet shut down, your fingers or toes may feel cold or numb. They could even change color when it’s cold outside and look white, red, or blue.

Rheumatoid vasculitis, which affects blood vessels, can also cause numbness, tingling, burning, or pain in your hands or feet due to damaged nerves. If your hands or feet are so numb that they drop or go limp when you try to raise them, see your doctor right away.

Numbness and tingling are side effects of biologics, too.

Stomach Pain or Indigestion

RA and medicines used to treat it are linked to mouth and stomach ulcers, stomach bleeding, acid reflux, diarrhea, and constipation. Painful diverticulitis (inflamed pouches in your GI tract) and colitis (an inflamed colon) are also possible if you have RA.

RA drugs like NSAIDs often cause ulcers or an upset stomach.

Belly pain is sometimes a sign of a rare RA complication called rheumatoid vasculitis — when inflammation spreads to your blood vessels. Weight loss and lack of appetite are other symptoms. Vasculitis is serious, so see a doctor right away.

Trouble Breathing

If you have a hard time getting your breath and can’t figure out why, maybe RA is to blame. Some people with the disease, especially men who smoke or used to smoke, are more likely to get serious lung problems.

When RA inflammation causes scar tissue to form in your lungs, you might notice chronic cough, shortness of breath, fatigue, and weakness.

RA may inflame the tissue that lines your lungs. That can lead to shortness of breath or pain or discomfort when you breathe.

See your doctor right away if you have unusual breathing problems or a cough that won’t go away.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Why are my RA symptoms getting worse?

From WebMD, medically reviewed on October 8, 2020

Getting control of you moderate to severe rheumatoid arthritis can be difficult, here are some common reasons why.

You’re Having a Flare

Red, warm, swollen joints are inflamed. A flare is when inflammation in your body spikes. Your symptoms can get worse. You might also have a mild fever, fatigue, and feel sick all over. To treat a flare, your doctor might adjust your medicine to lower the inflammation. To feel better, get more rest and apply hot or cold packs to sore, swollen joints.

You’re Under Pressure

Stress, anxiety, and even depression are common with RA. It’s more than just a bad mood. Depression can make it hard for you to manage your symptoms. Stress tells your body to release cortisol, an anti-inflammatory hormone. But ongoing stress triggers too much cortisol. This makes pain feel worse. Find ways to relax, like yoga, bubble baths, or exercise.

Your Sleep Cycle Is Off

RA pain and sleep trouble are a vicious cycle. If you’re in pain, you can’t sleep well. If you don’t get enough rest, your symptoms get worse. Good habits can help you get the downtime you need. Use guided imagery to distract you from the pain. Take pain meds before bedtime so you can nod off more easily. Switch off your phone and bedside clock. Their lights can disturb your slumber.

Your Meds No Longer Help

Even if what you’re taking has kept your RA under control for a while, things can change. If your body starts to resist current treatments, your symptoms may get worse. Talk to your doctor. You may be able to change to a new treatment. If you’re on a biologic, they might add other rheumatoid arthritis drugs to get your symptoms under control.

You Have Another Disease, Too

As if RA isn’t enough to handle, you can get related conditions that cause similar symptoms. People with RA are more likely to get fibromyalgia, too. It causes chronic pain, fatigue, and tender points that mimic RA. Your doctor can diagnose fibro to be sure it’s the cause of your problems and suggest treatment.

You’re Out of Remission

The goal of RA treatment is to make disease activity stop or slow down greatly so you have few or no symptoms. Doctors call this remission. But it doesn’t always last. RA might return and get worse. Over the years, your symptoms can come and go. See your doctor to adjust your medications.

You Don’t Exercise Enough

RA joint pain and stiffness can make you want to stay on the couch. But if you don’t move your joints, your symptoms will get worse. Exercise actually helps ease RA pain and fatigue. Try to get some activity every day. Walk, bike, or swim to rev up your heart. Do range-of-motion stretches to keep your joints limber. Work your muscles so they stay strong.

You Just Had a Baby

RA symptoms often ease up when you’re pregnant. But this can end soon after delivery. It’s hard to care for a baby when you have severe joint pain and fatigue, too. Your doctor can prescribe treatments that control your symptoms but are also safe for your baby if you plan to breastfeed.

You’re Carrying Extra Pounds

Added weight puts more stress on inflamed joints, which leads to more pain. Too much fat in your body can release hormones that worsen RA inflammation.  Your treatments may not work as well if you’re overweight. Exercise daily, and get help from a nutritionist if you struggle to stay at a healthy weight.

You Smoke

If you have RA and smoke, you should quit! Smokers with RA who quit often see symptoms improve. Smoking raises the odds that you’ll get RA in the first place. It can also affect the way your RA drugs work. They may not control your symptoms like they should. And it can zap your energy so you don’t exercise, which could ease your joint pain. Quit smoking or get help to kick the habit.

You’ve Been Too Active

Exercise is good for your RA, but you can overdo it. If you’ve been active all day, take time to relax. Rest can cool inflamed joints and help you bounce back from fatigue. Take breaks so you don’t get hurt. A physical therapist can teach you how to protect your joints, prevent painful muscle spasms, and exercise safely.

You’re Low on Vitamin D

People with RA often have low levels of vitamin D in their bodies. If you don’t have enough, your RA could become more active. That can lead to painful inflammation and even bone loss over time. Low vitamin D can worsen pain and fatigue. Your doctor can test your blood to measure your levels. More time in the sun (with sunscreen) and supplements might give you what you need.

You Have an Infection

RA and the treatments you take for it make you more likely to get an infection. Your immune system is overworked already, so it’s hard for it to fight off common bugs. Even seasonal flu can trigger RA symptoms. It also puts you at risk for septic arthritis, which causes severe pain in your knees, hips, or shoulders. Get the vaccines that your doctor suggests, such as a yearly flu shot.

You Stopped Taking Your Meds

Maybe they’re too expensive. Or perhaps you felt better so you thought it was OK to ditch your meds. But symptoms may flare up if you stop your medications. Talk to your doctor. You might be able to switch to a drug that doesn’t have as many side effects, or take a lower dose.

You Were Diagnosed Late

Your RA symptoms may be worse if you had the disease for years before you knew it. If it isn’t spotted and treated early, inflammation can lead to joint pain, damage, and deformity that won’t get better. Physical therapy may help you move better and ease your pain. Surgery can also replace your damaged joint with a new one.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Everything You Need to Know about Fibromyalgia

From Medical News Today

Fibromyalgia is a common and chronic syndrome that causes bodily pain and mental distress.

Symptoms of fibromyalgia can be confused with those of arthritis, or joint inflammation. However, unlike arthritis, it has not been found to cause joint or muscle inflammation and damage. It is seen as a rheumatic condition, in other words, one that causes soft tissue pain or myofascial pain.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), around 5 million adults aged 18 years or over in the United States experience fibromyalgia, and 80 to 90 percent of fibromyalgia patients are women.

Fast facts on fibromyalgia:

Here are some key points about fibromyalgia. More detail is in the main article.

  • Fibromyalgia causes widespread pain, fatigue, and other types of discomfort.
  • Symptoms resemble those of arthritis, but fibromyalgia affects the soft tissue, not the joints.
  • The cause is unknown, but risk factors include traumatic injury, rheumatoid arthritis and other autoimmune disorders, such as lupus, and genetic factors.
  • There is no cure, but medications, exercise, acupuncture, and behavioral therapy can help relieve symptoms and improve sleep quality.

Symptoms

Common symptoms include:

  • widespread pain
  • jaw pain and stiffness
  • pain and tiredness in the face muscles and adjacent fibrous tissues
  • stiff joints and muscles in the morning
  • headaches
  • irregular sleep patterns
  • irritable bowel syndrome (IBS)
  • painful menstrual periods
  • tingling and numbness in the hands and feet
  • restless leg syndrome (RLS)
  • sensitivity to cold or heat
  • difficulties with memory and concentration, known as “fibro-fog”
  • fatigue

The following are also possible:

  • problems with vision
  • nausea
  • pelvic and urinary problems
  • weight gain
  • dizziness
  • cold or flu-like symptoms
  • skin problems
  • chest symptoms
  • depression and anxiety
  • breathing problems

Symptoms can appear at any time during a person’s life, but they are most commonly reported around the age of 45 years.

Treatment

Medical attention is needed because fibromyalgia can be difficult to manage. As it is a syndrome, each patient will experience a different set of symptoms, and an individual treatment plan will be necessary.

Treatment may include some or all of the following:

  • an active exercise program
  • acupuncture
  • psychotherapy
  • behavior modification therapy
  • chiropractic care
  • massage
  • physical therapy
  • low-dose anti-depressants, although these are not a first-line treatment

People with fibromyalgia need to work with their doctor to come up with a treatment plan that provides the best results.

Medications

Medications may be recommended to treat certain symptoms.

These may include over-the-counter (OTC) pain relievers. However, the European League Against Rheumatism (EULAR) issued a recommendation against using non-steroidal anti-inflammatory drugs (NSAIDs) to treat fibromyalgia in their updated 2016 guidelines.

Antidepressants may help reduce pain. Anti-seizure drugs, such as gabapentin also known as Neurontin, and pregabalin, or Lyrica, may be prescribed.

However, a review has suggested that patients often stop using these drugs because they are not effective in relieving pain or because of their adverse effects.

Patients should tell the doctor about any other medications they are taking to avoid side-effects and interactions with other drugs.

Exercise

A combination of aerobic exercise and resistance training, or strength training, has been linked to a reduction in pain, tenderness, stiffness, and sleep disturbance, in some patients.

If exercise is helping with symptoms, it is important to maintain consistency in order to see progress. Working out with a partner or personal trainer may help to keep the exercise program active.

Acupuncture

Some patients have experienced improvements in their quality of life after starting acupuncture therapy for fibromyalgia. The number of sessions required will depend on the symptoms and their severity.

One study found that 1 in 5 people with fibromyalgia use acupuncture within 2 years of diagnosis. The researchers concluded that it may improve pain and stiffness. However, they call for more studies.

Behavior modification therapy

Behavior modification therapy is a form of cognitive behavioral therapy (CBT) that aims to reduce negative, stress- or pain-increasing behaviors and improve positive, mindful behaviors. It includes learning new coping skills and relaxation exercises.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm