If you have rheumatoid arthritis, you’re familiar with painful, swollen joints. There are other symptoms to watch for, though.
RA can affect any part of your body, from your eyes to your heart to your toes.
Also, newer drugs called biologics often have serious side effects. The big upside to these medications is that they prevent long-term joint damage, disability, and discomfort, says Harry D. Fischer, MD. He’s chief of the division of rheumatology at Mount Sinai Beth Israel in New York City. But biologics control the disease by slowing your immune system, and that can lead to infections.
Never ignore these 10 symptoms:
1. Shortness of breath. RA can affect your blood vessels and heart, so you’re more likely to have a heart attack. Lung infections are also common, so shortness of breath or chest pain could signal a lung or heart problem.
If you feel winded or have chest pain, seek medical help quickly, even if you’ve never had these issues before.
2. High fever. If you take biologics, you’re at risk for infections with fevers over 101 F. Infection can spread through your body quickly and be hard to control.
“Your immune system cannot mount the same type of protection that someone else has,” says Tammi Shlotzhauer, MD. She co-wrote Living with Rheumatoid Arthritis. “Pay more attention to a fever, chill, or cough.”
Call your doctor early and remind the staff that you take drugs that suppress your immune system, she says. If the doctor can’t see you within a day, go to urgent care or the ER.
3. Stomach woes. Many people with RA take NSAIDs (nonsteroidal anti-inflammatory drugs). They control pain but increase your risk of bleeding stomach ulcers.
If you have belly troubles with NSAIDs, heartburn, or stomach pain, tell your doctor.
4. Numbness. If swollen, inflamed tissues press against a nerve in your hands or feet, you may feel numb or tingly. This can weaken your grip.
“In the wrists, it’s like carpal-tunnel syndrome, but not due to repetitive motion,” Shlotzhauer says. Tell your doctor — some RA drugs may help.
5. Red eyes. Blood vessels in your eyes may swell. This can make your eyes red and inflamed. Sometimes, eye drops can ease minor pain.
“A severe, painful red eye tends to be alarming,” says John Esdaile, MD, scientific director of the Arthritis Research Centre of Canada. “You should see an eye doctor or go to an emergency room.”
6. Broken bones. People with RA are more likely to get osteoporosis — a disease marked by bone loss — and broken bones.
“Bone loss is often very silent [lacking obvious symptoms] until you break a bone,” Fischer says, “but there are ways of assessing if there is bone loss in patients who are at risk.”
If you’ve reached menopause or take drugs called corticosteroids, ask your doctor if you should have your bone density checked. Calcium, vitamin D, and exercise can help strengthen bones.
7. Dry mouth. You might not make enough saliva. Dry mouth may cause gum disease.
“Patients don’t think, ‘This could be due to my arthritis,’ so it’s good to know,” Esdaile says. Let your dentist know if you have dry mouth and RA.
8. Cataracts. These are cloudy areas in the lens of the eye.Most people need cataract surgery in their 60s. But if you have RA, you can get cataracts as early as your 30s.
Corticosteroids make this eye problem even more likely. It depends how much of the medicine you’ve taken over time, Shlotzhauer says. Tell your eye doctor about your RA.
9. Hand or foot that won’t move. This rare complication happens when inflamed vessels limit the amount of blood that reaches nerves in your hand or foot. See your doctor quickly or go to the ER.
“Once you treat it, the nerve [should] recover,” Fischer says. “Sometimes it can take a while. It doesn’t happen overnight.”
10. Spots on fingers. Years ago, some people with RA got small red or black spots on their fingers or toes around the nails, which meant the tissue had died.
“They’re caused by inflammation of the blood vessels,” Fischer says. “It can affect the blood supply to the fingers, which can affect the skin.”
Today’s improved RA drugs have made this symptom rare. But if you see dark spots near your nails, tell your doctor at once. If you let it go without treatment, you could lose a finger or toe.