5 Warning Signs of Rheumatoid Arthritis
Warning Signs of Rheumatoid Arthritis Complications
Although rheumatoid arthritis (RA) is an autoimmune disease that affects the joints, the chronic condition can also cause complications in other parts of your body, including your eyes, lungs, heart, bones, nerves, and blood vessels.
"With rheumatoid arthritis, many people think about inflammation affecting the joints, but it can affect the entire body," says Dennis C. Ang, MD, section chief of rheumatology and immunology and an associate professor at Wake Forest Baptist Medical Center in Winston-Salem, N.C.
However, early and aggressive treatment of RA symptoms can help reduce the severity of possible complications associated with the disease, including:
RA also increases the risk for eye problems, such as dry eye syndrome. The whites of the eyes and the cornea can become inflamed. Severe RA complications involving the eye can result in blindness, Ang says.
Early warning signs of these eye problems include:
- Blurred vision
- Dry eyes
- Eye pain
- Difficulty looking at bright lights
- Red eyes
- Any change or loss in vision
About 10 to 20 percent of people with RA will develop chronic lung disease at some point, Dr. Ang says. That's similar to the findings of a 2010 study published in the journalArthritis & Rheumatismthat found the lifetime risk of developing interstitial lung disease, a group of lung disorders that inflame and scar the lungs, was 7.7 percent for people with RA, compared with just 0.9 percent for those who don't have RA. The researchers note the risk increased for those who had more severe cases of RA and those who were diagnosed at a later age.
Not only does the inflammation associated with RA increase the risk for lung scarring, known as pulmonary fibrosis, but lung problems linked to RA may also include blockage of the small airways and high blood pressure in the lungs. Additionally, Ang says that some of the drugs used to treat RA can cause inflammation in the lining of the lungs.
Signs of lung complications among people with RA include:
- Shortness of breath that gets progressively worse
- Chest pain
- Persistent cough
"Typically, people show up in their doctor's office complaining of coughing or having difficulty breathing during routine daily activities for a number of weeks," Ang says.
Signs of RA complications that affect the lungs, such as coughing and shortness of breath, could also signal heart problems. This is generally attributed to atherosclerosis, commonly known as hardening of the arteries, a common condition in people with RA that seems to accelerate as the disease progresses. One review of studies, published in the journalRheumatology: Current Research in 2013, reported that people with RA are 50 percent more likely to die from a cardiovascular problem, two to three times more likely to have a heart attack, and nearly twice as likely to have a stroke.
Ang says that congestive heart failure is another complication that can develop among people with RA. "Congestive heart failure isn’t a direct complication," he says. "It's more of an indirect association after many years of having rheumatoid arthritis."
For people with RA, neck pain or balance issues could be a red flag for nerve damage. RA can affect the upper portion of the spinal cord known as the cervical spine. The deterioration of the joints in the neck can irritate and put pressure on the nerves in the spine.
Initial warning signs of nerve damage include:
- Neck pain
- Problems with balance, coordination, or walking
- Strange sensations or numbness in the hands and feet
- Weakness or loss of fine motor skills
RA can also affect the peripheral nerves outside the brain and spinal cord. The disease may compress the median nerve, which runs from the forearm through the wrist to the hand. This can lead to carpal tunnel syndrome, which can cause numbness or weakness in the hands and loss of hand function.
Inflammation of Blood Vessels
RA can also lead to inflammation of the blood vessels, or vasculitis. When the blood vessels become inflamed, they may narrow or shrink in size or get weak. In extreme cases, this may stop blood flow.
Warning signs of vasculitis include:
- Painful spots or redness on the nail beds, fingers, or hands
- Painful rash on the skin, often on the legs
- Ulcers or sores on the skin
The inflammation associated with RA can also predispose people to osteoporosis, Ang says. In addition, some medications used to treat RA can also lead to bone loss. Additionally, being physically inactive or sedentary because of joint pain can increase your risk for osteoporosis.
Warnings signs of bone loss include:
- Change in posture or curvature of the spine
- Broken bones from a fall, particularly in the wrist or hip
- Back pain
"It's important to make sure people with RA are getting enough calcium and vitamin D," Ang says. "People with RA should have their bone density checked every two years."
Low Blood Platelet Count
Blood platelets are colorless blood cells important to blood clotting and stopping blood loss. Low blood platelet count is usually caused by a separate disorder, such as RA, or from a side effect of medication. "It's not really a direct complication of rheumatoid arthritis, but some medications for this condition can potentially cause low blood platelets," Ang says.
Symptoms of a low blood platelet count include:
- Easy or excessive bruising
- Bleeding that looks like a rash of tiny reddish-purple spots on or just under the skin, often on the legs
- Prolonged bleeding from minor cuts and scrapes
- Blood in urine or stools
- Spontaneous bleeding from the nose or gums
- Unusually heavy menstrual bleeding
- Excessive bleeding after dental work or during surgery
"When treating rheumatoid arthritis, we check blood counts often so we can pick up a low blood platelet count before it gets dangerously low," Ang says.
Video: 11 Effects of Rheumatoid Arthritis on the Body
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