Take Note When RA Symptoms Improve — or Worsen
When you have RA, it’s important to stay on top of the disease, your symptoms, and potential signs that complications are developing. You know your body better than anyone else, and you will be the first to notice hints that a new symptom may be brewing. While it can be natural to want to downplay or minimize new joint stiffness, swelling, or pain that could indicate a complication, there is a real benefit to paying attention to new developments and taking action sooner rather than later.
Talk to Your Doctor When You Experience a New Symptom
If you are attentive to worsening symptoms, such as morning stiffness changes in terms of severity, duration, frequency, or intensity, you may be better prepared to describe and discuss any changes or side effects with your rheumatologist. Joint pain and swelling RA can affect any joint in the body, but it most commonly strikes the hands (including the knuckles and middle joints of the fingers), wrists, feet, and knees, says David Stephen Pisetsky, MD, PhD, a professor of medicine in the department of immunology at Duke University Medical Center in Durham, North Carolina, and past president of the United States Bone and Joint Initiative. Affected joints can be warm, achy, stiff, or tender to the touch. But if pain and other symptoms in your joints persist despite treatment, it might be a sign of a complication. “RA therapy directly targets inflamed joints, so if joint pain is persistent despite treatment, call your doctor,” Dr. Pisetsky says. “There is also a special concern if one joint is far, far more painful or swollen than the others and gets red or tender when touched.” This could signal an infection, and you should reach out to your rheumatologist right away if this occurs, he stresses. Extreme fatigue “Extreme fatigue is a hallmark of RA,” Pisetsky says. If your joints seem to get better with treatment but pain and fatigue persist, it could be a sign of depression, a common complication of RA, he adds. Talk with your doctor about a referral to a mental health specialist if your pain and fatigue persist even after starting RA treatment. Persistent cough The inflammation that comes with RA also affects other parts of the body, including your lungs. In fact, RA-related lung complications are among the most common manifestations of RA outside the joints, according to the Arthritis Foundation. “RA can involve the lungs and cause chest tightness and coughing,” Pisetsky says. “If you are on biologics to treat RA, there’s also concern about infection, which can cause a persistent cough.” A cough that lasts longer than a week should be evaluated by a healthcare professional, especially if it’s accompanied by a fever and you feel sick, he adds. A persistent cough and shortness of breath could also be a sign of interstitial lung disease, another common complication of RA that causes inflammation and scarring in the lungs, which can make it difficult to breathe. Chest pain or shortness of breath People who have RA are also more likely to develop heart disease, according to the Arthritis Foundation. “If you have RA and experience chest pain or shortness of breath, get it checked out,” Pisetsky advises. It could be a sign of a heart attack or heart disease. To lower your risk for heart disease, he recommends maintaining a healthy weight, quitting smoking, and keeping your cholesterol and blood pressure down. Numbness or trouble with balance Although it is less common today, thanks to improved treatment options, RA can affect the spine, causing “numbness and balance issues,” Pisetsky notes. But these can also be symptoms of diabetic nerve damage. As people with RA are at increased risk for developing type 2 diabetes, this can be an all-too-common complication. Proper treatment of both RA and diabetes can help. Skin rash A rash could be a drug reaction or a sign that the disease is progressing outside the joints, says John M. Davis, III, MD, a rheumatologist at the Mayo Clinic in Rochester, Minnesota. Red eyes, blurry vision, or eye pain These symptoms can indicate inflammation in the eye, and they need attention, says Dr. Davis. Another potential RA-related eye risk is retinal detachment, where the retina is lifted from its normal position. This is considered an emergency, because if it’s not promptly treated, it can lead to permanent vision loss, according to the National Eye Institute.
The Bottom Line on Changing Symptoms
“The better your RA is controlled, the less likely these signs are to occur,” Davis says. “But identifying them early can also help stave off long-term consequences in and outside of the joints.” That’s why it’s important to work closely with your doctor to control your RA and maintain good health. Additional reporting by Erica Patino
