7 Rheumatoid Arthritis Symptoms You Shouldn’t Ignore

Rheumatoid arthritis (RA) is a chronic autoimmune disease that occurs when the body’s immune system mistakenly attacks its own joints and tissues, causing pain and inflammation. RA is described as a progressive disease, because it can get worse with time; without adequate treatment, this can lead to problems throughout the body. The inflammation caused by RA can also damage your heart, lungs, and blood vessels, leading to serious complications.

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.
7 RA Symptoms to Keep an Eye On
If you’re aware of which symptoms to watch out for, you may be able avoid lasting joint damage and disability later on. Here are a few to keep an eye on.
1. 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 and integrative immunobiology at the 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, it’s usually a sign of inadequately treated inflammation. In late disease, Dr. Pisetsky notes, persistent pain can be a sign of damage.
“RA therapy directly targets inflamed joints, so if joint pain is persistent despite treatment, call your doctor,” 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, he says.
RELATED: 5 Ways to Make Everyday Activities Easier on Your Joints
2. Extreme Fatigue “Extreme fatigue is a hallmark of RA,” Pisetsky says. Like persistent pain, fatigue is a sign of inadequately treated inflammation, he adds. It could also be a sign of depression, a common complication of RA. Talk with your doctor about a referral to a mental health specialist if your pain and fatigue persist even after starting RA treatment.
RELATED: The Link Between Rheumatoid Arthritis and Mental Health
3. Persistent Cough The inflammation that comes with RA 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. There is always a concern about infection in people treated with anti-rheumatic drugs,” Pisetsky says, noting that such “infection is usually more acute.” Chronic cough suggests other types of infection or other problems. 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.
COVID-19 is a concern, too, so communication with your provider is important when pulmonary symptoms develop, notes Pisetsky. It’s vital to stay up to date with your COVID-19 vaccinations.
RELATED: How Rheumatoid Arthritis Affects the Lungs
4. Chest Pain or Shortness of Breath People who have RA are 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.
5. 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 says. But these can also be symptoms of diabetic nerve damage. As research shows that rheumatoid arthritis is associated with an increased risk of type 2 diabetes, this can be an all-too-common complication. Proper treatment of both RA and diabetes can help.
6. 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.
7. Red Eyes, Blurry Vision, or Eye Pain These symptoms can indicate inflammation in the eye, and they need attention, says Dr. Davis. One RA-related eye risk is uveitis, inflammation that affects the uvea, the middle layer of your eye. If not treated, it can lead to vision problems, notes CreakyJoints.
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 and Deborah Shapiro.

Alexa Meara, MD
Medical Reviewer
Alexa Meara, MD, is an assistant professor of immunology and rheumatology at The Ohio State University. She maintains a multidisciplinary vasculitis clinic and supervises a longitudinal registry of lupus nephritis and vasculitis patients. Her clinical research is in improving patient–physician communication. She is involved in the medical school and the Lead-Serve-Inspire (LSI) curriculum and serves on the medical school admissions committee; she also teaches multiple aspects of the Part One curriculum. Her interests in medical-education research include remediation and work with struggling learners.
Dr. Meara received her medical degree from Georgetown University School of Medicine in Washington, DC. She completed her internal medicine training at East Carolina University (ECU) at Vidant Medical Center in Greenville, North Carolina, then spent two more years at ECU, first as chief resident in internal medicine, then as the associate training program director for internal medicine. She pursued further training in rheumatology at The Ohio State University in Columbus, completing a four-year clinical and research fellowship there in 2015.

Denise Mann
Author
Denise Mann is an award-winning health journalist in New York. Her articles regularly appear in Healthday, Wall Street Journal, Health.com, Newsday, American Profile, and other consumer health portals. She is the chief editor of Plastic Surgery Practice and a feature writer for WebMD. She writes about women's health, cancer, diabetes, heart disease, diet and fitness.
Her first foray into health reporting was with the Medical Tribune News Service where her articles appeared regularly in such newspapers as the Detroit Free Press, Chicago Sun-Times, Dallas Morning News, and the Los Angeles Daily News. She received the Journalistic Achievement Award from the American Society for Aesthetic Plastic Surgery in 2004 and 2011.
She lives with her husband, their miniature schnauzer, and their two sons. An avid indoor cycler, Mann is always up for a Soul Cycle class. In her spare time, Mann is working on a fiction novel loosely based on her extended family.