Welcome to Thriving with Arthritis, the podcast that empowers you to live well with arthritis. I'm your host, Dr. Diana Girnita, a rheumatologist dedicated to helping you understand and manage arthritis and autoimmune diseases. In my last episode we talked about what is RA and what are your risk factors that will increase the chances to develop arthritis and also we discussed how RA presents.
Today, we'll explore more about RA. We will discuss about the uncommon signs of rheumatoid arthritis. These are signs that you might be ignoring, but shouldn't.
Most people who will come to me for a consultation will complain of the COMMON signs and symptoms of Rheumatoid Arthritis, which are:
- Joint pain, especially in the hands and feet
- Swelling of the Joints
- Inability to use the hands or walk properly
- Morning stiffness that lasts for more than one hour.
But ……
When I start interviewing them, I often find many other signs and symptoms they do not even think are caused by Rheumatoid arthritis .
Let’s dive deeper…..
1.Raynaud's disease
Raynaud's disease or phenomenon or disease is a change in the color of your fingers or toes, sometimes the nose or ears. Your fingers can become white and be painful, developing tingling and numbness. Then, the fingers will turn bluish as the blood supply in these areas decreases and then turn red again when the blood supply is restored. This is because your small vessels, capillaries, become very sensitive and react to cold or even emotions like laughing hard or crying….
These episodes can last seconds or minutes and can be severely painful.
About a quarter of patients with RA will have Raynaud’s phenomenon.
2. Sjögren's disease
Sjögren's disease can manifest in two forms: primary and secondary. In its primary form, Sjögren's appears as the sole systemic disease. However, its secondary form coexists with other connective tissue diseases, especially rheumatoid arthritis (RA) or lupus. Patients with RA often experience symptoms like dry eyes and mouth, especially when their inflammation isn't well-managed.
The dryness in the eyes is described as a gritty, sand-like sensation and may result in redness.
The dryness in the mouth increases the risk of gum disease or periodontal disease.
3. Bilateral Carpal Tunnel Syndrome (CTS)
In my clinic, I had multiple patients who were sent for evaluation due to carpal tunnel symptoms.
But instead of having one hand affected, these patients had Carpal Tunnel Syndrome (CTS) in both hands. There are only a few situations that can cause CTS in both hands, and they are
- Pregnancy
- Diabetes
- Thyroid disease
If you are not with any of these diseases, it may be Rheumatoid Arthritis. Do not go for surgery before checking with a rheumatologist. In my practice, Rheumatologist OnCall, I have seen patients who first went through a few surgeries for CTS in both hands without any success as they were suffering from RA.
4. Breathing issues
Rarely, patients undiagnosed yet with RA will present to their doctor for difficulties with breathing. Some patients might experience shortness of breath with walking, while others with rest.
In the process of evaluation of a lung disease, you might get tested for an autoimmune disease.
Rheumatoid Arthritis is one of the autoimmune diseases that can also affect the lungs so, if you test positive for RF, anti-CCP, or even an ANA you will be referred to a rheumatologist.
Usually, patients with RA, after years of battling inflammation, might get their lungs affected.
5. Neck pain
Yes, RA can affect the neck spine (cervical spine).
This is the most common part of the spine affected by RA. If you develop pain and stiffness and cannot move your head, this can be a sign of RA. Some patients can also develop pain that goes down on their arms.
This is important! If you need any surgery requiring intubation, then remind the doctors that you suffer from RA. They should order X-rays of the cervical spine to evaluate for any changes like subluxation or instability of the cervical spine that may complicate the intubation process.
6. Jaw pain
Pain in the jaw is seen in about 30-50% of patients with RA and is caused by inflammation of the temporomandibular joint (TMJ). If you experience
- Facial pain
- Headaches
- Ear discomfort
- You can’t open your mouth fully
- Clicking or popping noises in the jaw
- Intermittent jaw locking
Make sure you check with your doctor. Some patients benefit from orthodontic treatments, even changing the treatment for RA.
7. Eye Problems
Rheumatoid arthritis (RA) may affect your eyes, causing inflammation of the sclerae (the white part of the eyes). This is called scleritis or episcleritis. If you develop pain, redness, and visual changes, you should contact an eye specialist immediately.
If the RA is untreated for many years, it may lead to even more complications, such as vision loss (e.g., scleromalacia perforans). Thus, make sure you stay in close contact with your rheumatologist and keep your RA under control.
8. Voice and Throat Issues
Do you experience any change in your voice? If you suffer from RA, the change in voice and hoarseness can be related to the inflammation affecting your voice box. About 30% of patients with RA may experience changes in voice due to inflammation of the joint in the larynx (called the cricoarytenoid joint).
9.Overwhelming Fatigue
Most patients with Rheumatoid Arthritis (RA) complain about being tired. This can majorly impact their daily activity, making it hard to focus on their job responsibilities. Most of the time, the cause of fatigue is not only one but a multitude of factors that may contribute as
- Anemia due to a chronic disease
- Thyroid disease
- Pain itself
- Depression
- Difficulties to sleep due to pain
- Ongoing inflammation in the body due to uncontrolled disease.
10.Low-grade Fevers
Persistent low-grade fevers may indicate how your body reacts to RA inflammation. If you are experiencing fevers, calling your doctor and discussing your symptoms is important. Fevers can be caused by:
But also
- Infections: Patients who develop fever and use certain medications that can lower the immune system (e.g., steroids, disease-modifying anti-rheumatic drugs, - DMARDs, biologics ) must be evaluated for a possible infection. You may have a sinus infection, pneumonia, or a urinary tract infection.
- Lymphomas/ cancers: Patients diagnosed with RA might be at increased risk for developing cancers, so if no infection is detected, it is important to be evaluated for this possibility. In addition, patients taking immunosuppressive medications may also have an increased risk of developing cancer, although this is still under debate at this time.
- Uncontrolled RA: If the RA is not well controlled, you continue to have pain, swelling, and severe stiffness in the joints, and ongoing inflammation can also cause low-grade fevers.
Now that you learned about these uncommon signs , you most likely recognized that you have some of them……
You see, that is why Rheumatoid arthritis requires special attention and expertise from a trained physician a rheumatologist that will recognize all these uncommon signs.
Thank you for joining me today on Thriving with Arthritis. If you or someone you know is struggling with RA, visit our website or contact our office for a consultation. Don't ignore the signs—take control of your health and thrive with arthritis. Remember to leave your comments below and subscribe for more episodes. Until next time, stay well and keep thriving!
Thanks for joining me on today on another episode in my podcast Thriving with Arthritis. Tune in next week when we'll be discussing about that you should not ignore.
Thanks for tuning in to the "Thriving with Arthritis" podcast. In my next episode I will discuss more in depth about what is RA. Remember, you're not alone in this journey.
Until next time, stay strong, stay positive and keep thriving!