Rheumatoid arthritis (RA) primarily causes joint pain, swelling, and stiffness. Less common symptoms include lung problems, hearing loss, and skin changes.

RA occurs when the immune system mistakenly attacks the body’s own tissue, causing inflammation. Although it typically attacks the joints, people may sometimes experience symptoms in other areas of the body, such as the eyes and mouth.

This article lists some uncommon RA symptoms and provides information on what a person can do if they suspect that they have RA. It also outlines some lifestyle practices that may help reduce a person’s risk of developing the disease.

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According to the Arthritis Foundation, some people may experience lung complications as one of the first signs of RA.

Some possible lung complications of RA include:

  • Pulmonary nodules: These are small growths in the lungs.
  • Pleural effusion: This term refers to a buildup of excess fluid between the layers of tissue lining the lungs and the chest cavity.
  • Bronchiectasis: This widening of the airways increases the risk of lung infections.
  • Interstitial lung disease (ILD): ILD is an umbrella term for conditions that cause inflammation and scarring of lung tissue.
  • Pleurisy: This type of chest pain occurs due to inflammation of the lining that separates the lungs and the chest wall.

Immunosuppressant medications for RA can increase the risk of infections, such as pneumonia and flu. It is important that people with RA receive vaccines against these conditions, where possible.

The Arthritis Foundation notes that the medication that doctors use to treat arthritis is the most likely cause of arthritis-related hearing loss.

Nonsteroidal anti-inflammatory drugs (NSAIDs) that a person takes to manage RA pain may reduce blood flow to the cochlea, which is the part of the inner ear involved in hearing. Reduced blood flow to the cochlea can affect a person’s hearing.

RA itself may also contribute to hearing loss. Some people with RA develop a condition called autoimmune inner ear disease (AIED), in which the immune system attacks structures of the inner ear. This attack causes chronic inflammation in these areas, which can result in hearing loss.

The inflammation associated with RA can also affect a person’s eyes. This may lead to various symptoms, including:

The Arthritis Foundation notes a link between gum disease, known as periodontitis, and RA.

A 2017 study found that moderate periodontitis was more common among people with RA than among those without the condition. The authors note that this association was not due to the use of RA medications.

Researchers believe that the bacteria that cause gum disease may also cause RA. However, further research is necessary to support this claim.

Sjögren’s disease is an autoimmune condition that has an association with RA. A 2019 population-based study from Taiwan noted a further association between Sjögren’s and periodontal disease, which could be due to an inflammatory immune response.

RA can cause a range of skin problems, including those below.

Increased sun sensitivity

Certain medications that a person takes to treat RA or related complications can increase the skin’s sensitivity to sunlight. Examples include:

A person should see a doctor if they begin to burn easily or develop a skin rash or hives following sun exposure.

Cold, discolored fingers or toes

Frequent coldness and bluish discoloration of the fingers or toes may be a sign of Raynaud’s disease, which affects a person’s circulation.

Raynaud’s disease can develop as a complication of an existing condition, such as RA or lupus. In such cases, doctors refer to the condition as secondary Raynaud’s. It is usually more severe than Raynaud’s disease that develops as a primary condition.

Sores or lesions

Multiple sores or purplish lesions could be an indication of vasculitis. This is the medical term for inflammation of the blood vessels.

Chronic inflammation of the blood vessels can lead to them becoming damaged and defective. This may result in insufficient blood supply to the body’s organs, which then leads to organ damage.

There are many forms of vasculitis, and they often occur alongside rheumatic diseases. A person should speak with a doctor if they notice any unexplained sores or lesions.

Unusual bruising

Unusual or excessive bruising can occur as a result of RA or its treatment.

Platelets are a type of blood cell that helps the blood clot. A low platelet count can lead to excessive bleeding and bruising. A person may experience a low platelet count due to their RA or as a side effect of RA medications such as methotrexate or biologics.

Some people with RA may take corticosteroids to help reduce inflammation. However, a side effect of corticosteroids is that they can weaken tiny blood vessels called capillaries. This can lead to unexplained bruising or the development of large bruises following a minor incident.

Purple or red lines underneath the skin

Purple or red lines underneath the skin may be dilated blood vessels. If these occur on the face or around a person’s nails, they could be a sign of dermatomyositis. This connective tissue disease can occur alongside RA.

A wound that does not heal

Some people with RA take medications called tumor necrosis factor (TNF) inhibitors to help reduce inflammation. According to a 2019 review, these medications may increase the risk of certain skin cancers.

A wound that does not heal after a month may be a sign of skin cancer. Other possible signs of skin cancer include:

  • pain
  • infection
  • bleeding

If a person notices any unusual or unexplained changes in their skin, they should speak with a doctor.

RA can cause nerve conditions that may result in sensations of numbness and tingling.

Carpal tunnel syndrome

Carpal tunnel syndrome is a condition that may cause numbness, tingling, or burning sensations in the thumb and fingers. The condition occurs as a result of a compressed median nerve in the wrist.

RA can cause inflammation inside the wrist or lead to bone spurs that press against the median nerve. These effects can result in the development of carpal tunnel syndrome.

Peripheral neuropathy

Peripheral neuropathy is a type of nerve damage that can cause pain, numbness, or muscle weakness. The condition occurs due to damage to the nerves that branch out from the brain and spinal cord.

A 2019 study found that peripheral neuropathy in RA was associated with the following:

  • increasing age
  • longer duration of RA
  • increased severity of RA
  • use of certain RA medications

The Arthritis Foundation states that people with RA are about 70% more likely than those without RA to develop a gastrointestinal problem.

Possible reasons for this higher risk include inflammation, increased likelihood of infections, and the use of certain medications.

A 2018 study found that loss of muscle mass was four or five times more common among people with early RA than among those without the condition. On average, the participants with RA also had more fat around their abdomen.

Both findings may be due to reduced physical activity in response to joint pain or stiffness.

The Arthritis Foundation notes that more than 80% of people with RA list fatigue as a symptom. This may be due to RA pain causing sleep disturbances that leave a person feeling fatigued the following day.

Additionally, people who take the corticosteroid prednisone for RA may experience insomnia as a side effect.

RA can significantly affect a person’s mental health, and it can cause or worsen depression and anxiety, possibly due to ongoing pain and stress.

Chronic stress can also alter a person’s brain chemistry. This, in turn, can affect mood, thinking, and behavior. In particular, people with RA may find that they develop issues with the following:

  • memory
  • attention
  • concentration

If a person suspects that they have RA, they should speak with a doctor. It is important to begin treatment as soon as possible to get the inflammation under control. Uncontrolled RA can lead to complications, such as:

In some cases, untreated RA can cause premature death.

A person should contact a doctor if they notice any symptoms of RA, such as:

  • pain or aching in more than one joint
  • swelling, stiffness, or tenderness in more than one joint
  • the same symptoms on both sides of the body, such as in both hands
  • unexplained weight loss
  • fever
  • fatigue
  • weakness

A doctor will run tests to diagnose the cause of the symptoms. If they confirm that the individual has RA, they will work with them to develop a treatment plan that will likely include a combination of medications and lifestyle changes.

Rheumatoid arthritis is an autoimmune condition that primarily causes inflammation, pain, and swelling in the joints. The condition can also cause less common symptoms, such as hearing loss, skin problems, and digestive issues.

If a person suspects that they have RA, they should speak with a doctor as soon as possible. Without treatment, RA can lead to complications, such as obesity and disability. It can even result in premature death.

Certain lifestyle practices may help reduce a person’s risk of developing RA. Examples include eating a nutritious diet, maintaining a moderate weight, and quitting smoking, if applicable.