Rheumatoid Arthritis (RA) Symptoms and Complications

Medically Reviewed by Poonam Sachdev on March 05, 2024
Written by Kendall K. Morgan
7 min read

Rheumatoid arthritis (RA) symptoms are almost always in your joints. The inflammation it causes often leads to these three hallmark symptoms:

Pain. Inflammation inside a joint makes it hurt whether you’re moving it or not. Over time, it causes damage and pain.

Swelling. Fluid in the joint makes it puffy and tender.

Tenderness. It hurts when you move or push on a joint.

Other RA symptoms include:

Stiffness. The joint is harder to use and doesn't move as well as it should. It’s especially common in the morning. Many people with other forms of arthritis also have stiff joints in the morning, but for people with RA, it may take more than an hour (sometimes several hours) before their joints feel loose.

Redness and warmth. The joints may be warm and have color changes related to the inflammation.

RA symptoms can vary among people who have this long-term disease. You may feel it in different places and to different degrees. Some people have long periods with few or no symptoms, while others go through months of intensified symptoms, known as a flare. For some people, RA gets worse quickly, while it can move more slowly for others.

Most people have lasting problems with episodes of more severe disease. However, the overall picture is changing with newer and earlier treatment options, resulting in more and more people having low disease activity or even remission.

Juvenile rheumatoid arthritis symptoms

Juvenile rheumatoid arthritis, also called juvenile idiopathic arthritis, is the most common type in kids. The symptoms of it are similar to RA in adults.

Osteoarthritis vs. rheumatoid arthritis symptoms

Both types of arthritis can cause pain, stiffness, swelling, and tenderness in your joints. If you have osteoarthritis, you may also have:

  • Trouble moving your joint fully
  • A feeling that your joint is grating, perhaps with popping or crackling sounds
  • Bits of bone that feel like hard lumps around your joint

You'll likely notice tenderness or pain in small joints. This may be in your fingers or toes. You may also notice pain in a bigger joint, such as your knee or shoulder. At first, it may be subtle, and you may it easy to ignore. But it's a good idea to get checked out if you think you may have signs of RA. The sooner you can get treated, the better off you'll be since the disease can cause permanent damage to your joints over time.

RA symptoms usually start in your hands. Other commonly affected areas on your body are:

  • Elbows
  • Wrists
  • The knuckle where each finger meets your hand, known as the metacarpophalangeal (MCP) joint
  • The first joint in your fingers, known as the proximal interphalangeal (PIP) joint
  • Ankle

But RA symptoms can appear anywhere on your body, including:

  • Toes
  • Hips
  • Jaw
  • Knees
  • Neck
  • Shoulders
  • Finger joint closest to the thumbnail

Your symptoms are usually symmetrical, as they show up in the same joints on both sides of your body.

It doesn’t happen often, but RA can also affect joints in your voice box called the cricoarytenoid joints. It can make your voice hoarse. Rarely, you may lose your voice.

RA symptoms can also go beyond your joints. You could feel:

  • Fatigue
  • Muscle aches
  • Poor appetite
  • A general feeling of sickness (your doctor may call this malaise)
  • Depression

Extreme fatigue could be a sign of anemia, which refers to a lack of healthy red blood cells. Your doctor will test you for anemia as part of your RA diagnosis.

Depression could also cause some of these symptoms. A long-term disease such as RA can be challenging to live with. Talk to your doctor if you feel sad or down.

Some people with RA get rheumatoid nodules. These are bumps under the skin. Most of the time, they aren’t painful, and they move easily when you touch them. About 1 in 4 people with RA get these skin bumps.

They usually happen on your elbows, but they might show up on other bony areas such as:

  • The underside of your forearm
  • The back of your head
  • The base of your spine
  • Your Achilles tendon
  • Tendons in your hand

RA inflammation can affect more than just your joints, including your lungs or the lining around them. This causes chest pain that worsens with breathing, called pleurisy. Lung problems are the most common symptoms of RA outside the joints. This may not cause symptoms, or you might notice shortness of breath. Your doctor can treat it with drugs that ease the inflammation in your lungs.

Severe inflammation from RA in your lungs can make the tissue stiff, thickened, and scarred. This is pulmonary fibrosis, a hard-to-treat condition that makes it tough to breathe.

RA can inflame the lining around your heart (called pericarditis) or your heart muscle (called myocarditis). You probably wouldn’t notice symptoms from that. There’s a chance you could feel shortness of breath or sharp, stabbing chest pain. If you do, call your doctor. It can also raise your odds of heart failure, atrial fibrillation, and stroke.

When RA gets into the cartilage that connects your ribs to your sternum, it can feel like you’re having a heart attack. This is known as chest wall pain.

The most common vision-related complications of RA include:

Cataract. A clouding of the lens in your eye that affects your vision.

Dry eyesyndrome. Whether it’s because of medications or damage to your tear glands, your eyes can’t make a healthy tear film.

Scleritis. Inflammation and redness in the white part of your eye.

Bones. The chemicals that cause inflammation can also take a bite out of your bones. RA often affects your hips and spine. Sometimes, it’s a byproduct of years of treating RA with steroids.

Liver and kidneys. It’s rare for RA to affect these organs, but the drugs taken to treat it can. Nonsteroidal anti-inflammatory drugs (NSAIDs) can be bad for both. Cyclosporine may cause kidney disease, and Methotrexate can damage your liver.

Immune system. The medications you take to treat RA can slow your immune system, making you more likely to get infections.

Mucous membranes. You might be more likely to get a condition called Sjogren’s syndrome that dries out moist places in your body such as your eyes, your mouth, and the inside of your nose.

Muscles. When inflammation stops you from moving your joints, the attached muscles can get weak. Or you could get a condition called myositis , which weakens them. The medications you take for RA can also cause it.

Nerves. RA causes symptoms that range from numbness and tingling to paralysis. It can result from joint damage that RA causes, the disease process itself, or medications that treat it.

Blood vessels. RA can cause inflammation of your blood vessels. It can show up as spots on your skin or cause ulcers in more severe cases.

If you have RA, you may also have more risk for depression or other mental health problems. There's evidence that arthritis can be harder to treat when you also have depression. However, the link between RA and mental health hasn't been fully understood. It's unclear if pain and other RA symptoms lead to depression and anxiety, or if the arthritis-related inflammation causes depression.

If you have depression and RA, you could have worse symptoms, such as:

  • More pain
  • More risk of heart problems
  • More trouble at work
  • Trouble with family and friends
  • Sexual dysfunction

If you have RA and depression, anxiety, or other mental health problems, it's a good idea to talk to a doctor about it so that you can get help for both conditions.

RA affects everyone differently. Some people have mild RA, while others have severe cases with joint damage.

Many people with RA have symptoms on most days. Some days may be better than others.

It’s rare, but some people have symptoms only from time to time, with months of relief between these flares.

Keeping track of your symptoms may help you monitor how your disease is progressing. You can use pen and paper or apps to record when you have symptoms and for how long, how intense they are, and what makes them worse or better. Remember to take your symptom diary every time you visit your doctor or rheumatologist.

Rheumatoid arthritis causes pain, swelling, and tenderness in your joints. But RA inflammation can also affect many other parts of your body and worsen your mental health. If you think you may have RA, see a doctor for early treatment to avoid permanent damage to your joints and other related health problems.

  • What is the life expectancy of a person with rheumatoid arthritis?

RA isn't a fatal disease, but studies show that people with RA don't live as long as people without it. Your life expectancy could be reduced by 3-10 years. That may be because of the effects of RA inflammation on many parts of your body. You also could have complications from treatment. If you have RA with symptoms throughout your body or other complications, it's a good idea to get treatment and close monitoring to reduce your risks.

  • Can you live with RA without medication?

It's possible to live without treating RA. But you'll have more pain, disability, and a higher risk of an early death. Most of the damage from RA happens early on in the disease, and people who don't get treated are twice as likely to die as those who don't have RA.

  • How do I know if I have rheumatoid arthritis?

If you think you may have RA, see your doctor and ask for a referral to a rheumatologist. They'll check you out and ask about your RA symptoms. They can also order blood tests to look for signs of inflammation and imaging tests to look for damage in your joints.