A low grade fever is a common symptom of living with rheumatoid arthritis. Read on to find out causes, symptoms, and possible treatments.
Rheumatoid arthritis (RA) is an autoimmune disease that primarily affects the small joints of the hands, wrists, feet, and ankles. It can also have some systemic (whole-body) symptoms, including a fever.
RA-related fever is an elevation in body temperature above 100.4°F (38°C) that lasts for an extended period of time.
Typically, RA-related fevers remain in the low grade range, between 99°F (37.2°C) to 100.4°F (38°C). Some people do report longer-lasting higher temperature readings.
RA-related fevers are usually caused by the underlying autoimmune disease, but there are a couple of different reasons the fever might occur:
“Fevers were the first sign that something was wrong. RA is a frustrating condition that is poorly understood, but try to get to the root cause of your fevers and flares. Once I identified this, ibuprofen and rest helped me the most.”
— Nicole L., diagnosed with RA in 2022
An RA-related fever is different from other kinds of fevers because of its underlying cause. You cannot have an RA-related fever unless you have RA.
RA-related fever is usually low grade, ranging from 99°F (37.2°C) to 100.4°F (38°C), over an extended period of time, usually weeks to months. Fevers from other causes typically have a rapid onset and resolve in a much shorter period of time, usually days to a week.
In addition to fevers, you’ll usually have traditional symptoms of RA such as joint pain, stiffness, swelling, fatigue, and limited mobility. Someone with RA may also report a flare in their symptoms at the time of the fever.
Fevers from other causes will be accompanied by symptoms typical of that problem. For example, pneumonia may cause a fever, and you would most likely have a cough and shortness of breath.
“I get fevers right before I have a flare-up. Sometimes it’s a low grade temperature, and sometimes it’s cold sweats. I recommend acetaminophen, hot/cold compresses, and rest.”
— Heather C., diagnosed with RA in 2006
Treatment of RA-related fevers will depend on trying to decipher the underlying cause. While related to RA, determining whether it’s due to inflammation or infection from suppressed immunity will help to tailor treatment.
It’s important to consult with your doctor prior to starting any treatment. They will likely do the following:
If related to systemic inflammation, the RA-related fevers may respond to medications and other treatments directed at controlling the underlying RA symptoms. Managing inflammation may involve changing, stopping, or adjusting the dosages of your RA medications in combination with other lifestyle modifications.
For example, this review suggests that a healthy diet, avoiding obesity and smoking, and frequent physical activity can effectively support treatment outcomes.
You might have a fever from an infection due to being immunocompromised with RA. If this is the case, you may require antibiotics or antivirals to bring down the fevers.
Symptom management is also an important treatment consideration. This may include the use of medications to lower the fever such as aspirin, ibuprofen, naproxen, or other nonsteroidal anti-inflammatory drugs (NSAIDs). You should talk with your doctor before taking these treatments and familiarize yourself with the side effects and possible medication interactions.
If you’re taking NSAIDs or corticosteroids to manage what you feel is an RA-related fever, and you’re still having measurable temperatures over 99°F (37.2°C), you should seek medical attention as soon as possible. These medications are very effective at lowering body temperatures, so a persistent fever while taking them could be a sign of something more serious.
“I use ibuprofen or Tylenol as needed when I get RA-related fevers. Warm baths helped for me in the past, too.”
— Rhonda T., diagnosed with RA in 2006.
“I never register a fever, but my body feels hot inside. I do everything I can to cool it off. I use CBD and natural herbs to manage this, which is helpful at managing both my RA and the hot feelings.”
— Dionie P., diagnosed with RA in 2018.
RA-related fever is not the same as rheumatic fever. RA-related fevers are associated with the underlying condition of RA. Rheumatic fever is a complication of untreated (or incompletely treated) streptococcal throat infections caused by Group A Streptococcus bacteria. Learn more about rheumatic fever here.
Typically, RA-related fevers are due to poorly controlled RA with high disease activity and inflammation. Managing these symptoms and inflammation is a more general approach to the treatment of RA-related fevers.
If fevers are an ongoing or recurring issue, you might want to monitor your own health status day-to-day. Keeping a symptom log or using a symptom tracker app is especially helpful for this. It may help you or your doctor figure out a cause and treatment for your fevers.
If you have RA, a fever may be a sign of an underlying infection or worsening inflammation somewhere in your body. It can be a common symptom of RA, but you should talk with your doctor right away.
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*All quotes were shared with permission.
Medically reviewed on August 14, 2023
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