Beyond the Joints: 10 Unusual Symptoms of RA

These are some of the symptoms that you might not immediately associate with RA, including brain fog, fatigue, weather sensitivity, and more.

When you think of rheumatoid arthritis (RA) symptoms, swollen and painful joints might immediately spring to mind. But you may be surprised to learn that RA can cause symptoms in nearly any part of your body. These are 10 of the more unusual and less known symptoms.

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1. Brain fog

Feel like you can’t think clearly, concentrate, or remember things? It could be brain fog caused by your RA. Brain fog is also known as cog fog, and is referred to as cognitive dysfunction in research literature.

RA causes chronic pain and inflammation, both of which can affect your ability to think.

A review from 2020 notes that the pathways for pain and cognition are closely linked and may affect one another. So, if you’re in pain for a long time, those pain pathways can interfere with your thinking pathways.

Another study showed that inflammation can change the way parts of the brain are connected. The pain and inflammation from RA may cause changes that lead to foggy thinking.

RA warrior, Eileen Davidson, has shared her experience with brain fog and RA and her best tips to cope.

2. Digestive issues

If you’re living with RA, the Arthritis Foundation notes you have a 70% higher chance of developing gastrointestinal (GI) issues or digestive issues compared to others. For example, researchers have found that about 20% of people living with RA develop irritable bowel syndrome (IBS).

Several things may be responsible for this, including:

• your medications
• infections
• complications from inflammation associated with RA
• comorbidities (other medical conditions that happen at the same time)

If you find you’re struggling with digestive symptoms, such as indigestion, diarrhea, constipation, or others, you may want to talk with a doctor. They can help figure out if it’s your medications or if another condition is the real problem.

You may also find that making changes to your diet can help. Some general dietary guidelines for IBS include:

• Eat regular meals at a slow pace.
• Drink at least 8 cups of water each day.
• Avoid garlic, onions, and any other food that triggers your symptoms.
• Eat until you feel full and then stop.
• Limit tea and coffee to 2 or fewer cups a day.
• Reduce or stop drinking alcoholic, sugary, or carbonated drinks.

You may also want to try different foods and drinks to see what combinations work best for you.

3. Weather sensitivity

Weather sensitivity can be a complaint for those living with RA.

You may find that cooler temperatures help make your pain more tolerable, while warmer temperatures in summer may increase your discomfort.

Interestingly, a 2017 study actually noted that a subset of people with RA react negatively to cold temperatures. They reported increased pain and other symptoms at cold temperatures. So, extreme hot or cold temperatures may affect your RA symptoms.

Though you probably can’t just up and move to a temperate climate, you can take some steps to help during the heat of summer or cold of winter. Some suggestions include:

• dressing for the weather: think loose-fitting clothing on hot days and layering up on colder ones
• staying cool in the shade or inside on hot days
• keeping temperatures in the home at a comfortable setting
• stretching and other light exercises on really hot days
• opting for indoor exercises on really cold days
• staying hydrated

Find out why RA Warrior Fiske Nyirongo also suggests prioritizing your diet and staying in tune with your body.

4. Chest pain

Chest pain may be associated with RA. The condition can cause what is known as costochondritis, which is inflammation of the cartilage of the chest.

The inflammation can cause localized pain in the center of the chest that may worsen when taking a deep breath or pressing on your ribs.

If you don’t know what is causing your chest pain, you should seek emergency medical attention, particularly if it is accompanied by radiating pain, nausea, or other symptoms.

You can find out more about costochondritis and the different ways RA can cause chest pain here.

5. Skin concerns

RA can cause easy bruising, skin discoloration, and rashes. And it can make it more difficult for you to heal from wounds to the skin.

Some potential skin-related symptoms you may experience include:

• bruising
• hives
• pustules
• nodules
• tiny red, purple, or brown spots known as petechiae

Of these, nodules are one of the most common, affecting nearly one-quarter of people living with RA.

The underlying cause of these skin-related symptoms may be RA itself or a reaction to a medication used to treat it.

6. Hearing loss

Hearing loss is another less common complaint that you may notice when living with RA. There are two possible reasons: inflammation associated with RA and side effects of your medications.

If RA is responsible, what is likely happening is that your immune system is also attacking your ears with inflammation. This can cause damage to the ears and lead to hearing loss.

Medication culprits include commonly used pain relievers like aspirin and acetaminophen. These may reduce blood flow to the ears and also reduce the amount of protective proteins in the ears.

Often, you can reverse the loss of hearing either by switching medications or taking additional steps to address the inflammation associated with RA.

7. Eye irritations

As a result of systemic inflammation, RA can cause issues with other areas of your body, like your eyes.

You may notice:

• swelling
• dryness
• redness
• discomfort

Over-the-counter drops may help. You may also find that using a humidifier helps with dry eyes.

It can also lead to the development of several different eye-related complications, including dry eye syndrome, swelling of the eye (uveitis), or glaucoma, to name a few.

There are nutrients that can help optimize your eye health, such as vitamins A and C. But if these eye conditions develop, you’ll likely need specialized treatment from a doctor.

8. Sleeping problems

Sleep loss can be a common concern for people living with RA, but you may not realize that your RA could be the culprit.

In a study from 2018, researchers found that patients with RA often report a high prevalence of nonoptimal sleep. This was found to be linked to pain level.

If your pain keeps you up at night, you may want to talk with a doctor about new strategies to help get your symptoms under control. They may recommend changes to medications or additional therapies.

You may also find that stretching, light movement, or taking a relaxing bath before bed may help to alleviate joint pain before trying to sleep. You can read up about other sleep hygiene hacks here.

9. Increased body fat

According to a 2018 study, arthritis contributes to a loss of muscle mass and an increase in body fat.

Greater body fat can increase both your blood pressure and cholesterol levels, which puts you at a higher risk of developing cardiovascular disease.

You can combat this with lifestyle changes, including diet, exercise, stress reduction, and getting enough sleep each night.

Exercise can feel daunting when your joints hurt, but your symptoms will likely improve when exercising or being active.

In fact, the American College of Rheumatology’s 2022 guidelines reports that engaging in exercise has the strongest evidence for improving physical function and decreasing RA pain. If you have any damage to your joints, you may want to stick with low impact exercise, such as swimming, biking, or walking.

Find out how RA Warrior, Victoria Stokes, was able to use diet and exercise to manage her RA diagnosis.

10. Fatigue

Inflammation caused by RA can lead to general physical weakness, drowsiness, and exhaustion.

A 2020 study found that most people with RA have mild fatigue, and at least 1 in 6 have severe fatigue. The study noted that it may not be directly related to disease activity. Instead, it may be due to other factors that often occur with RA, including:

• comorbidities
• pain level
• mood
• personality traits
• medications used to treat RA, such as methotrexate
• poor sleep
• obesity

You may find that one or more of the following helps, though no standards of treatment exist yet. This means that doctors do not fully agree on what works best for everyone.

• manage RA itself
• cognitive behavior therapy
• exercise
• mindfulness training

You can read more about Rachel Charlton-Dailey’s experience with fatigue here.

Let’s recap

RA can affect more than just your joints. You may not expect your eye irritation or hearing concerns to be related to your RA, but it’s important to know that it’s a possibility.

Across the board, the most common reasons for these symptoms include RA disease activity, medication reactions, and comorbidities. You can often take steps to help manage these symptoms. This can include managing RA disease activity with medications as well as home remedies.

If you do experience any of these symptoms and they don’t get better with your efforts, you should consider talking with a doctor as soon as possible for help in managing them.