Complications When You Have Rheumatoid Arthritis. 

 July 5, 2024

By  Linda Rook


In this blog I shall explore the complications of rheumatoid arthritis or for short RA.  It is the second common type of arthritis, with osteoarthritis being the most common.  Whereas osteoarthritis is a wear and tear of the joints as you age or if you have had a fall. Rheumatoid arthritis attacks your immune system, that can targeting the synovial joints also it can attack your organs.

In this blog I shall explore the long-term effect of complications when you develop rheumatoid arthritis, and the complications that you could have a second disease like heart or lung disease, or you could develop osteoporosis and much more... 

But firs I shall explain what is rheumatoid arthritis...

Understanding Rheumatoid Arthritis.

Rheumatoid arthritis or RA is a type of arthritis that attacks your immune system, it targets your synovial joints and it can lead to your organs. It mainly attacks the synovial fluid in the joints, which leads to inflammation, swelling, stiffness and pain, and can lead to a progressive joint deformity.

The precise cause of RA remains unknown, but it is thought to be connected to genetic, environmental, and immunological factors. Research has found that the genetics could be the gene called HLA-DRB1, which is the strongest that is associated genetic factor, the environmental triggers could be smoking and certain infections.

Driving with painful back.

While RA is primarily known for affecting joints, its systemic nature can lead to a wide array of extra-articular appearances. These complications can impact the cardiovascular, pulmonary, hematologic, renal, neurologic, ocular, dermatologic, gastrointestinal, and psychological systems. Chronic inflammation in RA is a major contributor to these systemic issues, highlighting the necessity of comprehensive disease management.

RA’s long-term complications significantly impair your quality of life. Chronic pain, functional disability, and systemic complications; decrease physical, emotional, and social well-being. Additionally, the economic burden is substantial, involving both direct medical costs and indirect costs from lost wages, productivity.

Long-term Complications of Rheumatoid Arthritis.

Rheumatoid Arthritis (RA) Overview.

Rheumatoid arthritis (RA) is a long-term autoimmune disease that causes inflammation in the joints. It affects about 0.5 to 1% of the global population, occurring more often in women than men. RA primarily presents with joint pain, stiffness, and swelling, but it can also lead to various long-term complications affecting multiple organs and systems.

1. Complications of RA.

Musculoskeletal Complications.

Joint Damage and Deformities: When you have chronic inflammation, it can over time cause joint damage and deformity.

Common deformities:

  • Fingers may shift sideways.
  • Swan Neck Deformity: Finger joints bend incorrectly.
  • Boutonniere Deformity: Different finger joints bend in opposing directions.
Fingers bent due to OA


RA increases the risk of osteoporosis, making your bones fragile and more likely to fracture, especially in your spine and hips.

2. Cardiovascular Complications.

  • Atherosclerosis and Coronary Artery Disease: RA can increase the risk of heart attacks and strokes; this is due to accelerated atherosclerosis.
  • Heart Failure: The chronic inflammation as well as high blood pressure in RA can lead to heart failure.
  • Pericarditis and Myocarditis: When you have inflammation of the heart’s outer lining and muscle can occur, possibly leading to heart failure.

3. Pulmonary Complications.

  • Interstitial Lung Disease (ILD): ILD causes lung scarring and breathing difficulties.
  • Pleural Disease:  RA can cause inflammation of the lung lining, leading to chest pain and breathing issues.
  • Rheumatoid Nodules: Nodules can form in the lungs, potentially causing problems if they burst or get infected.

4. Hematologic Complications.

  • Anemia: Anemia is common when you develop RA, it is due to chronic inflammation and potential blood loss from medications.
  • Felty's Syndrome: A rare condition combining RA with an enlarged spleen and low white blood cell count, increasing infection risk.
  • Lymphoproliferative Disorders: RA increases the risk of certain types of lymphomas.

5. Renal Complications.

  • Amyloidosis: Long-term RA can cause protein deposits in the kidneys, leading to kidney problems.
  • Glomerulonephritis: Inflammation of kidney filters, though rare, can happen in RA.

6. Neurologic Complications.

  • Peripheral Neuropathy: Nerve damage in RA can cause numbness and weakness, especially in hands and feet.
  • Cervical Myelopathy: Neck vertebrae instability can lead to severe nerve problems and even partial paralysis.

 7. Ocular Complications.

  • Keratoconjunctivitis Sicca (Dry Eye Syndrome):  RA can reduce tear production, leading to dry, gritty eyes.
  • Scleritis and Episcleritis: Severe eye inflammation can cause pain, redness, and vision problems.
dry eyes

Dermatologic Complications.

Rheumatoid Nodules: Small lumps under the skin, often at pressure points like elbows.

Vasculitis: Inflammation of blood vessels can lead to skin ulcers and other serious issues.

Gastrointestinal Complications.

Drug-induced Complications: RA medications can cause stomach issues like ulcers and bleeding.

Liver Disease: Some RA drugs can cause liver damage, requiring regular monitoring.

feeling nausea and headache

10. Psychological and Social Complications.

Depression and Anxiety: The chronic pain and disability from RA increase the risk of mental health issues.

Social Isolation: Physical limitations can lead to social withdrawal and reduced quality of life.

Understanding these complications can help in managing RA more effectively and improving the quality of life for those affected.

Management Strategies for Long-term Complications.

Managing Rheumatoid Arthritis (RA).

Managing RA and its complications requires a team approach, involving various healthcare professionals. Key strategies include:

1. Early Diagnosis and Treatment.

Start treatment early with DMARDs to prevent joint damage and systemic complications.

Biological DMARDs provide targeted therapy to control inflammation and halt disease progression.

2. Regular Monitoring and Screening.

Regularly check disease activity and watch for medication side effects.

Screen for complications like cardiovascular issues and osteoporosis.

3. Lifestyle Modifications.

Encourage regular exercise, a healthy diet, quitting smoking, and limiting alcohol to manage symptoms and lower complication risks.

4. Patient Education and Support.

Educate patients about RA, its complications, and self-management.

Support groups and counselling can provide emotional and psychological help.

5. Integrated Care Approach.

Healthcare providers should work together to address both joint symptoms and the overall effects of RA.

Regular follow-ups and coordinated care plans are essential.

doctor and patient


RA is a complex disease that affects more than just the joints. Understanding and managing its long-term complications can improve patient outcomes and quality of life. Advances in treatment and a holistic care approach help manage these complications effectively, allowing patients to lead healthier lives. Continuous research and education are vital for further improving RA management and prognosis.


Rheumatoid arthritis (RA) is a complex condition that extends beyond joint inflammation, impacting multiple aspects of health. Effective management involves early diagnosis, regular monitoring, lifestyle modifications, patient education, and a coordinated care approach. By addressing both the immediate and long-term complications of RA, patients can experience improved outcomes and a better quality of life. Continuous advancements in treatment and ongoing education are essential for enhancing the management and prognosis of this chronic disease.

Significant advancements in RA treatment have occurred over the past few decades. Disease-modifying antirheumatic drugs (DMARDs), including conventional synthetic (csDMARDs) and biologic (bDMARDs), have transformed RA management. Early and aggressive treatment with DMARDs aims to control disease activity, prevent joint damage, and reduce long-term complications. However, many patients still experience disease flares and complications, necessitating ongoing research and comprehensive care strategies.

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I am not a medical professional, and this blog is for information only. If you have any worries, you should consult your doctor.

I hope this blog has helped.


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Linda Rook

Linda is now retired and has suffered from Osteoarthritis for about 40+ years.  She struggled with her weight until she found the correct one that also helped with her arthritic pain.  Linda was in terrible pain until the physician thought her right hip needed replacement. 

Now Linda has an artificial right hip, which has left her with the left leg shorter than the right.  Therefore, her spine is now wonky, and has arthritis of the lower back, also it seems to be going all over the body, her pain is now in the knees, elbow, wrist, fingers and both hips.

Linda now spends her days writing information to help others with the same conditions, so they do not suffer like Linda.

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