Understanding the Dangers of Untreated RA

Medically reviewed by Nancy Carteron, M.D., FACR, Rheumatology - Immunology — Written by Stephanie Pierce — Updated on August 22, 2022

Rheumatoid arthritis (RA) causes inflammation of the lining of the joints, especially in the hands and fingers. Left untreated, it can cause severe damage to the joints and serious complications in the major organs.

The signs and symptoms of RA include red, swollen, and painful joints and reduced mobility and flexibility. Because it’s a progressive disease, the symptoms typically get worse.

However, there are a number of effective treatments, and proper treatment is critical to managing the progression of RA.

Short-term effects

When you develop RA, you’ll start to have flare-ups. These are periods when your symptoms get worse. Treatment can help relieve and reduce flare-ups.

Before you get diagnosed and begin treatment, you may suddenly experience pain and stiffness in the affected joints. In particular, RA tends to affect the joints that connect your big toes to the rest of the foot first, so you may notice difficulties with walking.

You may also feel tired, lose weight, or develop nodules under your skin. You may find it difficult to do everyday tasks.

When you have RA, you’re also more at riskTrusted Source for developing a bacterial or viral infection. This is because your immune system is attacking your own joints and tissues, making it unable to fight actual pathogens effectively.

This risk does not go away with treatment, as some medications for RA can also weaken your immune system.

Long-term effects

As RA progresses, it continues to cause pain and inflammation to joints throughout the body. This includes:

• wrists, elbows, and shoulders

• ankles, knees, and hips

• The C1-C2 vertebrae in the spine

• ribcage

If left untreated, the long-term damage to the joints can be significant. Fibrous tissue may form around the joints, and bones may fuse together.

This can cause deformity and a loss of mobility. Of course, with the hands being the most commonly affected, this loss of mobility can cause serious issues with the quality of life.

Other complications

When RA isn’t properly treated, serious complications can develop in the major organs, including the skin, heart, lungs, and kidneys.

Effects on the skin

The same immune response that attacks the lining of the joints can also impact the skin. Rashes are common in those with untreated RA.

This also includes blisters and lumps of inflammatory tissue under the skin called nodules, which occur in 25%Trusted Source of people diagnosed with RA.

Effects on the heart

People with uncontrolled RA may have inflammation that spreads to the blood vessels, causing them to narrow. This can lead to blockages and clots in the arteries and smaller blood vessels.

These blockages can doubleTrusted Source your chances of having a heart attack or stroke. RA can also lead to pericarditis or inflammation of the membrane that surrounds the heart.

Effects on the lung

Lung problems that result from untreated RA include:

• Scar tissue: This develops over time due to long-term inflammation. This tissue can trigger breathing difficulties, chronic cough, and fatigue.

• Rheumatoid nodules: These appear in the lungs and are similar to those that appear under the skin. Occasionally, these nodules rupture, which could cause a lung to collapse.

• Interstitial lung disease: This is inflammation within the lungs. Its symptoms can range in severity but most often causes shortness of breath.

• Pleuritis: This is inflammation of the tissue that surrounds the lungs. Fluid can also build up between the layers of the pleura, leading to breathing difficulties and pain.

Effects on the kidneys

People with RA are more likely to develop kidney disease. A combination effect of inflammation, medication side effects, and other contributing factors seem to cause kidney problems.

Because of this, it’s important that your doctor monitors your kidney function regularly. Symptoms of kidney disease include:

• fatigue

• decrease in appetite

• swelling in the ankles or feet

• darkening of the skin

• itchiness

• muscle cramping

• shortness of breath

• increased urination

Your RA treatment plan

As soon as you’re diagnosed with RA, your doctor will likely prescribe disease-modifying antirheumatic drugs (DMARDs).

These drugs, which include newer biologic medications, can be extremely effective at slowing or even stopping the progression of RA.

In addition, another effective course of treatment developed in recent years can be antifibrotic agents such as nintedanib (OFEV), especially if there’s an impact on the lungs.

Your doctor may recommend additional prescription drugs, over-the-counter pain relievers like ibuprofen or naproxen, and regular exercise or physical therapy.

Frequently asked questions

Here you’ll find answers to additional questions about RA.

Can you live with rheumatoid arthritis without medication?

Since RA is a progressive disease, you cannot live with it without medical treatment. If you do, the symptoms will gradually get worse and become disabling.

There are some natural remedies that you can use to help with some symptoms relief. This includes using essential oils, getting acupuncture, and more.

Learn about natural ways to manage RA.

How quickly does rheumatoid arthritis spread?

Research shows that about 47%–53%Trusted Source of people diagnosed with early RA in the last year will develop moderate-to-severe disease symptoms within 5 years.

What are the signs that RA is progressing?

Signs that your RA is getting worse include increased joint swelling or stiffness, decreased range of motion in the affected joints, development of rheumatoid nodules, increased fatigue, and more difficulty performing day-to-day activities.

Takeaway

With so many potential complications from RA, the importance of staying on track with your treatment plan is clear.

If you have questions or concerns about any aspects of your treatment, be sure and discuss them with your doctor.

Open lines of communication between you and your healthcare professionals can help ensure the successful treatment of your RA and a better quality of life for you.