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  • Valerie Smith, APRN

How Rheumatoid Arthritis Affects Hands and Feet



Autoimmune diseases tend to impact the extremities, and rheumatoid arthritis (RA) is no exception.


In fact, your hands and feet can be the first areas of your entire body to experience RA symptoms.


According to the American Academy of Orthopaedic Surgeons: “Deformities of the hands and feet are the more obvious signs of RA. In about 20% of patients, foot and ankle symptoms are the first signs of the disease.”


If not in the beginning, “more than 90% of people with rheumatoid arthritis (RA) develop symptoms in the foot and ankle over the course of the disease.”


Why is this the case? Let’s discuss what makes the hands and feet susceptible to RA symptoms.


How an Autoimmune Disease Works


Rheumatoid arthritis is an autoimmune disease, which is a chronic inflammatory disease. When you have an autoimmune disease, your immune system confuses healthy cells for foreign cells.


The purpose of an immune system is to protect your body against bacteria, infection, viruses, and any other foreigners. When it senses these invaders, it sends out cells to destroy them.


But with an autoimmune disease, your immune system turns on itself and attacks all the wrong spots. Those fighter cells go after joints, tissue, skin, and organs, since it has difficulty deciphering between healthy cells and foreigners.


The result of this malfunction? Chronic inflammation is at the top of the list.


The Impact on Hands and Feet


While an autoimmune disease can trigger widespread inflammation that affects more than one body system, it often begins with the small joints.


And the hands and feet have plenty of tiny joints to attack! To be exact, each hand has 27 joints and each foot has 33 joints.


More specifically, rheumatoid arthritis goes after the lining of those smaller joints. The purpose of this fluid-filled lining is to lubricate the joint, protect nearby cartilage, and nourish the joint.





With rheumatoid arthritis, the lining becomes inflamed. The overactivity leads to joint:

  • Swelling

  • Pain

  • Redness

  • Warmth

  • Stiffness

  • Tenderness

  • Weakness


Prolonged inflammation leads to other problems, though. The inflammatory process slowly destroys the joint. It breaks down the ligaments and tissues that support the joint.


As the joint is weakened, joint deformities develop. Also, softening of the bone can occur, which results in stress fractures, broken bones, or bone erosion.


Nerve and Blood Vessel Complications From Rheumatoid Arthritis


Although rheumatoid arthritis is known for its impact on bones and joints, the inflammatory process can lead to nerve and blood vessel issues as well. Consequently, the hands and feet are specific body parts that most commonly feel the effect of that dysfunction.


Your nerves help you feel sensation, so when the nerve supply to your feet or hands is interrupted, peripheral neuropathy may settle in. Symptoms include:

  • Numbness or lack of feeling

  • Burning, throbbing, or sharp pain

  • Tingling or prickling sensations

  • Extreme sensitivity or decreased sensitivity to touch

  • Weight-bearing pain

  • Poor coordination

  • Weakness


If RA decreases blood supply to your extremities, a different set of conditions could arise. Restricted blood supply is associated with atherosclerosis and rheumatoid vasculitis. Atherosclerosis is when the blood vessels narrow and harden, and vasculitis is when the blood vessels are inflamed.


Although both conditions include similar symptoms as peripheral neuropathy, patients can also experience cramping, skin sores, skin discoloration, tissue death, and more as a result.


Treatment Options For Your Hands and Feet


Because hands and feet are a common target of RA, there are plenty of treatment options to help decrease disease progression and minimize symptoms.


Treatment options vary from patient to patient, and what works for one individual may not be the best fit for another. Unfortunately, this means finding the right treatment can become a trial-and-error process.


Plus, many treatment plans are based on the severity of symptoms. A treatment found successful in one patient may not be a possibility for someone else.


Treatment plans are highly personalized, but could include:

  • Prescribed medications

  • Steroid injections

  • Nonsteroidal anti-inflammatory medications

  • Vitamin or herbal supplements

  • Orthotics

  • Braces

  • Surgery


Furthermore, lifestyle choices significantly contribute to RA symptoms and conditions. Often times, a treatment plan will include elements such as:

  • Weight loss

  • Dietary restrictions

  • RA-friendly exercise

  • Physical therapy

  • Occupational therapy

  • Strategic downtime/rest

  • Ice/Heat

  • Stress reduction

  • Mental health support


Also, treatment plans are diagnosis-specific, so most rheumatologists will order imaging tests to confirm the internal condition of your hands or feet. These tests might include x-rays, MRI scans, or CT scans.


The Healthcare Team at Paducah Rheumatology


Here at Paducah Rheumatology, we have an extremely knowledgeable healthcare team that has extensive experience caring for patients with rheumatoid arthritis.


RA is an inflammatory disease that should be taken seriously. When diagnosed and treated in its early stages, you decrease the likelihood of developing severe symptoms.


Our goal at Paducah Rheumatology is to improve the quality of life of our patients, and it all starts with receiving proper and prompt treatment.


If you suspect you have RA, we can help.


If you have been living with RA for many years, we also want to hear from you.


We are accepting new patients with a referral from their physician.


Give us a call at (270) 408-6100 today.


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