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Rheumatoid arthritis (RA) is an autoimmune disorder in which the immune system mistakenly attacks the lining of the joints. This leads to joint inflammation and pain, often of the hands, feet, wrists, or ankles. While autoimmune disorders mainly affect a specific organ system (like the joints in RA), they can also cause inflammation throughout the body. When inflammation is more widespread, it can lead to fevers.
This article discusses fevers associated with RA, how to treat them, and when to be concerned.
Why Does RA Cause Fevers?
A fever is defined as a temperature at or above 100.4 degrees F (or 38 degrees C). Fevers are not as common in people with RA compared to other autoimmune diseases, but they still happen.
Both acute and chronic inflammatory processes cause fevers. RA is a chronic inflammatory process. An example of an acute inflammatory process includes a viral or bacterial infection.
In RA, the immune system is inappropriately triggered to attack the normal cells of the joint lining called the synovium. During this process, the immune system sends signals called inflammatory mediators that also function as fever-inducing signals called pyrogens. These signals activate the inflammatory process chronically but can be more severe at certain times, leading to fevers.
Other Symptoms of RA
Symptoms of rheumatoid arthritis include:
- Joint swelling
Symptoms are usually worse in the morning, and more than one joint is affected. The problem is often symmetrical, occurring in joints on both sides of the body, often affecting both hands or both feet first.
How Can I Tell If RA Is Causing My Fever?
It can be difficult for patients with RA and their healthcare providers to know what is causing their fever. There is no clear way to distinguish a fever caused by an acute infection from a systemic chronic inflammatory process.
At this time, healthcare providers use clinical experience to recognize patterns of symptoms that suggest an acute infection. For example, if a person also has signs of an upper respiratory infection, or if a person has a skin infection with an abscess (swollen, pus-filled pocket) the fever is more likely related to the acute infection.
If a person does not have any other new symptoms, it may be unclear whether the fever is related to a new developing infection or associated with the overall inflammatory process of RA.
The severity or height of the fever, and the duration of the fever, cannot help determine the reason for the fever.
What Causes RA?
Scientists are not sure why people develop rheumatoid arthritis, but certain people likely have a genetic predisposition for the disease, and it becomes activated by environmental triggers.
How To Treat an RA Fever
Treatment for a rheumatoid arthritis fever is the same as any other fever. Over-the-counter (OTC) medications, including Tylenol acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil or Motrin (ibuprofen), can treat a fever.
It can take 30–45 minutes for these medications to work. Additionally, a person can put a cool, damp washcloth on their forehead to provide relief.
You can safely take Tylenol and ibuprofen (Advil or Motrin) together to treat a fever, because they are different medications and can work together to bring the fever down.
When to See a Healthcare Provider
People with RA need to inform their healthcare provider when they have a fever in order to identify whether a potentially more serious infection is present.
If you have had RA for many years and never found another cause for your fevers, informing your healthcare provider will give them a better understanding of when to be concerned about fevers and avoid further tests.
However, patients need to work with their providers and obtain further evaluation and testing to ensure that the fever is not concerning in other situations.
People with autoimmune disorders like RA are more likely to develop complications when they have an acute infection. These people often take medications called disease-modifying antirheumatic drugs (DMARDs) that suppress the activity of the immune system. This immune suppression puts people with RA at risk for other acute bacterial infections.
Rheumatoid arthritis is an autoimmune disorder that causes inflammation throughout the body that can lead to fevers. However, there is no sure way to know whether a fever is related to the chronic autoimmune disorder, an acute infection, or other fever-inducing problem. A healthcare provider should evaluate fevers related to RA to ensure you do not have an acute infection.
A Word From Verywell
Living with a chronic autoimmune disorder like rheumatoid arthritis can be frustrating and stressful. There is no straightforward way to know whether a fever is concerning and caused by something new or if it's related to the underlying disease. Seeing your healthcare provider may help you determine the cause, get you relief, and ease your mind.
Frequently Asked Questions
- How long do rheumatoid arthritis fevers last?
The duration of an RA-related fever may seem long since the inflammatory process is chronic. However, a person should not wait to speak to a healthcare provider. RA-related fevers may come and go during a person's lifetime with the disease.
- Is rheumatoid arthritis curable?
Rheumatoid arthritis is not curable. It is a chronic disease managed with medications called disease-modifying antirheumatic drugs (DMARDs). Some people also take new medications called biologics that are effective as second-line therapy. In addition, people with rheumatoid arthritis manage their pain and disability with OTC medications, exercise, and maintaining a healthy weight.
- What is the typical body temperature of someone experiencing a rheumatoid arthritis fever?
A fever is a temperature at or above 100.4 degrees. People with RA often complain of fevers below 101 degrees F. However, a low-grade fever might also be related to a new infection, so people should always speak with their healthcare provider about any new fever.