Rheumatoid arthritis (RA) is a chronic autoimmune condition primarily known for affecting joints throughout the body. Individuals living with RA often experience a range of symptoms, and a common question arises: does rheumatoid arthritis cause dizziness? While RA may not always be a direct cause, there are several important connections and contributing factors to consider. Dizziness is a widespread symptom with many potential origins, and for those with RA, understanding the complex link is important for overall well-being.
Direct Connections Between Rheumatoid Arthritis and Dizziness
Rheumatoid arthritis can, in less common but serious instances, directly lead to dizziness through specific complications. Inflammation and damage in the cervical spine, or neck, can cause instability, particularly a condition called atlantoaxial subluxation. This occurs when the first two vertebrae in the neck, the atlas (C1) and axis (C2), become misaligned.
Such instability can compress vital structures like the spinal cord, nerves, or vertebral arteries. When vertebral arteries are compressed, blood flow and oxygen delivery to the brain may be reduced, potentially resulting in dizziness or even temporary blackouts. Spinal cord compression can also impair balance.
Another direct, though rare, complication is rheumatoid vasculitis, which involves inflammation of blood vessels. If this inflammation affects vessels supplying blood to the brain or the inner ear, it can lead to dizziness. In some rare cases, the inflammation associated with RA can directly impact the delicate structures within the inner ear responsible for maintaining balance.
Related Conditions That Can Cause Dizziness
Individuals with rheumatoid arthritis often experience other health conditions that can contribute to dizziness. Chronic inflammation, a hallmark of RA, can lead to anemia, a reduction in the number of red blood cells. A low red blood cell count means less oxygen is transported throughout the body, which can manifest as dizziness or lightheadedness. Nonsteroidal anti-inflammatory drugs (NSAIDs), commonly used for RA pain, can also cause gastrointestinal bleeding, leading to iron-deficiency anemia.
Cardiovascular issues are another common comorbidity, as RA can increase the risk of heart disease. Conditions such as orthostatic hypotension, which is a sudden drop in blood pressure upon standing, or irregular heartbeats (arrhythmias) can cause dizzy sensations.
Chronic fatigue is a pervasive symptom for many people with RA, and alongside inadequate hydration, it can contribute to feelings of lightheadedness. Dehydration specifically can lead to dizziness, and maintaining proper fluid intake is important for preventing this. Psychological factors such as anxiety and depression, which are frequently experienced by those with chronic illnesses, can also cause dizziness or lightheadedness.
Medications and Dizziness
A very common reason for dizziness in individuals with RA is a side effect from their prescribed medications. Many drugs used to manage RA have dizziness listed as a known adverse effect. Nonsteroidal anti-inflammatory drugs (NSAIDs), often taken for pain and inflammation, can sometimes cause dizziness, lightheadedness, or balance issues.
Disease-modifying antirheumatic drugs (DMARDs) are another class of medications that can induce dizziness. Methotrexate, a widely used DMARD, may cause dizziness. Sulfasalazine, another DMARD, can also lead to dizziness. Hydroxychloroquine, commonly prescribed for RA, lists dizziness, lightheadedness, and changes in heart rhythm among its possible side effects.
Corticosteroids, such as prednisone, are powerful anti-inflammatory drugs that can also cause dizziness. These medications can affect blood pressure and fluid balance, which can indirectly contribute to dizziness. Furthermore, other medications taken for co-existing conditions, like blood pressure drugs or pain relievers, can also cause dizziness and may interact with RA treatments. Discuss all medications with your doctor.
When to Seek Medical Help for Dizziness
It is important to seek medical attention for dizziness, especially when it is new, persistent, severe, or worsening. Any frequent or recurring episodes of dizziness should be reported to your rheumatologist or primary care physician. A medical professional can help determine the underlying cause and ensure appropriate management.
Certain symptoms accompanying dizziness warrant immediate medical evaluation. These include sudden, severe dizziness along with a severe headache, or if you experience weakness, numbness, difficulty speaking, or changes in vision. Other concerning signs are difficulty walking, chest pain, an irregular heartbeat, fainting, or confusion. If dizziness occurs after a head injury, immediate medical attention is also advised.
A doctor will typically begin by taking a detailed medical history and performing a physical examination. They may then recommend various tests, such as blood work, imaging of the cervical spine, or inner ear function tests to identify the cause. Professional medical evaluation is important for an accurate diagnosis and effective management, particularly within the context of a chronic condition like RA.