Why RA Can Cause a Sore Throat (2022) (2022)

The cricoarytenoids are a pair of small joints in the back wall of the larynx (voice box) that help open, close, and tighten the vocal cords during speech and breathing. These joints take their name from structures they lie between: the cricoid and arytenoid cartilages.

Rheumatoid arthritis (RA) and other rheumatic diseases can impact these joints and, because they sit near the windpipe,cause hoarseness and difficulty breathing. This condition is known as cricoarytenoid arthritis. Other potential symptoms include a sense of fullness in the throat with swallowing and/or speaking and ear pain.

Why RA Can Cause a Sore Throat (2022) (1)

Cricoarytenoid arthritis is most common in people with RA, but it can also occur in other autoimmune diseases, including:

  • Sjögren's syndrome
  • Anklylosing spondylitis
  • Lupus
  • Juvenile idiopathic arthritis
  • Autoimmune hepatitis
  • Dermatomyositis

RA was once thought to rarely affect the laryngealjoints, even though historical descriptions of the condition report hoarseness as a symptom. However, research in the 1960s found about one in three people with RA had cricoarytenoid arthritis.

Post-mortem studies have revealed that 90% of people with RA had involvement of the cricoarytenoid joint as well as the nearby cricothyroid joint, temporomandibular joint (jaw), and associated structures in the larynx.

Why RA Can Cause a Sore Throat (2022) (2)

Cricoarytenoid Arthritis Symptoms

Not everyone who has abnormalities involving the cricoarytenoid joint experiences symptoms, and the reasons behind this are not well understood. In some cases, symptoms begin even before there are observable changes in the joint.

Symptoms of cricoarytenoid arthritis include:

  • Hoarseness
  • Pain when swallowing (odynophagia)
  • Feeling like something is stuck in your throat
  • Pain when talking or coughing
  • Shortness of breath (dyspnea)
  • Harsh or grating sound while breathing (stridor)

If you have these symptoms, don't pass them off as being something minor. Sometimes the hoarseness and breathing problems are the only signs that someone has RA or another rheumatic disease.

Stridor Is an Emergency

Stridor is the sudden onset of an abnormal, high-pitched sound when you breathe that's caused by a blockage in the larynx or throat. It should always be treated right away as a medical emergency to prevent the airway from becoming completely blocked.

(Video) 6 Causes of Persistent Sore Throat without Fever or Cough - Dr.Harihara Murthy | Doctors' Circle

Causes

RA affects joints by causing inflammation in the synovium, which is the lining of the joint. This spreads to the surfaces of the bones and causes fibrosis, which can eventually lead to rigidity and immobility that's known as ankylosis. When this happens in the cricoarytenoid joint, it becomes less able to move the vocal cords or assist in breathing.

When cricoarytenoid arthritis is part of RA and other autoimmune diseases, symptoms are caused by the immune system attacking the joint or associated structures as if they were a dangerous pathogen instead of a normal part of the body. The causes of autoimmunity are unknown.

Why Rheumatoid Arthritis Develops

Diagnosis

When cricoarytenoid arthritis occurs as part of a previously diagnosed disease, healthcare providers may use various imaging techniques to look at the larynx, including:

  • Laryngoscopy: A laryngoscope (a long, thin instrument including a light and small video camera) is inserted through your mouth or nose to examine your larynx and other structures in your throat; alternatively, a light is shined at the back of your throat while the healthcare provider uses a mirror to get a look.
  • Microlaryngoscopy: This surgical procedure uses a laryngoscope with a microscope to examine the larynx, evaluate airway obstruction, and possibly to remove some tissue for biopsy.
  • Electromyography (EMG): This test uses electrodes to stimulate nerves and measure muscle response; it can help healthcare providers diagnose neuromuscular problems.
  • Computed tomography (CT) scan: Multiple X-ray images are taken and combined into a 3D image of the larynx and other structures in the throat.

A physical exam will likely include palpating (pushing on and manipulating) the cricoarytenoid joint to see if it's stiff or rigid.

If laryngeal symptoms are the first signs of disease, your healthcare provider may begin by checking for specific autoimmune diseases based on your symptoms and history. Blood tests may look for:

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  • Inflammatory markers, including erythrocyte sedimentation rate (ESR or sed rate), C-reactive protein (CRP) test, and plasma velocity (PV)
  • Autoantibodies (antibodies that attack healthy tissues)
  • Rheumatoid factor (RF), which can indicate RA
  • Complete blood count (CBC)
  • Comprehensive metabolic panel (CMP)

Treatment

Because cricoarytenoid arthritis is a consequence of other diseases, treating the underlying disease may help ease symptoms. This could include the use of immunosuppressive and anti-inflammatory medications.

Specific treatment for mild symptoms of cricoarytenoid arthritis usually begins with high-dose systemic corticosteroids. If that doesn't work, an injection of corticosteroids into the cricoarytenoid joint may be required.

In certain situations in which the arthritis is interfering with breathing or speech and not responding to other treatments, surgery may be an option. Procedures can include:

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  • Tracheostomy: An emergency surgery that may be needed when breathing becomes seriously blocked, this involves creating a hole in your windpipe and inserting a tube to serve as an alternative airway
  • Arytenoidectomy: Generally performed to maintain an open airway after tracheostomy, this procedure involves removal of laryngeal cartilage to which the vocal cords are attached.
  • Arytenoidopexy: The cartilage at the back of the larynx is fixed in place surgically to restore loss of voice due to total vocal cord paralysis.

Precautions for Surgery

If you have cricoarytenoid joints and need to be intubated for surgery, precautions need to be taken to prevent the procedure from causing further damage.

How RA Is Treated

Frequently Asked Questions

What are the cricoarytenoid joints?

The cricoarytenoids are two small joints in the back of the larynx between the cricoid and arytenoid cartilages. The joints help to open, close, and tighten the vocal cords during speech and breathing.

Can arthritis affect the throat?

Yes, arthritis can affect the cricoarytenoid joints in the throat. Symptoms include hoarseness, painful swallowing, feeling like something is stuck in your throat, shortness of breath, and loud breathing.

What do the posterior cricoarytenoid muscles do?

The posterior cricoarytenoid muscles control the vocal cords.

A Word From Verywell

If you have RA or another autoimmune disease, be sure to mention it when you go to the healthcare provider with symptoms that could be due to cricoarytenoid arthritis. With proper diagnosis and treatment, you should be able to find some relief from these symptoms.

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12 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Farah C, Tabesh OA, Okais J, Hajjar A, Haddad A. Cricoarytenoid joint arthritis: A possible complication of dermatomyositis.Pan Afr Med J. 2020;36:74. Published 2020 Jun 9. doi:10.11604/pamj.2020.36.74.18891

  2. Bienstock H, Ehrlich GE, Freyberg RH. Rheumatoid arthritis of the cricoarytenoid joint: A clinicopathologic study.Arthritis Rheum. 1963;6:48-63. doi:10.1002/art.1780060106

  3. Hamdan AL, Sarieddine D. Laryngeal manifestations of rheumatoid arthritis.Autoimmune Dis. 2013;2013:103081. doi:10.1155/2013/103081

  4. Pradhan P, Bhardwaj A, Venkatachalam VP. Bilateral cricoarytenoid arthritis: A cause of recurrent upper airway obstruction in rheumatoid arthritis.Malays J Med Sci. (3):89-91.

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  5. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Stridor.

  6. Ohio State University Wexner Medical Center: PathologyOutlines.com. Bone & joints: Arthritis, rheumatoid arthritis.

  7. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Autoimmune disorders.

  8. Stojanovic S, Belic B. Laryngeal manifestations of rheumatoid arthritis. In: Matsuno H, ed.Innovative Rheumatology. IntechOpen

  9. Hamdan AL, Khalifee E, Berjawi G. Unilateral cricoarytenoid joint ankylosis in rheumatoid arthritis.Ear Nose Throat J. 2020;99(1):11-12. doi:10.1177/0145561319825734

  10. Eddaoudi M, Rostom S, Amine B, Bahiri R. The involvement of vocal cords in rheumatoid arthritis: A clinical case.Pan Afr Med J. 2019;34:102. Published 2019 Oct 21. doi:10.11604/pamj.2019.34.102.20490

  11. Iacovou E, Vlastarakos PV, Nikolopoulos TP. Laryngeal involvement in connective tissue disorders. Is it important for patient management?Indian J Otolaryngol Head Neck Surg. 2014;66(Suppl 1):22-29. doi:10.1007/s12070-012-0491-z

  12. Yılmaz T, Altuntaş OM, Süslü N, et al. Total and partial laser arytenoidectomy for bilateral vocal fold paralysis.Biomed Res Int. 2016;2016:3601612. doi:10.1155/2016/3601612

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Additional Reading

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2. Infections Associated with Rheumatoid Arthritis

3. Sanjeevani | Sore Throat : Causes,Treatments ||

4. Rheumatoid Arthritis Explained: The Symptoms, Effects, and Management Options for Patients

5. 7 Causes of Swollen Lymph Node in neck | Enlarged lymph glands- Dr. Harihara Murthy| Doctors' Circle

6. Best Tip For Rheumatoid Arthritis – Joint Pain Relief By Dr.Berg

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FAQs

Can rheumatoid arthritis cause sore throats? ›

Much more rarely, RA can attack joints in the larynx, or voice box, and cause hoarseness, pain during swallowing or talking, a feeling of having something stuck in your throat, lowering of the voice or shortness of breath. Several decades ago, RA-related larynx problems were more common.

Can rheumatoid affect your throat? ›

Answer: It is possible. Hoarseness in patients with rheumatoid arthritis may be related to inflammation of the cricoarytenoid joints, which sit adjacent to the vocal cords and help open and close them when you speak or breathe. Hoarseness may be accompanied by swallowing issues.

Can arthritis cause throat inflammation? ›

Can arthritis affect the throat? Yes, arthritis can affect the cricoarytenoid joints in the throat. Symptoms include hoarseness, painful swallowing, feeling like something is stuck in your throat, shortness of breath, and loud breathing.

Can RA give you flu like symptoms? ›

Some patients describe these non-joint symptoms of RA as being “flu-like” — that general yucky feeling you get when you're on the verge of getting sick. Normal body temperature ranges from 97°F to 99°F. A low-grade fever is generally considered less than 101°F.

What autoimmune causes sore throat? ›

Rheumatic fever is an autoimmune disease that inflames the body's tissues, such as the joints and heart. Healthcare providers may also call it acute rheumatic fever. It happens when the body's immune system overreacts to a strep throat or scarlet fever infection that hasn't been fully treated.

Can you get arthritis of the throat? ›

Cervical spondylosis, commonly called arthritis of the neck, is the medical term for these age-related, wear-and-tear changes that occur over time. Cervical spondylosis is extremely common. More than 85% of people over the age of 60 are affected.

Does RA affect your esophagus? ›

Among the range of symptoms that may affect patients with rheumatoid arthritis (RA), oral, pharyngeal, and esophageal motility disorders are common. The estimated prevalence of swallowing dysfunction in this patient population is 13.1% to 33.3%.

Does rheumatoid arthritis affect your esophagus? ›

RA is associated with dysphagia, which is often seen in severe disease. Symptoms can be attributed to xerostomia, however, RA can also directly affect the esophagus and LES through rheumatoid vasculitis. Rheumatoid vasculitis is an extra-articular manifestation of RA that can affect the gastrointestinal tract.

How does RA affect the mouth? ›

In addition to general health complications, RA can cause you to develop serious oral conditions, such as: Gingivitis, a mild form of gum disease that causes swollen and tender gums. Periodontitis, an inflammatory condition affecting the bone and tissue supporting the teeth.

Can rheumatoid arthritis affect the larynx? ›

Laryngeal Symptoms. Autoimmune diseases in general and rheumatoid arthritis in particular can cause dysphonia or change in voice quality secondary to either functional or anatomical laryngological alterations, both of which have an impact and restrictions on quality of life.

Can rheumatoid arthritis cause swollen glands in neck? ›

Your hands may feel “puffy,” because more blood flows to the sore hand joints. You might find swollen glands in your underarms, neck, or elbows. Some people also have a mild fever or body aches, or do not want to eat.

Which lymph nodes swell with rheumatoid arthritis? ›

Overall frequencies of enlarged lymph nodes in patients with active RA and SLE were 82% and 69%, respectively. Enlarged lymph nodes associated with RA were mostly located in the axillary region, and in SLE the nodes were smaller and lymphadenopathy was more generalized compared with RA.

Does rheumatoid arthritis make you feel unwell? ›

Rheumatoid arthritis can make your joints feel stiff and can leave you feeling generally unwell and tired.

Does RA make you feel sick? ›

Rheumatoid arthritis (RA) is an autoimmune condition that mainly affects a person's joints. However, RA can also cause symptoms that affect the gastrointestinal (GI) system, such as nausea, indigestion, and abdominal pain.

What aggravates rheumatoid arthritis? ›

Overexertion, poor sleep, stress or an infection like the flu can all set off RA symptoms. With a predictable flare you'll temporarily feel worse, but your symptoms will resolve in time. Unpredictable flares have more uncertainty associated with them.

Can sjogrens cause throat problems? ›

You may experience dryness in your nose or throat or on your skin. Sjögren's syndrome can also affect the joints, lungs, kidneys, blood vessels, digestive organs and nerves, causing symptoms such as: Swollen glands, specifically behind the jaw and in front of the ears. Joint pain, swelling or stiffness.

What autoimmune disease causes strep throat? ›

Rheumatic fever is a complex disease that affects the joints, skin, heart, blood vessels, and brain. It occurs mainly in children between the ages of 5 to 15. It is an autoimmune disease that may occur after an infection with strep (streptococcus) bacteria. Strep infections include strep throat and scarlet fever.

What autoimmune causes laryngitis? ›

Autoimmune disorders such as granulomatosis with polyangiitis (Wegener's disease) or pemphigoid/pemphigus. Irritants such as gastroesophageal reflux and sinus issues can indirectly cause inflammation of the vocal folds.

What are the first signs of arthritis in the neck? ›

Symptoms of Arthritis in the Neck
  • Headaches.
  • Grinding or popping noise or sensation when you turn your neck.
  • Muscle spasms in the neck and shoulders.
  • Trouble walking.
  • Weakness in the hands or legs.
  • Loss of balance.
20 Jun 2019

How do I know if my rheumatoid arthritis is getting worse? ›

Signs Your RA Is Progressing

Flares that are intense or last a long time. Diagnosis at a young age, which means the disease has more time to become active in your body. Rheumatoid nodules -- bumps under your skin, often around your elbows. Active inflammation that shows up in tests of joint fluid or blood.

What causes arthritis in the neck to flare up? ›

It may be related to wear and tear, autoimmune disorders, infection and other conditions. Sometimes, the inflammation may also affect the sites where ligaments and tendons attach to the bones of the spine. Regardless of the exact location, arthritis in the back or neck can be painful and often becomes chronic.

Can RA cause acid reflux? ›

Stomach Pain or Indigestion

RA and medicines used to treat it are linked to mouth and stomach ulcers, stomach bleeding, acid reflux, diarrhea, and constipation. Painful diverticulitis (inflamed pouches in your GI tract) and colitis (an inflamed colon) are also possible if you have RA.

Does rheumatoid arthritis affect memory? ›

A lot of people with rheumatoid arthritis (RA) report having trouble with memory, attention, and mental focus. They forget names and appointments, struggle to find the right words and have trouble making and carrying out plans.

Can arthritis in neck affect swallowing? ›

Aged-related changes in the cervical spine, including cervical instability, anterior osteophytes, herniated disks, osteoarthritis, and altered cervical curvatures, have been linked to swallowing difficulties, which are diagnosed as CGD.

Can RA affect your ability to swallow? ›

Swallowing disorders increased with self-reported RA disease severity and contributed to a significantly greater burden on overall quality of life. Conclusion: Chronic, longstanding swallowing disorders are common in individuals with RA and appear to increase with disease severity.

What organs does rheumatoid arthritis affect? ›

In rheumatoid arthritis, your immune system attacks healthy tissue in your joints. It can also cause medical problems with your heart, lungs, nerves, eyes and skin.

Can rheumatoid arthritis cause stomach bloating? ›

A condition called small intestinal bacterial overgrowth (SIBO) can develop with RA, causing uncomfortable bloating and diarrhea, in addition to abdominal pain, and may be related to the gut microbiome,” says Dr. Kröner.

How do people get rheumatoid arthritis? ›

Rheumatoid arthritis is an autoimmune condition, which means it's caused by the immune system attacking healthy body tissue. However, it's not yet known what triggers this. Your immune system normally makes antibodies that attack bacteria and viruses, helping to fight infection.

Does methotrexate affect your teeth? ›

Chemotherapy treatments – Chemotherapy medications, like methotrexate, can lead to inflammation of the inside lining of your mouth and result in tooth decay.

Does rheumatoid arthritis affect your tongue? ›

Other potential oral side-effects of RA medication include dry mouth, ulcers, bleeding gums, pain/swelling of the gums or tongue, white spots/patches on the lips or in the mouth, itching/swelling of lips and tongue, taste changes (e.g. metallic taste), changes in breath odour, numbness/tingling/burning sensation of ...

What does a rheumatoid arthritis flare up feel like? ›

A person with RA may feel intense pain in their joints during flares. This may feel like sustained pressure, a burning sensation, or a sharp pain. However, people with RA may also experience periods of remission when they feel few to no symptoms. In addition to causing pain in the joints, RA can affect the whole body.

Can rheumatoid arthritis affect your tonsils? ›

The tonsil has been demonstrated to be a site of citrullination, and tonsillectomy has been reported to be a potential treatment of RA, suggesting the possibility that the tonsil could be a site of autoimmunity generation in RA2,3.

What are the 4 stages of rheumatoid arthritis? ›

The four stages of rheumatoid arthritis are known as synovitis, pannus, fibrous ankylosis, and bony ankylosis.
  • Stage I: Synovitis. During stage I, you may start having mild symptoms, including joint pain and joint stiffness. ...
  • Stage II: Pannus. ...
  • Stage III: Fibrous Ankylosis. ...
  • Stage IV: Bony Ankylosis.
12 Oct 2021

How do I know if my rheumatoid arthritis is getting worse? ›

Signs Your RA Is Progressing

Flares that are intense or last a long time. Diagnosis at a young age, which means the disease has more time to become active in your body. Rheumatoid nodules -- bumps under your skin, often around your elbows. Active inflammation that shows up in tests of joint fluid or blood.

What aggravates rheumatoid arthritis? ›

Overexertion, poor sleep, stress or an infection like the flu can all set off RA symptoms. With a predictable flare you'll temporarily feel worse, but your symptoms will resolve in time. Unpredictable flares have more uncertainty associated with them.

Can RA make you feel sick? ›

Rheumatoid arthritis (RA) is an autoimmune condition that mainly affects a person's joints. However, RA can also cause symptoms that affect the gastrointestinal (GI) system, such as nausea, indigestion, and abdominal pain.

How do you calm rheumatoid arthritis? ›

Use cool packs.
  1. Use aids, for example, a stick if your knee is a problem.
  2. Wear the right shoes.
  3. Do gentle exercises, to help relieve the stiffness that makes the pain worse.
  4. Take your pain medication regularly and at the right dose.
  5. Use hot baths or showers to relieve early morning stiffness and pain.

Can rheumatoid arthritis affect the larynx? ›

Laryngeal Symptoms. Autoimmune diseases in general and rheumatoid arthritis in particular can cause dysphonia or change in voice quality secondary to either functional or anatomical laryngological alterations, both of which have an impact and restrictions on quality of life.

Can rheumatoid arthritis cause swollen glands in neck? ›

Your hands may feel “puffy,” because more blood flows to the sore hand joints. You might find swollen glands in your underarms, neck, or elbows. Some people also have a mild fever or body aches, or do not want to eat.

Do you get dry mouth with rheumatoid arthritis? ›

Sjogren's Syndrome and Dry Mouth

Drugs and aging are the most common causes of dry mouth. But if you have rheumatoid arthritis (RA) or lupus you're also at increased risk of Sjogren's syndrome, an autoimmune disorder whose main symptoms are dry mouth and eyes.

What is end stage RA? ›

End-stage rheumatoid arthritis (RA) is an advanced stage of disease in which there is severe joint damage and destruction in the absence of ongoing inflammation.

What is the safest drug for rheumatoid arthritis? ›

Methotrexate is widely regarded as one of the safest of all arthritis drugs, though it carries some potential downsides. Gastrointestinal symptoms such as nausea and vomiting are its most frequent side effects.

Is RA considered a disability? ›

The Social Security Administration (SSA) considers RA a disability if a person meets the following eligibility criteria: the person's condition is so severe that they will need to be out of work for 12 months or more. the person has gained enough work credits to qualify for disability benefits.

How does RA affect the brain? ›

People with RA are more likely to have narrowed or blocked arteries in the brain – the result of systemic inflammation. This can cause problems with memory, thinking and reasoning. Arthritis Meds. Methotrexate is a mainstay of RA treatment and corticosteroids are sometimes used for short-term pain relief.

Can rheumatoid arthritis affect your eyes? ›

Rheumatoid arthritis is a chronic inflammatory disease that primarily affects the joints. However, rheumatoid arthritis occasionally affects other parts of the body — including the eyes. The most common eye-related symptom of rheumatoid arthritis is dryness.

How fast can rheumatoid arthritis progress? ›

Clinical History. The typical case of rheumatoid arthritis begins insidiously, with the slow development of signs and symptoms over weeks to months. Often the patient first notices stiffness in one or more joints, usually accompanied by pain on movement and by tenderness in the joint.

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