As many as one-third of people with rheumatoid arthritis (RA) experience systemic (all-over) symptoms along with the more characteristic joint symptoms of the disease. For example, some individuals have a low-grade fever (between 99 and 101 degrees Fahrenheit), also called “rheumatic fever.” As one myRAteam member wrote, “I’ve had very little pain lately, but keep running a random fever of about 100. I haven’t had fevers like this since I was first diagnosed.”
As this member pointed out, fevers may occur before diagnosis as one of the first signs of rheumatoid arthritis. For some people, fever may also be a sign that an RA flare-up is approaching.
Here's what you need to know about rheumatoid arthritis fevers, including how they can be managed. Tell your rheumatologist or a health care provider if you feel feverish or notice your temperature is higher than normal. They will be able to determine the cause of your fever and work with you to find treatment.
For some people with RA, periods of active disease (flare-ups) may bring many systemic symptoms — including fatigue, appetite loss, and low-grade fever — alongside the typical joint pain, swelling, and stiffness. This fever may be accompanied by other unpleasant, flu-like feelings.
One myRAteam member described fever as one of the symptoms they experience during a flare: “I started having a flare-up,” they wrote, adding that they had started to feel “the deep-down bone ache, the never-ending exhaustion, and fever.” As another member shared, fever seemed to exacerbate other RA symptoms: “The low fevers seem to magnify the pain for me … miserable.”
Some myRAteam members have fevers that last for consecutive days. “Does anyone else get random fevers that last, say, an evening or two?” wrote one member. “It lasted two separate evenings in one week, then I felt better the next morning.”
This member went on to describe the frequency and duration of their fevers: “I have the fever about once every month or two. It’ll go from 101 to 103. It will last about 10 or 12 hours, then the fever breaks, and I’m OK.” Another member found that their fevers have lasted even longer, asking others, “Has anyone else had a problem with running a fever for weeks at a time?”
Take stock of the symptoms you typically experience during RA flare-ups. This will help you understand what is normal and what is out of the ordinary for you. If you know that fevers often accompany your other symptoms, a small temperature change may not be a cause for concern. But if you have never experienced this symptom during a flare-up, coming down with a fever may warrant a call to your doctor.
Several factors can cause a person with rheumatoid arthritis to experience fevers.
The most common culprit of RA-related fevers is inflammation. Rheumatoid arthritis is an autoimmune disease. In people with RA, the body’s immune system mistakenly attacks healthy tissues in the joints. This autoimmune response can cause low-grade fevers in certain people with RA.
Some medications for rheumatoid arthritis work by suppressing the immune system. These medications (known as antirheumatic drugs) have been associated with fever. This is because suppressing immune activity leaves you more susceptible to developing fever-causing infections.
Members of myRAteam have reported feeling feverish as a side effect of certain RA medications — particularly the immunomodulator methotrexate. As one member wrote, they don’t actually develop a fever (no rise in body temperature), but they feel as if they have one: “Sometimes, I feel like I have a fever after my shot of methotrexate, but I check, and I am fine.”
Keep in mind that there are other possible causes of fever. Even if you have rheumatoid arthritis, you could develop a fever as the result of a viral or bacterial infection — especially if you take immune-suppressing drugs.
Still’s disease is a rare form of inflammatory arthritis. It causes rashes, joint pain, and high spiking fevers. A person with Still’s disease may develop a daily fever of at least 102 degrees Fahrenheit that lasts for a week or longer. This fever can peak twice per day, usually in the late afternoon or early evening, with your temperature returning to normal in between spikes.
Ask your doctor for medical advice if you develop a fever higher than 100.4 degrees Fahrenheit. They will be able to determine whether your fever is related to RA or if you are fighting off an infection.
If your doctor determines that your fever is associated with RA, they may recommend or prescribe the following treatment options.
In most cases, RA-related fevers can be treated in the same way as other fevers. These remedies include staying hydrated by drinking plenty of fluids and getting as much rest as your body needs to recover. Ask your doctor about taking an over-the-counter pain reliever, such as Advil (ibuprofen) or Tylenol (acetaminophen).
Placing a cool compress on your forehead or neck may also help provide relief if you are feeling flushed or hot, and dressing in layers will allow you to stay warm if you get chills or remove clothing if you feel too hot.
Treating the underlying RA with medications like disease-modifying antirheumatic drugs (DMARDs) usually helps improve systemic symptoms, including fatigue and fever. However, it is possible to develop low-grade fevers occasionally as your disease activity increases and wanes.
Over-the-counter pain relievers, like Advil, known as nonsteroidal anti-inflammatory drugs (NSAIDs), are often prescribed for both fevers and RA, as they reduce pain and inflammation.
If you have a fever as the result of an infection, your doctor may advise you to stop taking one or more of your RA medications. Do not stop taking one of your medications without talking to your doctor first.
In some cases, changing the dose of your RA medications may also help relieve fevers. As one myRAteam member wrote, “Finally got relief a couple of days after we increased my prednisone to 10 milligrams. Hoping the methotrexate gets the fevers under control.”
Managing the symptoms of rheumatoid arthritis disease can be a challenge. The good news is that you don’t have to do it alone.
On myRAteam, the social network for people with rheumatoid arthritis and their loved ones, more than 150,000 members come together to ask questions, give advice, and share their stories with others who understand life with RA.
Have you had fevers with RA? What works to manage them? Share your experiences in the comments below or by posting on myRAteam.