Can Rheumatoid Arthritis Cause Chronic Cough? Discover How It Affects Lungs

Can rheumatoid arthritis cause chronic cough? If you’ve ever wondered that, you’re not alone. Working as a Rheumatology nurse practitioner, I’ve had more than a handful of patients come in worried about this exact symptom. It’s not the kind of question you hear every day, but it’s one that deserves attention. People often associate rheumatoid arthritis (RA) with joint pain and stiffness—but what about the cough that just won’t quit? You’d be surprised how many times this hidden symptom is overlooked or dismissed. Let’s unravel this together.

Understanding the RA-Cough Connection

Rheumatoid Arthritis: More Than Just Joint Pain

When people think of rheumatoid arthritis, they picture swollen fingers, stiff knees, and the occasional flare-up that makes getting out of bed a struggle. But as I tell many of my patients, RA isn’t just a joint issue—it’s a full-body autoimmune condition. It can affect the lungs, heart, skin, eyes, and more. And yes, that includes the respiratory system.

One of the lesser-known but surprisingly common extra-articular (outside the joints) manifestations of RA is lung involvement. This can show up in a few different ways, and chronic cough is often the first clue that something’s going on deeper than just achy knees.

How RA Can Mess with Your Lungs

RA-related lung issues can range from mild to quite serious. Here are the most common culprits that can cause a persistent cough:

• Interstitial Lung Disease (ILD): A frequent offender in RA patients. ILD causes scarring and inflammation in the lungs, leading to a dry, nagging cough that doesn’t go away. Think of it like trying to breathe through a sponge instead of a balloon—tough and exhausting.
• Pleuritis: This is inflammation of the lining around the lungs. It can cause chest pain and—you guessed it—a chronic cough, often mistaken for something like bronchitis.
• Rheumatoid Nodules: These are little lumps that can form in the lungs, especially in long-time RA patients or smokers. They’re usually harmless but can irritate the airways, prompting coughing spells.
• Medication Side Effects: Some of the drugs we use to treat RA—like methotrexate—can cause lung inflammation. I’ve had patients cough for weeks before realizing it was the meds and not a seasonal allergy.

Now, not every RA patient develops lung issues, but the risk increases the longer you’ve had the condition and the more active the disease is. Smokers and older adults tend to be more vulnerable, too.

Why That Cough Shouldn’t Be Ignored

When a Cough Isn’t “Just a Cough”

From a clinical standpoint, I always tell my patients: if you have RA and a cough that lasts more than a few weeks, we need to talk. It might not be serious, but we can’t rule things out without proper evaluation. I once had a patient who assumed their cough was due to post-nasal drip. Turns out it was early-stage ILD. Catching it early meant we could adjust treatment and prevent further lung damage.

Pay attention to other symptoms that might come along with your cough. Things like:

1. Shortness of breath (especially during activity)
2. Chest tightness or pain
3. Wheezing or crackles when breathing
4. Fatigue that doesn’t improve with rest

These signs might mean your lungs are waving a red flag, and the sooner we investigate, the better.

How It Feels for Patients

This is the part most providers overlook. The emotional impact. Imagine having RA, struggling with daily joint pain, and now every breath feels like a chore. One of my patients once said, “It’s like my body’s already fighting me in one way, and now I feel like I’m fighting to breathe, too.” That hit me hard—and it’s why I’m passionate about educating others on the less-obvious signs of RA-related complications.

What to Ask Your Doctor If You’re Coughing

Don’t Settle for “It’s Probably Nothing”

If you’re dealing with a chronic cough and have RA, here are a few questions to bring up during your next appointment:

• “Could this cough be related to my RA or my medications?”
• “Should I get a chest X-ray or pulmonary function test?”
• “Have you considered ILD or other lung involvement?”
• “Are there any RA treatments that are safer for the lungs?”

Being your own advocate is crucial. And if your provider brushes it off, don’t be afraid to get a second opinion. Trust me, as someone who’s seen these symptoms missed more than once—it’s better to ask too many questions than too few.

Testing, Diagnosing, and Understanding the Full Picture

What Tests Can Reveal About That Chronic Cough

Once we start suspecting that your rheumatoid arthritis might be linked to a chronic cough, the next logical step is testing. As a nurse practitioner, I often walk patients through what to expect so they’re not caught off guard. And if you’re like most folks, just hearing the words “lung tests” can make you a little uneasy—but trust me, most of them are straightforward and non-invasive.

Here’s what we typically use to dig a little deeper:

• Chest X-ray: This is the first-line imaging tool to check for nodules, scarring, or signs of inflammation in your lungs. It’s quick and can give us a lot of information early on.
• High-Resolution CT Scan (HRCT): If the X-ray hints at anything unusual, an HRCT provides a much more detailed view. This is especially useful in identifying interstitial lung disease, which is common in RA patients with a chronic cough.
• Pulmonary Function Tests (PFTs): These tests measure how well your lungs are working—how much air you can inhale and exhale, and how efficiently your lungs transfer oxygen. They’re super helpful in spotting subtle lung impairment before it becomes serious.
• Blood Work: Sometimes inflammation markers, autoimmune panels, or even oxygen saturation levels can give us extra clues. As someone who looks at labs daily, I can tell you—those numbers tell a story.

I had one patient—let’s call her Maria—who only mentioned her dry cough in passing during a joint flare-up visit. But a quick chest X-ray revealed early ILD. We were able to get her in for treatment before symptoms worsened. That’s why even those “by-the-way” symptoms matter!

Treatment Options When RA and Cough Collide

It’s Not Just About the Joints Anymore

When chronic cough becomes part of the RA package, treatment has to be tailored carefully. This is where working closely with both your rheumatologist and a pulmonologist becomes crucial. I’ve seen firsthand how collaboration between specialties can really improve outcomes.

Treatment approaches may include:

• Adjusting RA Medications: If a drug like methotrexate is contributing to the cough, we might switch you to something like leflunomide or a biologic that’s gentler on the lungs.
• Starting Immunosuppressants: For patients with RA-related ILD, medications like mycophenolate mofetil or rituximab can slow disease progression and improve symptoms.
• Cough Suppressants or Inhalers: These won’t fix the root problem, but they can offer relief, especially if the cough is disruptive or painful.
• Pulmonary Rehab: This includes breathing exercises and physical training to improve lung efficiency and reduce breathlessness. It can feel a bit intimidating at first, but I’ve seen so many patients regain confidence and strength through this.

It’s important to note—what works for one person might not work for another. I’ve had patients who felt better just by changing their medication, while others needed a full workup and multi-specialty management. Your body, your rules—but with guidance, of course!

When RA Cough Turns Serious: Warning Signs

Know When to Seek Help Right Away

Okay, so most coughs won’t turn into something scary overnight—but there are red flags you really shouldn’t ignore. As someone who’s managed patients in both clinic and hospital settings, I always stress the importance of listening to your body.

Here’s when that persistent cough might be more than just a nuisance:

• Coughing up blood – even small amounts need to be evaluated
• Rapidly worsening breathlessness – especially if it interferes with walking or basic activity
• Fever, chills, or night sweats – could point to an infection or even something more serious
• Sudden weight loss – always worth investigating when combined with respiratory symptoms

These are not things to “wait and see” on. If something feels off, say something. I’ve seen patients delay seeking help and wind up with complications that could’ve been avoided. You know your body better than anyone else—don’t let anyone downplay that.

RA, Cough, and Quality of Life

Finding Your New Normal

Let’s be honest—managing RA alone can be overwhelming. Throw in a chronic cough, and it’s like you’re juggling an invisible extra diagnosis. I’ve had patients who say they avoid going out in public because they’re tired of explaining their coughing fits. Others feel drained from the mental and physical toll.

Here are some small but effective ways to make life a bit easier:

1. Stay hydrated: Dry coughs can be soothed with warm fluids. Ginger tea, anyone?
2. Use a humidifier: Especially in the winter when indoor air gets bone-dry.
3. Track your symptoms: A simple cough log (just use your phone notes!) can help you and your care team notice patterns.
4. Lean on your support system: Whether it’s a Facebook group or your local RA support meetup, connecting with others who “get it” makes a huge difference.

In my years working with RA patients, I’ve learned that it’s not about chasing perfection—it’s about adapting, adjusting, and making informed decisions that support your long-term health. You’re not in this alone.

Living with RA and a Chronic Cough: How to Stay on Track

Managing Your RA-Cough Combo Day-to-Day

Once you’ve got your RA and chronic cough under control, it’s all about managing the symptoms and staying on top of your health. I’ve worked with countless patients who felt completely overwhelmed by the idea of juggling RA, a chronic cough, and everything else life throws at them. It’s tough, but I’ve also seen people find ways to make it work. It’s about learning to adjust, one step at a time, and finding a rhythm that works for you.

Here are some practical tips that I’ve shared with many of my patients to help them stay on track while dealing with both rheumatoid arthritis and that persistent cough:

• Prioritize rest: RA can make you feel tired, and add a chronic cough into the mix, and it’s easy to feel drained. Take breaks when you need to, listen to your body, and don’t feel guilty about it.
• Exercise safely: While too much strain can be harmful, gentle stretching and low-impact exercises, like swimming or walking, can help improve your energy levels and keep your joints moving. Plus, a little exercise might actually help with your lung function, especially if you’ve had lung involvement.
• Watch your environment: Things like cold air, dust, or even a stuffy room can irritate your lungs, making your cough worse. I’ve had patients say that they felt so much better once they made simple changes, like using a humidifier or avoiding areas with strong fumes.
• Keep up with your meds: Medication management is key. Make sure you’re sticking with your RA treatment plan, as proper disease control can reduce the chance of your RA causing further lung damage. And if you notice your cough worsening, talk to your doctor about adjusting your meds.

Some days will be better than others. But consistency is your best friend here. I always remind patients: it’s about steady progress, not perfection. You’re doing the best you can, and that’s enough!

How Diet and Lifestyle Can Help

Food for Thought: Can Your Diet Help Manage Symptoms?

As a Rheumatology nurse practitioner, I often encourage my patients to consider how their diet can impact their overall health. When it comes to rheumatoid arthritis and lung issues, what you eat can either help or hinder your symptoms.

For instance, foods that are rich in anti-inflammatory properties are a great choice. Think of the Mediterranean diet—lots of fruits, vegetables, whole grains, and healthy fats. Omega-3 fatty acids, which are found in foods like fish, walnuts, and flaxseeds, have been shown to help reduce inflammation, and I’ve seen many patients report feeling less stiff and less fatigued when they incorporate these into their meals regularly.

But don’t forget the lungs! Some foods can actually help support lung health, like:

• Garlic: Known for its anti-inflammatory properties, garlic can help fight infection and may reduce inflammation in the lungs.
• Turmeric: Curcumin, the active ingredient in turmeric, has strong anti-inflammatory properties and might help ease both RA and lung inflammation.
• Vitamin C-rich foods: Citrus fruits, bell peppers, and strawberries can help support your immune system, which is crucial if you’re managing an autoimmune condition like RA.

Also, be mindful of the foods that can trigger flare-ups. Some RA patients find that gluten, dairy, or even processed sugars can worsen their symptoms. It’s not a one-size-fits-all, but tracking your diet and symptoms can give you valuable insights. And if you’re unsure, a dietitian specializing in autoimmune conditions can guide you through the best choices for your health.

When to Seek Help: Don’t Wait Too Long

Knowing When to Reach Out to Your Healthcare Team

As much as I’d love for everyone to be able to manage their symptoms and live life without disruptions, sometimes things do take a turn for the worse. When that happens, don’t hesitate to reach out to your healthcare team. Here’s when I think it’s absolutely critical to pick up the phone or schedule an appointment:

• If your cough has become debilitating and significantly affects your day-to-day life—whether it’s interfering with your sleep or preventing you from going about your normal activities, it’s time to act.
• If you develop new or worsening symptoms such as chest pain, wheezing, or rapid breathing, it’s important to get checked out.
• If your cough is accompanied by fever, night sweats, or unexplained weight loss, these could be signs of a more serious infection or another lung issue, like pneumonia or even fibrosis.
• If you’re feeling more fatigued than usual or notice your RA symptoms worsening, it’s always better to get things checked early.

As I tell my patients, your health is a partnership between you and your providers. You don’t have to go through this alone—whether you’re experiencing complications with RA or simply need advice on managing that persistent cough. Get proactive, ask questions, and advocate for yourself. The sooner we address issues, the better the outcomes.

References & Disclaimer

References:

• American College of Rheumatology. (2024). Rheumatoid Arthritis: Diagnosis and Treatment. Retrieved from https://www.rheumatology.org/Practice-Quality/Clinical-Support/Clinical-Practice-Guidelines/Rheumatoid-Arthritis
• National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2024). Rheumatoid Arthritis. Retrieved from https://www.niams.nih.gov/health-topics/rheumatoid-arthritis
• American Lung Association. (2024). How RA Affects Your Lungs. Retrieved from https://www.lung.org/lung-health-diseases/lung-disease-lookup/rheumatoid-arthritis

Disclaimer: The information in this article is not intended as a substitute for professional medical advice. Always consult your healthcare provider for guidance on managing your rheumatoid arthritis or any symptoms you experience. This article is for informational purposes only.

Tarra Nugroho

Tarra Nugroho is a dedicated Nurse Practitioner with a strong foundation in family and preventive care. She brings both compassion and clinical expertise to her practice, focusing on patient-centered care and health education. As a contributor to Healthusias.com, Tarra translates medical knowledge into clear, empowering articles on topics like women’s health, chronic disease management, and lifestyle medicine. Her mission is simple: help people feel seen, heard, and informed—both in the clinic and through the content she creates. When she’s not caring for patients, Tarra enjoys weekend hikes, plant-based cooking, and curling up with a good health podcast.