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arthritis - RA vs. osteo

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:19 AM in Arthritis, Osteoarthritis
was wondering what you guys might have to say about the possibility that i might have ra in my back...

was diagnosed with severe back mess about 8 yrs ago, that was what put me off work permanently and onto disability. i had severe degen. arthritis, several ruined herniated discs, a little stenosis, some spurring, ddd, cant remember what all else, showing on my mri then. oh, i was also diagnosed by the first rheumy with fibromyalgia upon my primary's referral, she thought it was ra, but it took some time for the rheumy to see all the signs, so i don't know if that fibro dx still holds or if it changed to the ra, when the ra was dx'd. anyhow,i moved to neighboring state, got new rheumy who was about to start enbrel or one of those new drugs, (that i did not know much about, then) then she moved back to india. i went to another rheumy but got disgusted and yet another but got disgusted again, when both of them seemed to very rudely and inappropriately push aside my valid concerns over most of the newer drugs since my family history seemed to rule them out, at least i thought so. so my primary has been dealing with me for several years now with pain relievers and mainly steroids (but i also have osteoporosis and hate to take them and recently tapered myself from 60 mg. down to 10 mg, would like to get it further down).

anyhow, during this time my back improved quite a lot up until i "did something" maybe about 2 years ago, i thought i broke some ribs wrestling with my big snow blower but it was never confirmed. I had about an entire year of severe pain and only recently have the 3 rib areas gotten less sore. but all of this time since the snow blower incident, i have had severe back pain that has moved around, i should say has spread around, from lower, upwards now around my shoulder blades area, and this is driving me insane. my whole back is SORE. if i lean back on a hard chair, i can feel that my muscles are sore. i depend very heavily on various heating and massaging back pads, i've got them all (second hand). anyhow my primary has said its time to find another rheumy, i dont think he knows what to do next.

my point, my question, has to do with whether this could be the ra in my spine. i know i have all those other defects that could be causing the pain, but in spite of them, the pain was very low for a couple years when i first moved here, and i was very active physically. my understanding has been, from my previous rheumy's,that RA does not attack the spine or if it does, rarely, it just attacks the neck area (only part of my body that does not hurt). however i have seen on various forums, where people have said they have RA in their spines. having seen 4 rheumy's,i see that they sure dont all agree on much about RA, and i was wondering what other sufferers have been told about this. i havent yet settled on a new rheumy, frankly i am afraid the first thing they will want is a new mri, and the last time i tried that, i could not, COULD NOT, lie on that hard thing and hold still for the whole mri, and the girl got very snippy and mad at me about it. i doubt very much whether i will be able to do it now, either. also i am afraid of spending money only to disgustedly walk away again and have to look for still another rheumy. but i know i need something because this is going into the 2 yrs+ now of very bad pain, although much better than last summer, and i must get more functional, i just must. i ruled out surgery on my back way back at the beginning because i was told it would probably help my legs but not my back, and my primary at the time said only if her very life was threatened, would she let anyone near her back with a knife. she took her training standing beside a neurosurgeon, too, so i figured she said that on good authority... i did not want the surgery anyhow, not trusting what the doctors say when so many people seem even worse off with back pain, after various surgeries. it is such a gamble. i figure i have enough trouble there, there is no way adding CUTTING to the mess is going to improve things, after the scar tissue and all that.

i am just seriously wondering if the RA could have invaded my back and if so, i would have to look at treatment in a different light. so far it has attacked my hands wrists knees feet shoulders elbows and possibly my jaw, but the actual pain from it is nowhere near what my back has,although i can see the changes taking place from the RA, in all those places. but i've been rheumatoid factor negative so far. but the actual pain from it just isnt that severe. also i'm wondering how they could even tell from a mri or other picture, the difference between whether it was just all those back defects, or RA. does the spine even have synovial fluid?

lately i have been thinking maybe i have some vertebrae fractures and that would explain this awful long lasting pain. my father had those, he also had osteoporosis, but it was hard to find them with xrays. i dont have unlimited money to spend to get every test known to medicine and to keep trying to find a rheumy willing to work with me on how to treat these issues. doctors seems so rushed these days, they dont waant to spend more than your 15 minute allotment but unfortunately i have more wrong with me than can be quickly shoved a script at, and then push me out the door. i am 64 years old and the medicare that i am on due to disability only pays 80% of all these things, i have no supplemental insurance, none is available through my employer, in this geographic region, so far anyway. I just cant afford to keep doing what i have had to do in the past, with these doctors. 20% plus deductibles plus premiums adds up, as you all know, no doubt.

anyway, thanks for anyone's thoughts or opinions about this back that i have. what i need is a back transplant, i know! sorry to be so long winded.


  • I wish that I had the answers that you are searching for you, but I don't.
    I am here to at least keep you company anyway. Welcome to Spine Health!!!!! You have found a great site for support and someone should be along that can give you more guidance than I can. Just give them the time to come along.
    Keep posting and please stay on and you will get the support you need so you won't feel so alone with your pain.
    Take Care and Welcome Aboard, nana2007~Dawn
  • Hi and Welcome to SH,

    I am sorry I don't have the answers you are looking for either, but I can offer you some "tea and sympathy." I too have a negative Rheumatoid factor, but have been in RA treatment for 5 months. Mine was diagnosed from blood tests, and the rheumy saw what 2-3 other drs saw and she diagnosed me right away. Mine is affecting my c-spine, feet, hands, and knees and shoulders, slightly. I take methotrexate and prednisone and tramadol for pain. I also have a trial of Celebrex.

    My advice would be to find a large Rheumatologist practice with more than one dr. That way, if you don't like one dr, you can have another. If a research facility is available, I would go there. That's what I did, and I have to travel 2 hrs. But it is worth it. My first appointment was so comprehensive, I was there about 3-4 hours. They covered my whole health/social history, examined my whole body (first by the PA and then by the dr herself), took x-rays and did blood work. All done right there on site. I figure they are up on the latest research, because they are DOING the research. Also, if you can get involved in a study, sometimes there is no cost to you.

    I wish you the best of luck in finding a dr. Try to get recommendations from some patients before you settle on one, though. I think that means a lot. Please keep us posted about your progress as well. Best to you, Marti
  • RangerRRanger on da rangePosts: 805
    Been talking about this before, in fact this past weekend. I too have symptoms of RA but my rheumy is treating me for OA because of my blood
    tests don't indicate RA. But a good friend of mine was diagnosed with RA
    after they the Dr's assumed since his sister and father were diagnosed with
    RA, he most likely has the same which genetically makes sense to me. With my symptoms and my father had similar and his sister (my aunt) having the
    same, I would conclude that I'm there also. But when I think about it, it is just a word. Is it really important that they put the right tag on this type of arthritis? Does it really matter in the long term? Please post your thoughts on this matter as I've thought about it for a long time now.
  • I would think that since the treatment and prognosis differs that it would be important to diagnose which one. That is just my opinion though.
  • I was just diagnosed with some type of spondylitis, and my symptoms sound VERY similar to yours! I also have the other issues listed in my signature line, but the relentless, gnawing pain that would NOT go away has all but disappeared since I started taking a new NSAID six days ago.

    The rheumatologist spent a total of nine hours with me over two days and went through my complete life health history (I have kept an ongoing history for years, so I just update it and print it off when I need to) to come up with that, because I've had conflicting bloodwork, x-rays, scans, etc. Some of us are just much harder to diagnose than others because of all the "oddities".

    It IS important to figure out which type of arthritis it is because the treatments are completely different. Hopefully you can find a rheumatologist you feel good about and get some answers.


  • Hi,

    There is a very specific test for RA, it's called an anti-ccp test, it's pretty well indicitive of RA in higher titers along with a higher than normal sed rate and CRP test.

    The spondos, AS, PsA are more indicitive of inflammatory arthritis of the lower spine and often time test results are negative, careful watching by a rheumatologist along with x-rays should show differences, ideally an MRI would be better.

    I have both RA and Osteoarthritis in my spine. I am RA positive on all testing, and have overt swelling in my joints or did till a TNF blocker.

    Inflammatory arthritis and Osteo are treated differently. However both horribly painful.

    Best wishes.
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