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How to distinguish cervical pain from RA?

I saw my OS earlier this month for some worsening symptoms in my right arm and hand, tingling and numbness. I have had the tingling numbness and arm pain intermittently mainly in my left arm. MRI in April showed worsening DDD and bulging/herniated disks at c4 - c7., no impingment on spine. I also have RA affecting hands, knees and feet. I have another MRI scheduled next month due to the increased symptoms.
Today I woke up with swollen joints in both hands but also shooting pain in my left hand from the knuckles down all joints in all fingers. In my right hand just swollen and achy joints per normal. Was wondering if anyone else deals with this type of issue and how do you distinguish what symptoms are from what.
OS says I need a 3 level fusion but wants to postpone as long as possibe to minimize the need for further fusions down the road. On good days I think I can wait on days like today I'm not so sure.
laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched


  • I don't have RA but are you taking any medications for the RA? Usually will provide some relief from the painful hand swelling. I know I have DDD and impingement at C4-C7 also and get left elbow pain and weak wrist and pain in my fingers mainly index finger. Have you had an EMG/nerve test for the C-spine issues? Are you taking Lyrica or Cymbalta for the nerve pain? It must be difficult when you have RA and C-spine issues with nerve impingement but would be concerned about the nerves impinging. I usually get inferential treatments for my neck when I have a flare up pain in my elbow and finger pain. I hope you have a good Rheumatoid Dr. giving you treatments for the RA? Maybe a second opinion Ortho or Neurosurgeon for surgery will help you find more answers. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • I am on medication for RA, Prednisone, Methotrexate, Folic Acid. Due to heart issue I can't take an anti-inflammatory regularly. I have had an EMG on my left arm which showed irratic signal from C6-C7. I have all the issues you describe for C-spine plus swollen joints and the throbbing shooting pain from knuckles to other joints in my fingers.
    I am on cymbalta but may need to have it increased. I had a partial knee replacement before the RA was diagnosed and now need to have it revised to a full knee replacement as my knees continue to swell as the RA attacks the remaining cartlidge. Next month I see my RA Dr, back Dr and knee Dr as well as getting another MRI so hopefully will have some better answers soon. I will be seeking a second opinion after I see the spine OS.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
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  • Have you tried one of the newer meds, like Humara or Embral? I had pain and numbness down my arms when I had information in my spine and shoulders. It stopped after I started Humara.

    I have Ankolysing Spondylits, Ulcerative Colitis, DDD and a bit of OA to make things fun. Most of my problems are due to inflation of many joints, tendons and ligaments. I see a GP, a Rheumatologest, an orthopedic Dr and a wonderful PM.
  • I have an appointment in 2 weeks with my rhuematologist and plan on talking to her about different meds. I am on methotrexate, prednisone folic acid and amiltriptlyne for the RA but still have significant swelling going on in knees and hands as well as the issues/symptoms with my neck. It is frustrating because you don't know who to go see, Primary, Rhuem or Spine Dr. This month I have appointments with all of them.
    In the past when I discussed the different meds with the Rhuematologist she didn't want to perscribe some of the stronger ones due to side effects and the belief that my RA was mild as I test negative on the RF test. If this is mild I really feel for those that have an agressive form.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • Recently after seeing a massage therapist and two friends who have RA, they suggested that I see a rheumatologist because they think my symptoms sound very strongly like RA. I am currently being seen by a PM for chronic post op pain from ACDF from C5-C7. I also have herniated disk at C4/5 and arthritis and DDD in cervical spine. I also have permanent nerve damage at cervical root C7. I have no idea what the rest of my spine looks like because I have only had a cervical MRI. I know I have some issues in the lumbar region due to earlier injuries in my life but have dealt with sporadic flare ups. I also know that I have had arthritis in my hands as evidenced by swelling I the joints and pain.
    I also have the same question. How do I tell if I have RA or if pain is all from neck. I am on Cymbalta, for depression, Oxycodone, Oxycotin, and Methocarbamol (muscle relaxer). I have used paraffin therapy for hands in he past and would love to immerse my whole body in it because every muscle and joint in my body hurts.
    At thoughts?
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  • done to see if that is the diagnosis. RA symptoms can mimic other problems, just as spine symptoms can mimic other medical conditions as well. The Rheumotologist will run blood test to confirm the diagnosis.
  • I had surgery on my neck about two years ago. I recently had an updated xray. The doctor told me that I had developed more RA since the surgery. I would think that testing would differentiate between RA and disc disease, etc. Your doctor should be sending you for appropriate testing and giving you this information.
    2007 TLIF L2-L3 Fusion; 2012 C4 Corpectomy, C3-5 Fusion.
  • davrunnerddavrunner Posts: 591
    edited 04/28/2014 - 7:47 AM
    One of the problems with some of the tests is that they only show when the RA is acitve, specifically high Sed Rate. If you have a positive RF it is a help in diagnosing but not 100%. There are also those that can be sero-negative but have RA, usually a milder form. My rhuematologist diagnosed me with sero-negative RA due to swollen joints in both hands, knees etc. Joints that are sometimes red, swollen and warm to the touch. I gave myself shots of humira every other week for six months and didn't see a huge difference. I stopped the shots 3 month before I had my cervical fusion and haven't restarted. I have an appointment with a university in Nashville to see their rhuematology department to see if they can help figure out if I do have RA or one of the hundreds of other inflammatory arthritis'
    Tired of the pain - see if your PCP will refer you to a rhuematologist or if they will run the blood tests, testing isn't fool proof but a good start in getting answers. They can also draw fluid off your swollen joints and have that analyzed to rule out gout or psuedo-gout. I also had a biopsy of the synovial lining of my knee and it came back with indications of inflammatory arthritis.
    Good luck, hopefully you can get a diagnosis and a treatment regimen that will help.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • sandi said:
    done to see if that is the diagnosis. RA symptoms can mimic other problems, just as spine symptoms can mimic other medical conditions as well. The Rheumotologist will run blood test to confirm the diagnosis.

    RA does not always show up on testing. My RA showed negative 2 times, until I was tested twice, as someone stated, during a RA flare-up. Swollen and redness in and around the joints also is a sign it's RA.
  • it doesn't always show up on the bloodwork......I misposted that it would.........
    thanks for correcting that.........:)))
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