How can they really know?: I'm a bit... - Arthritis Action

Arthritis Action

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How can they really know?

Soreallover profile image
28 Replies

I'm a bit perplexed as to how they can really tell the difference between OA and RA.I have heard of so many people that are told they have RA, to later be told it's OA.

My arthritis symptoms have changed somewhat and are affecting other areas of my body and I don't know whether to bother mentioning it to my doctor or not

It has gone from being just painful OA to hot and painful, which I was lead to believe was RA which does run in my family.

I'm sick and tired of it all, like so many others, but all they are suggesting is physio, again like many others.

My doctor doesn't want me taking naproxen or ibuprofen because of my kidneys, so I don't know what else to do.

Any suggestions?

Thanks all!

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Soreallover
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28 Replies
DorsetLady profile image
DorsetLady

Have a look at these -

nhs.uk/conditions/rheumatoi...

creakyjoints.org/about-arth...

webmd.com/rheumatoid-arthri...

My understanding is that in RA, blood tests will show rheumatoid factors which isn't present with osteoarthritis..

Soreallover profile image
Soreallover in reply to DorsetLady

I believe this is true but my doctor has never taken my blood to test 😕

Soreallover profile image
Soreallover in reply to DorsetLady

Thank you so much for the information. It's still quite a minefield, isn't it? 🤔My gran on my mum's side died from complications of RA and my mum herself had Sydenham's Chorea, also known as St.Vitas Dance, when she was a child, due to scarlet fever. She subsequently developed RA.

I myself had repeated strep throat in my teens, which is the cause of scarlet fever and have a leaky heart valve.

I would be very interested to know if this is just a coincidence or hereditary 🤔

DorsetLady profile image
DorsetLady in reply to Soreallover

RA, like OA and other diseases are not hereditary as such , but there can be genetic and environmental connections.

My maternal grandmother had RA (I think, she was chair bound for as long as au can remember) can’t recall my mother having that or any other arthritis but my sister had and I have OA.

Bit more reading..,, rheumatoidarthritis.net/liv...

Jackie1947 profile image
Jackie1947 in reply to DorsetLady

You can have zero negative RA so the experts go on symptoms etc

DorsetLady profile image
DorsetLady in reply to Jackie1947

You can have zero negative RA so the experts go on symptoms etc

..and as we all know on the PMRGCAuk forum that sometimes makes it difficult to get a definitive diagnosis

Jackie1947 profile image
Jackie1947 in reply to DorsetLady

Yes I know

Happyrosie profile image
Happyrosie

some random thoughts (other than what dorsetlady has said)

I believe that only a rheumatologist can diagnose RA (in the UK).

Rheumatoid factor shows in blood tests and I assume that makes it definite. But I have also been told that you can have RA and the rheumatoid factor is negative.

There are other painkillers than you've mentioned. I've been through a few but I am happy(ish) on Butec (look it up) and I supplement this with CoCodamol

Soreallover profile image
Soreallover in reply to Happyrosie

Thank you for your reply.😊 I will look up Butec. I have only been taking paracetamol which doesn't do much, so I'll definitely look into this.

Runrig01 profile image
Runrig01

So with RA it tends to show up in the blood as both rheumatoid factor, and also elevated inflammatory markers, CRP & ESR, both of which would be normal in OA. You can be seronegative which means you don’t have the RF, then inflammatory markers and things like ultrasounds confirm it. Also because RA erodes the bone, there are classic signs on X-ray that differ from the wear and tear of OA. The other point is because RA destroys joints, that can lead to getting OA on top of the RA of joints. I have both inflammatory arthritis and OA in my knees. The tendons have stiffened causing both kneecaps to partially dislocate, as the normal anatomy of the knee is disrupted the wear and tear has accelerated, where the back of the kneecap is now rubbing on the femur. So you can have both.

Soreallover profile image
Soreallover in reply to Runrig01

I have trouble with my left knee periodically and my kneecap seems to dislocate/twist and I can't walk on it. The cartilage is wearing/worn away and the bones rub off each other and have to wear a knee support.I have been told that there is inflammation but not told I have inflammatory arthritis as such. Do my symptoms mean that I have?

This is where my confusion comes from! 🤯

Runrig01 profile image
Runrig01 in reply to Soreallover

The only way of knowing for certain that it’s inflammatory arthritis, is to have some bloods done, for rheumatoid factor and inflammatory markers. If you have raised markers then you should be referred to a rheumatologist for investigations.

medway-lady profile image
medway-lady

It is easy a simple blood test for RA sero positive,although some are negative but still have RA. You must not and I repeat must not take Ibrufen or any NSAID without a prescription if you like me have CKD it is dangerous. Please go to your GP and get a blood test as RA is treated with medications very well.

Lolabridge profile image
Lolabridge

The ESR and CRP blood tests are used to detect inflammation. Ask your GP to get those done for you. If the levels of those are raised ask for a referral to a Rheumatologist.

I have both RA and OA and find co- codamol help me cope with joint pain. You can get it over the counter at the pharmacy or the GP can prescribe Zapain which is the much stronger version.

Good luck!

Batty1 profile image
Batty1

it’s possible to have both OA and RA at the same time but it’s unfortunate that doctors once your being treated or seen for RA or any arthritic conditions every new pain issue you have seems to be blamed on OA not your arthritic condition … I go through this with my psoriatic arthritis and Rheumatologist every new blip I have is blamed on OA …. At the end of the day your treatment for RA is probably going to be the only treatment unless you become forceful and demand another look… X-rays are the standard OA diagnosis they say it show inflammation inside the joints but wouldn’t all joint attacking arthritis.

rubina786 profile image
rubina786

I was diagnosed with RA some 6+years ago. They tried methotrexate hydroxychloroquin, sulphasaladin (sorry can't spell). After about a 18 months of pain and various side effects in other organs I weaned myself off and now only on 10 mg prednisolon. No NSAIDS. Preds have bad side effects too but nothing else worked :(Am careful not to eat any sugar, gluten or cows milk and pain is in control. Wear copper bracelets and sometimes use pain relief ointments, sprays etc for temp relief. Generally a bit painful in the mornings but with a little hand exercises or housework the wrists and fingers start working by noon.

Trying to get to 5mg preds only.

Its been a long journey figuring out what foods aggravate the pain. Everyone is different do its a matter of trial and error I guess.

Good Luck. Xx

Soreallover profile image
Soreallover in reply to rubina786

Thank you for your reply.I haven't really given food a thought as to whether it affects me, but I will definitely take note from now 🥰

Beti69 profile image
Beti69

The only physio I've had in the past for my different pain , a printed out letter of the excerises to do and the physio having me back once to check if they had helped which they hadn't. I was in more pain getting to the appointments, 😕 where I just look up excersises to try now. I've just had my hip replacement done and the excerises to do aren't helping much and I can't do certain movements three months on but going back to physio I feel there is no proper help. I did think it would be half hour of excersises with the physio but it was a five min run through of my pain and then a print out. I'm on alot of different medication for pain and just live day to day in different levels.I hope you can get a satisfactory result if you do go to physio but I feel they see so many people that my expectations were not what I thought it would be.

Take care. Lesley.

Soreallover profile image
Soreallover in reply to Beti69

I totally agree with you. I ended up paying to go to a chiropractor as Physio wasn't helping. Physio seems to just direct you on to someone else. It's like the last line of defense they have before sending you to the proper clinic.

My shoulder is quite badly affected at the moment, and has been for about 4 months, and when I asked the doctor about cortisone injections , I was told that physio would decide if this was required!

It's so sad that you have to go through life now, just left to treat yourself. 😕

I hope you start to feel better soon.

Thank you for replying and take care 🥰

Joan

Billy-the-kiddie profile image
Billy-the-kiddie

Dearest Soreallover, pleased you are here and will get so much support from us all who have had physio, also want to say just know how you are feeling really do.

Myself have had physio as I have had chronic back problems for well over 23 years now and it was the first thing my G.P sent me for, they set me some exercise to take home which was tried at the physio but unfortunately the exercises did nothing bar make me hurt more. Went back to them after a month (I still kept trying), explained that I could not do them and not for the want of giving it a go, so my physio tried to get me to do some different ones while she was there to see exactly why I could not do any of these or the different ones. Then booked another appointment with her and this time she gave me acupuncture, had 8 of these needles all in different areas even had one in my head, and every 10 mins she would come back and flick the needles (not certain why), and this went on for around 60 mins I did not feel a thing did not hurt even when she flicked them.

I am so sorry to say but the exercises, acupuncture that was given to me and all the other things that have been tried at our Stoke Mandeville Hospital which were facet injections, hot and cold therapy, even pain management course could not help me. Went back to see the specialist at the hospital who just said that if they operated I would end up in a wheelchair, so instead I am on a large quantity of tablets which 2 of them are slow release Morphine 60mg and OraMorph liquid Morphine to keep the pain bearable.

It is in my case Osteoarthritis where your bones crumble and have this in my spine but know things are far worse illnesses than this so I am just thankful that this is only what I have.

Just know how painful this can be but please try the physio and it may help or may not but please, please try, they won't put you through anything that hurts I promise, also they could now have some more up dated things to help you as it was a long time ago since I went with my husband who also has Osteoarthritis and has it in his knees, hips, his right knee had some cartilage shaved off some time ago but now at 67 his hips are giving him pain he also had physio which helped a little and managed a few of them at home, this was when we first got married in 1981, he is now a retired plumber, but he his knee gave way while digging a trench out to find a burst pipe so we are a good pair together.🙂

I wish you good luck and please, please just give physio and if it doesn't work out then you insist your G.P sends you to see a specialist, as they do try to give the patient some kind of medication and am certain they keep their fingers crossed it will work, so let them know how bad you are feeling and how much it hurts you.

Please let us all know how you get on, we are all here and know how painful either Osteo or RA can be. xxxx

Soreallover profile image
Soreallover in reply to Billy-the-kiddie

Thank you so much for your reply...and very warm welcome! 🥰I will definitely go to physio when I get my appointment through. I had just stopped going for a back problem, then my shoulder went on the fritz!

I found out after my physio referred me to orthopaedics, that my CT actually showed up that I have Bertolotti Syndrome, where I have an elongated vertebrae at the base of my spine , which runs off my pelvis, bone on bone, as there is no cartridge. I nearly passed out with the pain from that a few times and didn't know what it was. It can also make me twist to once side later in the day and my right hip sits higher than my left. Seemingly it's a condition you are born with.

Anyhoo, enough about me. You and your poor hubby are being put through the mill aren't you? 🥺

It's so unfair. You just want to retire and be fit enough to enjoy it 😥

Thank you again for your good counsel and I'll keep you updated 🥰

Love to you both xxx

Helsinki96 profile image
Helsinki96

The difference can easily be diagnosed by a blood test

Kneesandtoes profile image
Kneesandtoes

We have cut out added sugar, white flour and what little UPF we used to eat. I did not have that much joint pain before, but I have noticed an improvement. Loss of a few kilos and less inflammation I think.

It is not easy as you have to make everything yourself.

BeeBee50 profile image
BeeBee50

I've had psoriatic arthritis for 10 years now, painful and even worse with the weather changes. I have a fantastic consultant at the hospital and earlier this year on one of my check up appointments he said OS has started at the top of my spine. The crunching I feel is awful and often wear a neck pillow that you would use when on a flight. I take naproxen and omeprazole plus methotrexate and quite a bagful of meds for other problems, and also have a blood test every 3 months to check my liver and kidneys are not being affected. I wish you well in finding pain relief but in my case yes you can have both types x

Soreallover profile image
Soreallover in reply to BeeBee50

Hi there! Thank you for your reply 🥰I have been diagnosed with moderate OA in my shoulder and elbow , along with degenerative disc disease at the base of my spine. I also have OA in my knee and hips, the same crunching in my neck as your good self and now painful joints in my hands. In short, follow to bits,so I literally feel your pain! 😩😅

You are lucky you are having your bloods monitored so closely. I think I get mine taken about once a year!

I am so sorry you have had your diagnosis of psoriatic arthritis. I can't imagine how you cope with that 🥺 I don't know about you, but I thought I'd be a lot older when all these aches and pains would start. I'm 59 this month, but my problems all started 11 years ago with plantar fasciitis. Peri- menopause related?

I must admit to being rather naive in thinking that my pains would all be successfully treated. 🤪 And I would not be surprised if I had both types 😩

I think I'll ask for bloods to be taken and get them checked 🤔

Thanks again ! 🥰

BeeBee50 profile image
BeeBee50 in reply to Soreallover

I have the bloods done every 3 months so I will get prescribed methotrexate which cleared my psoriasis and take folic acid to counter act it. Also omaprasole to protect my stomach lining as I have my daily intake of other medication is like having my own chemist 😔I have plantar fasciitis and enthesitis (excuse me if I've misspelt it) the arthritis is really hard to cope with especially when I have a flare up. The inflammation in my hands is unbearable 😫

Depression etc etc and I was so outgoing and confident but now because of this horrible disease I lost my old 'me'

I hope you had a good birthday despite your pain, you take care of you and hope you get your blood tests sorted xx

Jackie1947 profile image
Jackie1947

I had a blood test which confirmed zero positive RA. I also have OA. My RA is presently in remission but the OA is painful. Complicated yes

Soreallover profile image
Soreallover in reply to Jackie1947

It's a minefield! 🤯

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