Arthritis after brain injury ? All comments appre... - Headway

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Arthritis after brain injury ? All comments appreciated.

cat3 profile image
cat3
36 Replies

I had a subarachnoid haemorrhage in Dec. 2011 and was discharged from hospital in Feb.2012. Whilst in hospital I became increasingly aware of difficulty in walking, but was assured that this would improve with time and physio.

After coming home I concentrated on getting back to normal and proving to my family that there'd be no need for any more worry. I'd previously been strong and active but I started to notice a serious problem in all my joints....especially hands and feet....which caused pain and difficulty during simple tasks, especially walking. :-(

Eventually, I saw a consultant rheumatologist who diagnosed the problem as Osteoarthritis. He was insistent that this was no coincidence but that the sah had triggered the condition and he had witnessed this in countless other cases. I have tried studying the research but unfortunately my damaged memory wont allow me to retain the information.

I have periodic steroid injections but ,apparently, their effectiveness gradually diminishes ..... something I'm already beginning to notice.

I'd be really grateful to hear from others whether they can OR can't relate to this . Thanks for listening. :-) cat x

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cat3
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iforget profile image
iforget

Osteoarthritis is degenerative and generally considered a wear and tear condition. I have never heard of any links to OA and brain injury, although OA can develop in joints that have suffered traumatic injury...so if you broke bones in an accident in which you sustained a brain injury there could be a reasonable link...However there are proven links to trauma and the onset of auto immune diseases and that can include types of inflammatory arthritis (rather than OA).

Steroid injections for OA are uncommon and there is also a limit to the number of times a joint can be injected as the steroids affect bone and can cause more damage than good.

Usual management is with pain killers, NSAIDS (Ibuprofen type drugs) and local creams like capsaicin are sometimes helpful. Gentle exercise can be beneficial too.

There is so much information out there and there are many more types/sub types of arthritis than people realise.

I can;t relate to getting OA after brain injury but I can empatise with the pain and limitations arthritis brings....oh and I know this stuff purely because I have one of the systemic inflammatory auto immune arthropathies and was diagnosed 25 years ago...well before my brain injury.

cat3 profile image
cat3 in reply to iforget

Hi iforget. Everything you say makes sense but the more I try to research it, the more my addled brain strains and groans. I am well aware of the short lived efficacy of the injections but they give me such enormous relief for a while and, presently, I don't know what else to try. They're administered in the thigh.

I can't tolerate NSAIDS and I find the pain relief creams ineffective, but I do plenty of exercise and putting hands and feet in warm water is soothing short-term.

I suppose I have trusted the consultant (long established, highly respected) to give me the plain facts but my immediate reaction to the diagnosis was " you mean rheumatoid arthritis ?" He went on to explain that OA, even though caused by wear and tear, can stay dormant until it is triggered by the auto-immune system after a brain trauma.

I have,through necessity, done heavy manual work during the past 30+ years without any ill effects until the sah so I believe this to be responsible for all the damage.

Thank you for your comments. I'm trying to get as many anecdotes as I can before seeking further medical advice. cat x

iforget profile image
iforget in reply to cat3

Cat If what they have tried so far is not helping it would be wise to seek further advice and maybe even a second opinion.. If the injections help but on a limited basis it would suggest an element of inflammation.

One would assume that at the very least the doc has completed the usual tests for ESR , CRP and RF to rule out inflammatory disease and TFT and FBC to rule out thyroid disease and the assorted anaemias and deficiencies..

It would be interesting to know if there is indeed a link between brain trauma and OA but I guess more importantly you need a definitive diagnosis and to find an effective treatment option to give you some relief.

I hope you get the answers you need.

cat3 profile image
cat3 in reply to iforget

Thanks again iforget......I might come back to you on this.....poss.friday if that's ok with you ? :-)

iforget profile image
iforget in reply to cat3

That is fine...any time. I have notifications sent to email to remind me to check in when there are new posts added.,

cat3 profile image
cat3 in reply to iforget

Hi, it's me again. I want to say how grateful I am for your help with this matter. I have been dissatisfied with this situation for quite a while but have lacked the confidence to challenge the diagnosis of such a senior, established physician. However, it's an issue which only I can address and,subject to the outcome of other's consultations which might affect the wording, I will be asking to speak to him again and to see documentation regarding his claims of a definite link. Depending on the outcome I might need to request a second opinion.

I did,incidentally,undergoe all the relevant tests, none of which produced any issues.

Thank you again for your interest and advice. x

Molly15 profile image
Molly15

Morning Cat. That is an interesting question. My amazing husband suffered a massive SAH after a burst aneurysm in October last year, and came home from hospital in February. He has been left with numerous ailments since then, including pulmonary embolisms, kidney stones (he has just had some removed) a left sided weakness meaning he can only walk with a stick and assistance, and at the moment only around the house. His left arm is very weak, so he needs assistance with all basic needs. But in the last couple of weeks he has been in a lot pain from his left hip. He did have a fall in hospital, so not sure if it stems from then. We had a chat to the physio yesterday, but she didnt seem to have any answers. Sadly he cant take any ibuprofen based drugs (Im not sure if this is due to the pe's or the brain injury) so he is limited. She has suggested a tens machine, but on looking at this on Google, I would not be happy for him to use one as he has now had 2 tonic clonic seizures, and the machine is not recommended for people with epilepsy. It seems that he goes from one problem to another, and his recovery and progress is continually being hampered by this. His walking and use of the arm has made very little progress since his discharge in February, and trying to get physio sessions is difficult too, due to the usual problem of not enough physios and too many patients. I hope you find some answers Cat, and also hope you can manage your pain. Its the last thing you need after all the problems that go with the SAH.

Very best wishes, molly

cat3 profile image
cat3 in reply to Molly15

Hi Molly. I must say I can empathise with the 'numerous ailments' although this is the most debilitating for me. I was advised to avoid the tens machine owing to a heart problem.

I'm sorry your husband is still having all these problems but it's still early days isn't it & there's a good chance of further improvement. Keep your hope and humour.

Thank you for your reply and best wishes for you & your man. x

ricozoe profile image
ricozoe

Hi cat i hope u not in too much pain at this time. I dnt know for def but since my aneurysm my bones realy ache and cause pain.i have never had this b4. I think aftr tbi you can gt lots of diffrnt things.even when it hasnt been known tohappen to someone else.iwas told by drs the 1lot of tabs i tke cldnot mke me lose weight 9 mnths ltr and under 7 stone thy npw agree with me.i hope u cn gt help with this. Take care x

cat3 profile image
cat3 in reply to ricozoe

Hi ricozoe. I've been trying on and off since 9am to send replies. It's now 8.30pm & I've only managed two so far.

Yes it's a pretty mysterious business but, after hearing from iforget, I think I'm going to get some further medical advice.

Thanks for continuing support. xx

Daisybrain profile image
Daisybrain

Hi Cat3, wow, I was beginning to think it was just me. I had a SAH several years ago and the same as you, was a healthy, fit person with only a sports injured knee to deal with. I first went to my GP as I was finding it hard to run, my head hurt but it was my joints more than that. I was in constant pain and the doctor would not give me anti-inflammatory medication due to the possibility of causing another SAH.

The condition has now got so bad I struggle to walk or even turn over in bed. Pulling the duvet over me hurts my hands.

I had a very nasty chest infection which I caught on an air-plane coming back from Australia last Christmas and was given a course of steroid tablets. After a couple of days, I found I could walk forwards down the stairs for the first time in years, so when I went back to the doctor, I told him and he seemed to think that it must be some sort of auto immune arthritis otherwise the steroids would not have made any difference. I am 48 and last month, I missed a period for the first time and during this time I was in so much pain throughout my body, I was in tears each day, it even hurt to breathe in.

I then went onto the Bupa website in desperation and found rheumatoid arthritis can be triggered by trauma and even hormone activity and is therefore more common in women than men. I am waiting to see someone in rheumatology and am hoping to get some sort of pain relief at least.

The other symptom is incredible tiredness and I'm putting on weight because of the inactivity the pain causes. I hope this helps, surely there must be some sort of health professional who can piece this together and help people with this lead a more active lifestyle. The only relief I have found is in aqua jogging then hot tub, but achieving this was short term thanks to a friend. If I win the lottery it would be the first thing I would do. Take care of yourself and try not to let it grind you down, I am trying desperately too!

Best wishesCat3, daisybrain

cat3 profile image
cat3 in reply to Daisybrain

Well well well . You are the first person I've spoken to who has experienced this problem after a SAH. It's such a relief to find some support at last.....I can't tell you how alone I've been feeling when my GP has,all along, insisted the sudden onset of arthritis is simply a coincidence.

Even the consultant who I was so thankful to, for believing me, is starting to feel like a disappointment ......you get one shot with these Top Dogs then it's routine appointments with minions from then on.

I've changed my GP now, so I will ask him if I can see someone else (difficult as the guy I saw is head of rheumatology at THE orthopaedic hospital of the area. Or I could request a separate appt. with him and go armed with lots more questions this time.

Can you message me when you've seen the rheumatologist & let me know how you went on ?

Thank you, Daisybrain, for your comments & I will let you know if I make any further progress.

Take care & stay in touch. Best wishes, cat xx

bikerlifestyle profile image
bikerlifestyle

hi Cat

i have had arthritis since i was 21(which was caused by an infection) prior to my head injury, and i have noticed it has worsened since bumping my noggin, bump have never really associated one with the other.

cat3 profile image
cat3 in reply to bikerlifestyle

God, biker, you make it sound like you had a gentle collision with a lamp post instead of a major accident.

This is all very interesting .....I didn't really expect any response but, from the ones I've had, it has gone from a ridiculous idea to something worth further investigation. I wonder if Headway would consider it suitable for a poll ?

I realise I've been in denial.....not knowing much at all about my own condition.....I certainly didn't know it could be caused by infection. Is that Rheumatoid ? :-) x

bikerlifestyle profile image
bikerlifestyle in reply to cat3

reactive, i had something called yersinia pestis which triggered it (and yes when you google it, you can say omg lol)

cat3 profile image
cat3 in reply to bikerlifestyle

OH....MY....GOD.....Did you have a red cross on your front door ?

What a fascinating article. It's another example of how far science has progressed and the life-saving properties of antibiotics, which are now taken for granted.

I always thought those stone crosses were pagan relics (shows my ignorance) but instead they were either trading sites or memorials.

I've learned something new today.....thanks biker. :-) xx

bikerlifestyle profile image
bikerlifestyle in reply to cat3

doctors are always interested when i tell them :)

bikerlifestyle profile image
bikerlifestyle in reply to bikerlifestyle

Bring out yer dead lol

iforget profile image
iforget in reply to bikerlifestyle

I have to add my OMG to this... how/where on earth did you contract the plague? Yikes...I guess if you gotta get something, it might as well be interesting eh? ;)

bikerlifestyle profile image
bikerlifestyle in reply to iforget

to be honest to this day i still have no idea, i used to drive buses, but i had never been abroad or anywhere unusual, the doctors have no idea how i got it, but because they don't look for it, it took them 2 years to find out what was wrong with me

i was in and out of different hospitals and no one had any idea what it was and then on one of my admissions, to a general ward a doctor said he had seen this before and transferred me to his care, and found out what it was, but by then my arthritis had spread to all my joints and took on a life of its own, so even when they cured the yersinia i was left with chronic joint pains.

but at least i got a good story out of it lol :)

cat3 profile image
cat3 in reply to bikerlifestyle

Hell of a price for a good story ! x

AnthonyMs profile image
AnthonyMs

It depends, joint pain can be a sign of many other things such as, anemia, diabetes, thyroid problems, B12 deficiency, Vit D deficiency, etc. I wouldn't discount the possibility that your joint pain could be attributable to these other conditions. Sometimes the docs don't do the investigation they should be doing.

cat3 profile image
cat3 in reply to AnthonyMs

Had all above tests and my symptoms are certainly those of arthritis.......my dilemma is where to access appropriate treatment as the NHS professionals are, I agree, becoming increasingly blase'. I think I may have to start again at the beginning .

Thanks Anthony.

SASSYIAM profile image
SASSYIAM

Hi lovely cat,I incurred my ABI some 20 yrs ago.had been ultra active and because i have a 2yr old pup i am constantly on the go.had a minor fall at work as a PA for a solicitor and thought nothing of it.as a hobby I also studied to be a beauty therapist.I over the years have been formally diagnosed with both RHA AND OA.Y SPECIALISTS OFFERRED NSAIDS,TABS & CREAM.N LIKE U i found they just masked the pain.A beauty collegue of mine specialised in hot wax therapy and sugessted I give it a go as a guinea pig.i find this far and away better if quite messy.it can be expensive if u just rock up to any salon offering hot wax therapy.but if you have a beauty college near you they generally offer this service much cheaper aslong as you are willing to allow a supervised trainee to use you as their student.gives them experience and you get therapy for a tenner.and you dont need to turn up monthly the therapist will work out a tailored plan 4 u???? TAKE CARE GOOD LUCK XX

cat3 profile image
cat3 in reply to SASSYIAM

Thanks for the tip, SASSYIAM, & we do have a beauty college nearby which has reasonable prices......certainly worth checking out.

Your name suits your personality so well.....love it !

Thanks again. :-) cat xx

PS These replies are sending at the rate of one every two hours and, if I try to go on to the next, the previous one disappears !

crissy4361 profile image
crissy4361

Hi Cat3,

You have possibly answered a problem I have been having, I too had an SAH in Jan 2012 and recently have had severe pains in my legs, knees and ankles. I hadn't given any thought to a connection with the SAH but will check it out with GP, so thanks for this question x

cat3 profile image
cat3 in reply to crissy4361

Hi crissy....It's taking a long time to get replies to everyone, but almost there.

If we eventually do establish a link it will take more than a few anecdotes to convince anyone other than ourselves. I mentioned to bikerlifestyle that maybe Headway would be prepared to offer the issue as a poll. Anyway, let's keep it simmering 'til you've seen your GP and Daisybrain has seen the rheumatologist. Also, I need to speak again with iforget ......she seems knowledgeable on the subject but I want to wait until the site is working properly first.....It has been a nightmare today.

Thanks for your input.....it is so encouraging. Will you message me with your GPs response ? Best wishes, cat xx

pollyanne profile image
pollyanne

Hi Cat

Dont know if it may be of interest to you but Salford Royal Hospital are doing research into athritic knee probs and are looking for volunteers to undergo steroid injections . My other half has volunteered as in his view ' I'll give anything a go'!!

cat3 profile image
cat3 in reply to pollyanne

Hi pollyanne...sorry for the delay.....the site is working again now.

Salford Royal saved my life and I have such great affection for the place since then. I went back to thank the HDU nurses in August ,,,,,they are such lovely, dedicated people who I wasn't conscious enough to thank at the time, but my family were completely wowed by their attentiveness and efficiency.

Thanks for the info.,pollyanne, I'll go on their wedsite and get the necessary details.

Best wishes to you & your husband. cat xx :-)

headwayuk profile image
headwayukPartnerHeadway

Hi Cat,

Thank you for posting this question. Firstly, I'd like to apologise for the problems you have been experiencing with the website - is it working better for you now?

Having searched our database of journals, I can't find any documented link between brain haemorrhage and osteoarthritis. What iforget says does make a lot of sense, certainly given the clinical evidence that is available.

However, the comments of our members and the consultant you saw are very interesting and it would be good to hear more about this. Particularly if the rheumatologist has any more information on this link?

One of the big risk factors for osteoarthritis seems to be inactivity. One possibility could be that you were very active before the SAH, and perhaps a less active period following the haemorrhage could have allowed an underlying, early-stage arthritis to worsen?

This is a really interesting debate, I am sorry to hear about this additional issue you are experiencing though, are you getting plenty of support for it? There is actually a HealthUnlocked community for people with arthritis - it might be worth posting this question on there and posting back to us?

Do let us know if you'd like us to try and find any more information about this,

Best wishes,

Headway.

cat3 profile image
cat3

Thank you Headway. I have encountered so many contradictions with this condition which causes such anxiety since my brain has turned to mush. I did question the diagnosis at the time but there's only so much opposition a senior, authoritative consultant will tolerate and, really, I didn't have the knowledge to support my objections.

I've been relying on the injections and just accepting the situation 'til today but tomorrow I'm hoping iforget can help me out with a coherent argument.

I am a member of the HealthUnlocked arthritis group.

I still can't help remembering the consultant's absolute confidence that it was the correct diagnosis. He is a highly respected and established consultant who told me he had discovered a definite link between brain injury and Osteoarthritis. When I checked that he wasn't meaning Rheumatoid he assured me that he wasn't. So maybe you can understand my confusion.

Thank you again, cat.

headwayuk profile image
headwayukPartnerHeadway in reply to cat3

Hi Cat,

Yes, certainly - I wouldn't in anyway question the diagnosis itself, I am sure the consultant has done all the appropriate tests and is confident that it is osteoarthritis. In itself, this is a relatively common condition and having a brain injury would'nt make it any less likely.

It does sound like, if the treatment is no longer working as well, you need to go back to the specialist and discuss further options. Perhaps it would be worthwhile asking for the second opinion as iforget suggested, if only to get a different perspective on possible treatments as the steroids lose their effectiveness. I think your GP would be the usual person to speak to about this in the first instance.

It's very interesting to hear about the consultant's finding as we haven't heard this before and there doesn't seem to be any published information about it - would there be any chance you could let us know the consultant's name via a private message, so we can search our library for anything he's written? Don't worry at all if not, just thinking we have access to quite a big library of journals that could contain work he's done.

In the previous post I was wondering if the period of relative inactivity following the SAH could explain why the condition 'flares up' and becomes apparent in many cases - just one possible explanation for a link I suppose.

Best wishes,

Headway.

Lark12 profile image
Lark12 in reply to cat3

I would be interested to know the name of the consultant who linked arthritis and brain injury- I cannot find a medical professional anywhere that links them. I had a traumatic brain injury 5 years ago in a car accident, and it has caused SO MANY physical problems in addition to the memory loss and confusion. Among the problems are stomach issues, thyroid and hormone deficiencies, and osteoarthritis in my knees and now spreading to my elbows. I had one osteopathic doctor tell me to treat it with IV antibiotics as she thought it was a bacterial infection. I did not go through with that because every other doctor I'd mentioned it to says that is crazy. I just want to know if it is indeed a bacterial infection or if it is autoimmune in nature. I can't find any help with this and I can't run anymore and have trouble going up stairs. I'm only 37 and have been this way since I was 32 when I hit my head. It has changed my whole life.

cat3 profile image
cat3 in reply to Lark12

Hi Lark. The consultant's name is Dr Frank McKenna. I ended up writing to him, reminding him of his claims to have seen many cases of SAH resulting in Osteoarthritis and, knowing he's had many papers published on other health issue, I asked him if he'd produced any articles on this particular link.

He replied promptly, insisting that this phenomenon had been a frequent one throughout his career and much too marked to be classed as coincidence. Unfortunately, as no trials had been conducted, he had not produced any publications on the subject.

It seems he considers brain trauma as a definite trigger for Osteoarthritis but as, to date, there is no research offering credence to his findings, he concerns himself solely with treatment and prevention of the condition, and brain trauma isn't something preventable.

Best wishes, Cat x

cat3 profile image
cat3

Yes, I have considered the period of inactivity as a reason for the sudden onset but discarded the idea after speaking with the consultant.

The injections do work well for a couple of months before the pain starts to build up again, but I was warned that this might be the case, and have been offered drug treatment which I have so far declined, owing to the high amount of other medications I need to take. However, I've decided to go back to the beginning with this and hopefully get a second opinion.

I am,though, finding this all really difficult as I DID have enormous respect for this doctor and, after months of getting nowhere with my GP, it was such a relief to be listened to and treated.

I have messaged you with details of the consultant.

Many thanks, cat.

Mikey48 profile image
Mikey48

I had an arthritic knee which was exacerbated after suffering a subarachnoid haemorrhage.

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