Double whammy: osteoarthritis with my RA.: I don't know... - NRAS

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Double whammy: osteoarthritis with my RA.

Andrea_Shapiro profile image
20 Replies

I don't know if this has been queried before, and I apologise if it has, but I wanted to know about others' experience with diagnosis of osteoarthritis with their RA. This has been devastating for me today. I've been experiencing pretty much unbearable pain in my right hip now for about 2 years, (no analgesics touch this, not even BuTrans). I had this X-Rayed in the summer, but was repeatedly told by my GP that results weren't available, but the surgery would contact me if something was amiss. I had my Rheumy nurse review today, and she tells me: "I see your X-Ray result on here: you've got osteoarthritis in your hip, but the good news is that it's only moderate and your RA isn't attacking that joint". Bloody devastating news for me! When trying to give an example of wear & tear of osteoarthritis, she showed me the tip of her finger: "Look here! That's osteoarthritis!". Marvellous! I'm glad her nose-picking finger was still active, but I was broken knowing that I'm 45 and things may be going downhill. If anyone has experience of both, please let me know. I used to think that the pain of both RA & OA would be similar, but it's not.

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Andrea_Shapiro
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20 Replies
sallydogsmum profile image
sallydogsmum

Hi,

Total sympathy. OA pain is nasty. Can you get back to GP/family doctor/rheumatologist and ask for a referral on to a surgeon? They could re-surface the joint if it's superficial damage or replace it if needed. There is always something to be done. Don't be fobbed off.

All the best

Sx

helixhelix profile image
helixhelix

Yes, OA and RA pain aren't the same....I have OA in my back and knees and RA everywhere else. My RA is well controlled right now, so it's the OA that hurts!

Anyway, like Sallysdogsmum I'd get back to your GP and start pushing. There is hope, as think of Craig Revel-Horwood as he had his hip resurfaced and is dancing about seeming pain free again. For younger people this seems to be a better approach.

Vandf profile image
Vandf

Hello.

I have just been told the same thing. I am in so much pain, especially during the night and first thing in the morning. It came as a shock to me too. I don't know how to deal with this as I am not seeing the rheumatologist for another 2 months. I have decided to keep a diary in the meantime. I do hope that you can get some advice and support.

in reply to Vandf

If you need to Vanff go see a sympathetic gp. They can alter your painkillers and if they think it necessary write to rheum and get your appointment brought forward. Do you also have a rheumy nurse you can call? Be proactive, don't sit and wait 8 weeks in agony. X

Vandf profile image
Vandf in reply to

Thank you for your advice Kikideelili. I had a bad night and can hardly grip or use my fingers and hands today but there isn't much swelling. If this is Osteoarthritis, does a rheumatologist deal with it or is it my GP? Thanks. I hope you are keeping well.

in reply to Vandf

I would go to your Gp at first.

Wonderful example you give of the 'nose-picking finger'. That says it all. Inflammatory arthritis can cause osteoarthritis. That's the bottom line. If joints are inflamed or compromised by RA or PsA etc. then osteoarthritis is one of the forms of damage that may occur. How can the bio nurse be so sure that RA hasn't been attacking your hip? Unlike other joints, the hip doesn't show swelling. And RA moves around doesn't it?

You are very young for 'wear and tear' arthritis in your hip. Sorry to ask, but are you carrying a lot of weight? I'd imagine that would be one of the few explanations for wear & tear OA in that joint. Although, thinking about it, if knees, feet, ankles are affected by RA then of course we move awkwardly which in turn puts stress on the hip ..... whichever way you look at it RA seems very likely to be in the frame.

And yes. Pinky wear and tear in one digit is a very, very different proposition from early OA in the hip. Even if it's 'mild'. Those 2 letters 'OA' can cover a multitude of sins, many of them not very similar at all.

And yes, I have OA in knees, feet and hands. My rheumy is in no doubt that this rapid onset OA is secondary to PsA, a result of long-term inflammation.

Andrea_Shapiro profile image
Andrea_Shapiro in reply to

I don't mind being asked if I'm carrying excess baggage. That's just the thing: I'm not overweight, but could understand it more if I was placing extra strain on the joints. I need to ask more questions of healthcare providers, really. I was too gobsmacked yesterday to ask any further questions. I'll ring up the rheumy helpline when I've amassed a long list!

oldtimer profile image
oldtimer

I agree that the pain from RA & OA are different - but they are still both PAIN!

My son had a hip resurfacing - putting a metal cap over the top of the femur and a cup of metal in the hip joint - aged 45. He has been able to go back to an active life skiing, swimming, walking the dog etc.

Don't just put up with it -complain.

You are more likely to get OA in damaged joints, however damaged - by RA, by injury,overuse, etc.

Keep as fit as you can, the muscles help to protect the joint and the stronger they are, the better they work.

Niamhck profile image
Niamhck

I had a hip replacement last year with end stage osteoarthritis and diagnosed with RA this year, I agree OA pain is tough, my hip is doing really good now still have some soft tissue/muscle issues, but those are healing slowly too. Push for something to be done on hip, dont take the standard you are too young. I sought a second opinion when my first surgeon who killed my joint space said I was too young! Good luck x

Hi I am 55 and was diagnosed Osteoarthritis 4 years ago (knees, feet, hands, neck) and RD and Fibromyalgia in March this year followed by sjorgens and GERD recently. Osteo pain is different to RD but as I also have fibro I sometimes hurt so much all over I dont know what condition is worse. It has taken a long time to find anything that touches the pain and even then it doesnt always work. I have more recently started mindfullness sessions through pain clinic and although a bit early to say this is going to work I am feeling less stressed. I have tried many different pain meds and patches (I am a bit sensitive to side effects) and the only thing I find mildly touches the pain is tramadol which zonks me out so I try to limit this to nightime only. I also use a tens machine but to be honest I cant say anything takesthe pain away completely. I am just about to lose my job because of these conditions and that doesnt help with coping and makes me feel useless. I hope you find some relief soon. Gentle hugs Joolz.x

in reply to

Sorry to hear about your job joolz, I had to leave mine in sept as is been off sick since Dec 2013. I'm finding it a blessing really as I have more time to rest, exercise and prepare nutritious healthy food. I do miss it though and the money but not well enough.

I understand how you felt on being told this quite casually. I was told I had OA in my lumbar region wheh the physio was examining me in a routine appointment (my last - a few years ago now). She said, dead casually "oh yes that's quite clearly what is causing you stiffness, hip locking locking and lower back pain - I can feel the dip in your spine".

It was as if she had said "oh yes rain is on the way later" or something - so terribly casual? I've never been back to the physio and have asked GPs and rheumy to confirm but they just shrug and say it's my age and stage (48 when diagnosed) and tell me it's just very common and to keep moving. Yet when I get up from sitting position and everything locks often people stare with great embarrassment and I feel very old for my years (51 now). So it can't be that normal!?!

My sister is 45, not especially overweight and she has severe OA in one knee and gets weekly physio through her gp practice. They say she may need a total knee replacement within a year.

Andrea_Shapiro profile image
Andrea_Shapiro

Thank you so much everyone who has responded. It's always a comfort to know one's not alone. I wish I had a magic wand to make us all better.

in reply to Andrea_Shapiro

Hi Andrea

Have you tried Amitriptyline 2 hours before bed? I started it 3 years ago for RA pain in my ribs. Is get to sleep ok but wake in pain when the co codamol effect ran out. I was in a horrid no sleep more pain cycle so my rheumy suggested it. I knew it from when I worked in palliative care. It's great for bone pain. I only take 5-10mg a night but I sleep like a baby.

NeonkittyUK profile image
NeonkittyUK

Yes, same here .. osteo in many joints as well as my hips (fused hip) as well as the RA .. hideously painful and different to the RA pains. Nasty when both play up at once. When I was showed my xrays and it was explained several joints have fused it is not a good feeling but physio can help you keep moving and as much movement as you can manage at home. I hope your meds are protecting your joints. yes think of Craig ... and although re-surfacing is not an option for me as my problems are from a long while back don't be fobbed off. I am being just that with my knee by my rheumatologist. She wants to go straight to full replacement but my problems are tendons behind the knee but the hospital policy is not to scan and investigate if replacement is not being sought. I am going insane with this protocol. It is therefore only a guess as to what the many troubles are behind my knee. Hope you can keep your joints well and mobile. ;-) Sorry the transdermal pain patches not working for you. My Fentanyl takes the edge off it, but doesn't do enough. x

cathie profile image
cathie

Andrea I have OA in my fingers and knees. I saw a knee surgeon in June and he said that the difference between RA and OA in the knees was 'academic' as far as the op is concerned. I think he meant that he couldn't tell which had caused the damage. I freaked out at the idea of a knee op and instead I've been trying to strengthen the muscles around them with the help of a physio. I think this is really important for OA, we dont talk enough about physiotherapy on here and it does seem to make a difference. Sadly though I dont think I'll be able to avoid the knee replacement. Hips are apparently easier to deal with according to Arthritis Research UK.

Hope you can get some relief,

Cathie x

2lucyd profile image
2lucyd

I had a hip replacement in 2012 for what was described as moderate OA damage. I was working full time with no real problems previously when suddenly at the age of 53 I could not walk without using crutches and was in serious pain. I had a steroid injection into my hip bursa which did help but was told it was only temporary relief and I still needed a hip replacement. Well worth trying the steroid injection if you haven't had one as apparently the bursa can get inflamed if your posture is incorrect due to the pain.

18 months after the operation I had a swollen wrist which when ultra sounded appeared to show RD inflammation, then as I had a rheumatoid factor of 77.5 and CCP of 187 I was prescribed methotrexate.

The Rheumatologist said they were completely separate problems and there was no link whatsoever. Strangely enough after being relatively healthy for 53 years then getting incapacitating OA and RD diagnosed within two years I suspect there might be a link.

H

suzyrob profile image
suzyrob

Hi Andrea I have had both my hips replaced, first one in 09, very painful and second one this year Feb, which I had no pain from but was causing problems with my gait and giving me 'bursitis' in first one. Always told it was OA, but had many tests for RA over the years because of problems with my hands. But none had shown positive to RA. 3 months prior to having the thp this year I asked to be referred to Rheumy...scan of hands and confirmed RA..Inflammation in hands...due to hip replacement I was given steroids to see me through ..and then after was started on MTX. Always been active (squash/cycling etc over the years and I can honestly say having the hip replacement is amazing. The pain is horrendous if you require hip replacement and I would not hesitate to push your gp for new. I have more problems with my hands and being diagnosed with RA... I feel I have had problems, undiagnosed for many years, always being told wear and tear.... Im more concerned now with being diagnosed with RA than OA, but told should not attack hip replacements. Get replacement aSAP .

Lesley15 profile image
Lesley15

I know exactly how you feel. I was diagnosed with RA three years ago and then a year later osteo was just dropped into the conversation at a consultant's appointment. He was surprised I didn't know. Who am I mystic Meg? Then to cap it all was told pain in my hip was neither but avascular necrosis and had to have a hip replacement. Was told this is usually found in juveniles. Thanks for the compliment because it's a while(long while )since I could be described as juvenile. Glad ladies finger is still useful. The next person who says to me that they know how I feel because they sometimes get a sore thumb will get a verbal clip around the ear. No, you have no idea how I feel and how difficult it is for me to still work full time and whilst I'm sorry you have a sore thumb, hah! I should be so lucky! Don't despair, I know this diagnosis can be shattering but there are sometimes good days. I try to make silly comments when anyone asks me how I am so now everyone thinks I've lost the plot. I never knew there was one!

Wishing you well xx

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