Back and neck pain?

Hey all

I'm looking for a bit of help. I've been struggling with my back and neck for ages now. I'm under a rheumatologist but just for mixed connective tissue disease. Due to my back pain I went to see a chiropractor yesterday.

He said he was shocked that I hadn't yet had an xray on my neck and back to rule out rheumatoid arthritis. I have now had the xray and get the results next week. He also said it's rare for a 33 year old to have this type of pain.

Just wondering what anyone's experiences are... I know RA has been on the cards for a while.. Can an xray confirm or rule it out? Is back and neck pain even a symptom? I also get pains in my fingers and take hydroxychloroquine.

Any replies would be helpful

Thank you :)

10 Replies

It's a moot point, some say RD can present in the neck & back & others not. I'm older than you but I can empathise with the pain as I have OA in my neck & my back (considered so anyway, poss due to not being in the "yes" bracket), cervical & lumbar spondylosis. Thankfully a lot of my pain is helped with my BuTrans patch & other pain meds so I would also ask for effective pain relief pro tem if possible.

I had chest, spine, foot & hand x rays at diagnosis & regularly up until 3 years ago so I would think it's unusual if you didn't have basic x rays to form part of your Rheumy's considered diagnosis. Pain in your fingers may be an indication but as a rule there's often inflammation as well, though not always.

Do be careful though, whilst chiropractic is very good manipulation it's not always the best choice until you have firm diagnosis & maybe not even then. More harm than good could be done so I wouldn't go again until you see your Rheumy & discuss it with him/her.

Good luck.


A good rheumy will diagnose based on a whole range of things - blood work, imaging, physical symptoms and what you say about how you feel. There's no one thing that can 100% rule in or out RA, and in this whole family of auto-immune stuff it can be quite hard to distinguish one from another. So mixed connective tissue is a useful general category as sometimes it also takes years for the specific disease to really show itself. And back problems could hint more at AS than RA.

But back/neck problems could also just be back/neck problems - after all these are the most common ailments that people suffer from at whatever age. I had dreadful problems when I was that sort of age which turned out to be rubbish posture, and once I'd sorted that out I had no problems for the next 20 years.

Anyway, I'd tend to put more faith in diagnostic abilities of a rheumy than a chiropractor, so hopefully the X-rays will provide more clues. But as Heels says, do be careful about manipulation right now - and perhaps ask your chiropractor whether he/she has experience of dealing with people with RA.

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I would think spondyloarthritis needs to be ruled out as that affects back and neck far more than RA does/


Thanks everyone. I'm a bit worried about the 'manipulation' now so don't know whether to go ahead with it. I guess if I go along and get the xray results I can see if anything has shown up. And then be cheeky and not go for further appointments. I only really went to the chiropractor as I'm in so much pain and my rheumatologist doesn't seem to think there is much wrong with my back and neck. I understand there might not be anything technically wrong with it, in that it might just be a posture issue, but that doesn't mean I'm not in excruciating pain every day. I just can't concentrate at work at all. I only see my rheumatologist every year now and the last time I went I explained how bad my back is but I still didn't get anywhere with him.

My blood results are positive ANA but other tests non conclusive. My rheumatologist gave me hydroxychloroquine as I had symptoms ie muscle pains, joint pains and extreme fatigue. What about something like fibromyalgia? Could that cause back and neck pain? It's soo frustrating!

Thank you for all of your input.


Unless the Chiropractor has knowledge of RD & how important it is to be aware when manipulating then personally I wouldn't go again, except to collect your x rays. It may seem cheeky but do remember that it's your joints & you have to deal with the pain or damage which could be caused if he doesn't have any qualifications for using chiropractic on patients with RD.

Do you not see a Rheumy nurse between your appointments? If not I would ask as you only see him once a year if you could be added to the Rheumy nurse clinics list. Do you take an NSAID along with your HCQ? Thinking it could be inflammation causing your troubles?

My OA pain was on a par with uncontrolled RD pain so if it is OA or inflammation you really need pain relief & anti inflammatory to get you through until you see your Rheumy. Your GP should be able to prescribe that for you, mine does & I have regular reviews with her, in fact trying to get my neck pain to an acceptable level just now, not that the latest drug's doing much though it can be a case of suck it & see for us I'm afraid.


I don't dismiss pain from mechanical problems at all! They hurt just the same as pain due to a chronic disease like RA or AS. A lot of the time the bits of me that have OA hurt much more than they bits of me that are affected by RA.

It's just that could be responsive to a different solution - like a chiropractor or physiotherapy. Once the x Ray results are in could you ask GP to refer you to a physio?


I'm suffering with back & neck pain with me my spine is damaged I have RA &brittle bone disease for the pain I have been put on Buprenorphine Patch it last's a week then you put a new one on I need a higher does I hope this is some help to you


To be honest I'm not sure I'm being that we'll managed. My only concern is that if I wait til next March for my next rheumy appt, I still won't get anywhere, for some reason they just don't seem to take it seriously. I could go back to my GP for some better medicines, as ibuprofen works a bit but really isn't strong enough. Really, I feel a bit muddled and all over the place. Thanks for all the advice re the chiropractor though, do you think I should check whether he is qualified in treating patients with RA even though I've not been diagnosed with it?


If there's any doubt (particularly on the Chiropractor's part suggesting RD should be ruled out) I would hold fire until you see the x rays & they're explained to you. CMTD is condition which has overlapping disorders, you may or may not have had a bit of a lazy diagnosis, that is to say that you didn't present with or your bloods didn't determine one strong reason for giving a firm diagnosis. Only my take on it but best to be sure before having any more manipulation, speaking if it was me here.

I would go back to your GP anyway, for better pain relief & anti-inflammatiory & also to discuss if he/she thinks it would be prudent to test again for Rheumatoid Factor, ECR CRP & anti ccp, though be aware that RF may come back negative, RD results can be positive or negative so do state your case if your bloods come back negative. Unfortunately though neither are a given of a positive diagnosis, only a Rheumy will be able to determine that looking at the whole & if you wish to see a different Rheumy do let your GP know. It's possible your situation may have changed since you were first diagnosed with CMTD, I hope not in a way but if it has at least you'll receive the proper treatment particularly as you say it RD has been on the cards for a while.

It might help you to have a look at the NRAS website, to see if any other symptoms apply to you. Do keep us updated won't you.


Hi Iv'e suffered with very severe neck pain for years the Rheumy I was seeing for a long time just kept saying it would get better when sorted on the right medication, I have been on numerous medications including Rhituximab Infusions and it still didn't help.

I have a new Rheumy Consultant,been with him for three years and changed onto Abatacept Infusions still no joy with the neck,he referred me to the Pain Clinic about 8 weeks ago,he injected Local Anaesthetic into my shoulders and said he hoped that would help,went back 2 weeks ago and reported no joy with pain but a bit more movement in my neck. I am now waiting to go in August to have a nerve block in the top of my neck,have to go in for a day as he said to make sure that I don't fall over after having it. will let you know how it goes. Hope you get some ease soon xx


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