RA or OA

I have always had pain in my knees when walking or standing. But last Sunday my right knee was very swollen with a lump on the side of it which was hot and like a brick wall to touch.It was so stiff and swollen I could barely walk, my husband had to half drag half carry me to the bathroom.

I have a diagnosis of RA and SLE   After a couple of days rest the swelling went down somewhat but remains painful. I have noticed when I move it, especially from bending to standing I can feel and hear the bones moving.

I am beginning to think this is OA and not RA  in my knee.

Any ideas.

18 Replies

  • Hi there, I also have RA and Lupus and recently had terrible pain in my right knee. (Have been bothered with knee pain before but this was different.) Long story short - I had it x-rayed and I have OA /moderate wear and tear. 

    It's not fair is it? Rheumatoid Arthritis and Lupus for 35years and now Osteo Arthritis! My friends say I'm just greedy!

    Rest and anti inflammatory gel (Piroxicam) worked for me.

    Hope you get it sorted out.

  • Thank you will try the gel it was extremely painful and stiff.

    It comes and goes .Does yours?

  • Yes, mine comes and goes and I can't see a trigger/reason. When it gets sore it's really intense and I can't weight bear then it just goes as quickly as it came. Sometimes the pain lasts for a day and sometimes it's a week or more.

    I got the Piroxicam on prescription from GP, it helped a bit but really only rest and painkillers worked. 

  • Yes it is the weightbearing which is difficult we live in a house and the stairs are the stuff nightmares are made of.x

  • Believe me I feel your pain! We had to move house a few years ago because I couldn't manage the stairs.  Hope you get relief soon. x

  • Thank you. Yes we are considering moving.. They are becoming impossible.

  • My knees are affected & I have soft tissue swelling typical of OA (I have both OA & RD). I do strengthening exercises & find Pernaton gel eases the pain, which is by no means constant thanks to my pain relief, it's breakthrough pain but when I have it it's not pleasant! My Rheumy handed over my OA care to my GP & she's really helped with appropriate pain relief.

    Do you have a Rheumy appoinment any time soon? If you do I would certainly ask if they could be examined to determine what's the cause & if a treatment plan could be considered. 

    How are you getting on with the patches? x

  • Hi NMH patches I appreciate my GP has started  me on low strength , I see him again in another two weeks but hope I can have some a bit stronger as I am still experiencing a lot of pain in the affected joints.

    I see the rheumy nurse next month, I have been keeping a diary and certainly will ask to have my knee examined.

    Thank you x

  • Yes, it's a build up thing but by increasing the dose you'll start to notice the benefit, you understand why it needs to be done incrementaly. You're not woozy or anything? I think I said I started on 5 then up to 10, then 15 & now 20. There's no 15 so it will be a 5 & a 10 if needed.

    Great keeping a pain diary, it should be helpful, take pics of your knee too just in case it's not as bad when you're seen. Did you happen to take any last Sunday when you had the lump & note down how your h had to help you?

  • Yes have take. Photo's.As you say you can bet your bottom dollar everything disappears the minute you walk into the consulting room.

    I noticed in an earlier post you take Axocia my first consultant prescribed it and it helped. But my GP is reluctant to prescribe for regular taking due to side effects. So I have to try and make a months supply last about 4 months before I can get a repeat 

    No side effects on the patches.x

  • That's good you're taking pics too & pleased you've no side effects from the patches. 

    Arcoxia is the 4th or 5th NSAID I've had & the 3rd selective COX inhibitor. The others either didn't work well enough or became less effective over time but this certainly works. I take 90mg at night & had done for two years when I had an appointment with a Registrar who asked had I really taken them that long I said yes (they were first prescribed by my Consultant in Spain & my Rheumy here just reinstated my meds that my previous Consultant was treating me with). Well that was me off them, according to him I'd taken them too long & so I asked if I could have something to replace them I was told no as I was considered well enough controlled but I could take one on the odd occasion if it was absolutely necessary. He also told me to taper my steroid again, I only take 3mg but it stops me flaring. Well you can imagine the result, his insistence concerned me so I only took about 10 over the next three months. This resulted in a big flare & trigger finger started so I saw my GP who put me straight back on the steroid but wanted me to see if I coped enough on 1 Arcoxia every alternate day until my next appoinment with my Rheumy so she could decide if they were still necessary. This was my now retired GP not my current one & he told me that I didn't have trigger finger. Anyway my Rheumy was obviously not happy her Registrar had all but taken me off the two stating he should have asked her first & she'd have told him to keep me on the steroid & ask my GP to perform a full cardiovascular check to ensure my heart was ok. I have close family history of heart problems, both mum & dad, otherwise I'm fine, she says I have a good diet & I don't smoke, each add to possible risks. If you check you'll see that Arcoxia is a COX-2 NSAID & can increase the CV risk if used long-term so maybe that's what your GP meant by side effects? So, my GP arranged an ECG, BP, cholesterol bloods etc. & all was good except for a slight raise in my HDL (bad cholesterol) for me being in the higher risk category. After 3 months attempting to reduce it by diet it had risen which wasn't entirely a surprise considering my diet, I didn't have much room to reduce saturated fats, so I started statins. The first caused muscle problems but I've been on the second over a year now, actually I've just had my annual CV check & BP which is unmedicated is bob on again & everything else is ok so I can continue on Arcoxia. End of my not so potted history of etoricoxib!

    Surely if your Consultant prescribed it your GP shouldn't have pulled your rescript without consulting with the original prescriber & discussing his reason for stopping it? If you found it helped & with the state of your knee it could well have been, I would have a word with your Rheumy & see if he would represcribe it for you. Just be aware he may want a CV check like mine did to check you're heart healthy. If it's considered too risky there are other NSAIDs which aren't COX´s he can prescribe.

    Hope this rambling helps?! x

  • Yes it does and they were his reasons, however I had an ECG about a year ago BP is taken on a regular basis I normally do it myself and email it through.I take a statin and cholesterol is level is good cannot remember what it was at last count.I do not smoke and drink very little if at all.

    I am going to ask the rheumy consultant to reinstate them I do not want a CV but do want pain relief that works.

    Does taking axocia at night effect your sleep pattern?

    Thanks again Nomoreheels (every time I write that I think of some magnificent Indian chief sitting on an equally magnificent horse)

    I ramble.x

  • Ok, so if they were his reasons I see no reason given that you had all the CV checks & the only iffy one is controlled by meds for him to overrule your Rheumy & not represcribe it, you're in the same position as me apart from you have the odd drink, most odd. If he does reinstate Arcoxia your Rheumy may suggest as mine did that your GP performs an annual full CV check but that's no biggie & personally I think should be done as a matter of course anyway with patients with RD.

    I don't know if it would affect my sleep pattern because I take amitriptyline nightly so I sleep well with taking that but I don't see why it should being an NSAID, they're not normally known to cause disruptive patterns & nothing's listed on the PIL. The only thing that could be considered related is restlessness & that's in the rare category.

    Let me know how you get on. So now I'm Indian chief, that's different lol! x

  • Will do Thanks NMH.x

  • Hi. I have a mixture of RA and OA so where does one start and the other finish? Million dollar question. I find ice packs relieve swellings. I haven't got a knee problem but use ice on other swollen joints. Jackie 

  • Exactly it is almost impossible to tell which of them is causing the pain.

    Ice packs help a little thank you.

  • What Jackie says. I have had RA for 16 years. One new knee, two new hips. Was it RA or OA that caused the erosion? I have always thought doctors diagnose RA for the clinical symptoms and OA when there is joint damage. 

    Either way they both hurt and both destroy your joints. OA doesn't have the same systemic symptoms, but if you already have RA / SLE / PsA etc then you have those symptoms anyway. 

    I just smile politely and take the medicine these days. 


  • Yup they both hurt.Problem is finding the medicine that takes the edge off it.😥

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