RA+spinal pain=OA??

[jlp1977]

I am a year down the line after being diagnosed with RA. Have had no major problems so far, and I don't have the typical symptoms of inflamed joints - but over the past 3 months or so, I've had a lot of pain in my upper spine, that's really been getting me down. After a visit to the Rheumatologist yesterday, they casually told me it is very unlikely to be RA causing the pain, so it must be 'wear and tear'. They didn't seem bothered in the slightest, but now I'm quite worried, because I don't think I should have wear and tear in my spine! I'm only 35, super healthy and super active and not overweight... has anyone else experienced pain in their spine? If so, what was the outcome??

Many Thanks

[PFKAAde]

Hi jlp1977

I have had RA for the last 17 years (since the age of 29) and I have developed severe back problems over the previous 5 years.

My spine issues are Degenerative Disc Disease leading to spinal stenosis and also degenerative scoliosis. I have nerve impingement causing sciatica and neuropathy that has left me in chronic lower body pain (lower back, sciatica that sort of thing). There is also facet joint involvement (OA?) which causes more back pain.

The discs that have prolapsed so far (I'm not even certain how many but >6) have been spread out along my spine. I have had two emergency decompressions due to the pressure being put on my spinal cord from two specific disc protrusions. This left me unable to walk.

I have been told by the surgeon that did my back (and had it co firmed by my rheumatologist) that RA only ever affects the first vertebrae in your neck (C1). He has also stated, under questioning, that there is absolutely nothing in any of the literature about autoimmune involvement in DDD, or any of my other spinal issues.

Apparently I am 'just unlucky' 🙄😬

For what it's worth my problems presented with neurological symptoms (foot drop, sciatica, paralysis) not general back pain.

And I am also slowly recovering to some degree, the extent of recovery remains to be seen, but 2'years post my most recent surgery (Nov 2015) is the timespan I am told I have for recovery.

If I was you I would pursue the back pain with my GP and ask for a referral to a specialist. If you are a candidate for further back problems early diagnosis can only help, and being active (lots of exercising your core muscle group), along with correcting any posture issues, lots of stretching / loosening exercises for the spine and that kind of thing is probably the best 'defence'.

In my humble opinion anyway.

All the best.

Ade

[jlp1977 in reply to PFKAAde]

Thanks for your reply Ade, I am sorry to hear of all your spine problems, but I hope your recovery goes well. I agree with all your advice, and have already started Pilates to strengthen my core and improve posture. I shall definitely pursue it with my GP too. Thanks again, and good luck!

Maria

[earthwitch]

I have significant pain in my spine, but I have a diagnosis of ankylosing spondylitis. This is a seronegative inflammatory arthritis, but isn't the same as RA. AS does have inflammation in other areas than the spine, but the spine is pretty classic. Usually sacroiliac joints and/or neck first, but a lot of women seem to get thoracic spine pain too. DMARDs don't really do anything for the spinal stuff, but NSAIDs or steroids usually give significant relief. Staying still for too long will make it worse, and gentle movement usually eases it a bit, so its often worse on waking but relieves a bit during the day.

The other possibility (other than osteoarthritis) for thoracic spine pain is osteoporosis and/or a compression fracture. This wouldn't normally be likely in a young woman unless they had had significant risks - like having taken quite a lot of steroids, or having some kind of malabsorption problem (eg many years of undiagnosed coeliac or inflammatory bowel disease).

[jlp1977 in reply to earthwitch]

Thanks for your reply, I have heard of AS, but I thought it started in the lower back, so that's very interesting and useful to know. I think I will visit my GP and see where that gets me... sometimes I get a bit wrapped up with thinking/panicking that everything must be related to the RA so maybe a fresh pair of eyes would be useful.

Thanks again,

Maria

[earthwitch in reply to jlp1977]

Check out the list of criteria for differentiating inflammatory back pain from mechanical back pain on the National Ankylosing Spondylitis Society website. If you find you tick all the boxes for inflammatory pain then it might be worth asking for a second opinion from a rheumatologist who has a special interest in ankylosing spondylitis.