Does Ra cause Oa

[Jlwgsw]

Hi allI have had a problem with my hip and GP sent me for an x-ray and I have damage in my hip, I also have pain in back,knees and ankles and I'm worried I have damage to these joints. My Ra hasn't been controlled for three years and I'm currently on methotrexate injections weekly. Would it seem wrong to ask my rheumy team for x-rays on my other joints as I really just want my pain to be under control.

[Jlwgsw]

Thank you

[AgedCrone]

Tbh, only the really lucky people get away without developing OA. ….whether they have RA or not.

DMards which protect joints which have RA have no powers to help OA…it’s that pesky DOB that,s often responsible for the wear & tear of OA,

Do ask your rheumy team to suggest some pain relief for the OA…which can sometimes help the RA as well. They will get X-rays & Dexa scans if they think a joint maybe helped by surgery…but not until it has been present for a while.

Hope you get your pain under better control soon.

[Jlwgsw in reply to AgedCrone]

Thank you for your reply, constant pain is so debilitating and I work full time and do a lot of lifting and stand all day and don't want to give up my job so need pain relief but it seems whatever I do or whatever medication I take is like a double edged sword.

[AgedCrone]

It is a fact that finding the pain relief that works for you is often trial & error.

You say you do a lot of standing around and lifting …have you had any physio consultations…often some advice on posture & how to lift correctly can help.

It probably wouldn,t be available on the nhs,but it might be a few pounds well spent?

[bpeal1]

Yes you can get secondary OA caused by RA. That’s what happened to my feet (the tarso-metatarsal joints and the navicular cuneiform joints). It happens when the inflammation is so bad it starts ‘eating’ away at the cartilage.

[wishbone in reply to bpeal1]

Same with my shoulders...not much cartlige left according to my rheumatologist. With both shoulder joints being affected then I would have thought the chances are it's RA rather than OA which tends to be asymmetrical.

[BoneyC]

As bpeal1 above says, you can get secondary OA. That's how my surgeons and rheumatologists describe it. I basically have severe OA in all my joints. Hips have been replaced, ankles they wouldn't do (considered too young even though so debilitating), shoulders and elbows I've put off since 1998 (yes, 26 years!) but currently on waiting list for left elbow replacement, to be followed by right elbow then shoulders.

Would it be possible for you to change your working day, to include some sitting, less lifting and standing? Otherwise, look for something less physically demanding.

[Runrig01]

So anything such as injury or inflammation in a joint, however minor it may seem, will accelerate OA. I have AS rather than RA, but have severe OA in both knees from the structural changes in my knees, both kneecaps are subluxed. Unfortunately they won’t do tests out of curiosity, it would only be done, if it would change your current treatment plan. They may be persuaded to do an X-ray of which ever one gives most trouble, if they think surgery is an option. As others have said RA meds won’t help OA, you generally need your usual painkillers for those. I find glucosamine helps, but you would need to check you weren’t on anything it interacts with.

Of course it may be your OA isn’t associated with your RA, and you’re just unfortunate to have both. As many suffer with OA as they get older.

Have you seen occupational health, they are very good at recommending adjustments to your work, to make it easier to continue. That may be a chair instead of standing all the time, depending on if it’s an option with what you do, or more frequent breaks to stretch etc.

[cyberbarn]

The idea that osteoarthritis is wear and tear is outdated. This is from Verses Arthritis:

"There are a lot of misconceptions about osteoarthritis but one of the most unhelpful is that it’s ‘just a bit of wear and tear.’

"The truth is our joints aren’t like car tyres that wear down and need replacing. They’re complex living tissues that our bodies constantly repair and maintain.

"Osteoarthritis happens when our bodies can no longer do this effectively. So, it’s not an inevitable part of getting older. It’s an active disease process."

versusarthritis.org/news/20...

And here is a peer reviewed paper that shows the the shared pathways for RA and OA.

ncbi.nlm.nih.gov/pmc/articl...

"Our study indicates that during the 13-year longitudinal follow-up period, RA patients were at a higher risk of being diagnosed with OA than the control cohort. Developing effective OA prevention strategies are necessary in patients with RA. This study may be extended to evaluate the risk of OA among other kinds of inflammatory autoimmune diseases. Identifying the key pathogenesis mechanisms are necessary for future study."

So is anyone's rheumatologist talking about preventing strategies for OA? Or even recognising that their RA could be causing the OA?

[Haz58 in reply to cyberbarn]

This is true. I have been doing a pain management course the past 6 weeks. They have said that 'wear & tear' is a very outdated concept now and should not be used. My question was if it's wear & tear why does not everyone get OA? So it's not wear & tear.

[Gottarelax]

I never had any OA. I developed RA in all my large joints very quickly and was diagnosed within a couple of months. When the Rheum looked at my fingers he pronounced OA in them rather than RA...it always seems strange to me that within months I went from no OA to very painful OA at the same time as I developed RA. I would assume that normally OA would slowly develop. It makes me wonder whether RA is a catalyst for OA.

[Jackie1947]

I developed OA way before RA and there's a difference between the two. Wear and tear v autoimmune disease. However you are at a higher risk of getting OA due to damage caused by RA to the bones.

[Sheila_G]

OA is simply wear and tear on the joints.

[Uzor]

Sorry to hear of your pain, and symptoms.… it’s not easy, but we keep going.

I also have rheumatoid arthritis, osteoarthritis and Fibromyalgia .The osteoarthritis seems to have attacked many other parts of my body. I have had bilateral knee replacement, decompression and fusion of my cervical vertebra, and recently, decompression and fusion surgery to lumbar/sacral for spinal stenosis . Now my hip has taken over. My rheumatologist told me that it’s triggered by the rheumatoid.

I do hope you get the right treatment to help with the pain. Stay strong and blessed.

[Jlwgsw in reply to Uzor]

Thanks for your reply because I seem to have deteriorated over 18 months with OA according to my x-rays and because I can't seem to get my RA under control I assumed this was the case and wanted to be able to ask for more x-rays as I'm worried about my joints and pain.

[Lolabridge in reply to Jlwgsw]

Sorry to hear your RA is not well controlled and you should contact your Rheumy and say so! Yes, do ask for more investigation into specific pain areas.

It's my opinion that OA can develop whilst our RA is not well controlled and the unfortunate "trial and error" approach to finding the right drug to work for our RA is a primary cause. I've got OA in many joints and I've also got osteoporosis, probably from all the courses of steroids or steroid injections I've needed during the periods between drugs; waiting for one drug to exit my system and before the new drug is fully effective.

[Uzor]

likewise, with my health. Luckily both my Gp and Rheumatologist, do not hesitate to refer me to have X-rays, and scans. I had been suffering with back pain for many years, eventually it started affecting my thighs, was sent for a scan, only to discover the extent of damage to my spine. Was given an epidural with no effect. I eventually went private for this op,as I couldn’t wait any longer to have it on the National Health. I’m now on the waiting list to have physio on my hip, plus steroid injection.

I do understand what you are going through. We can never make plans, as we never know what changes will occur from one minute to the next

Try to keep your spirit up.

Have a lovely day.

[Jlwgsw in reply to Uzor]

Thank you and you too

[TheBoys]

hi

I would certainly ask them to do an X-ray or even an ultrasound.

I had uncontrolled pain in my left knee and it was assumed to be RA but it was diagnosed as OA only after a physio spotter it on a scan. Then an X-ray confirmed the joint was damaged and now the right is headed the same way.

I would ask the rheumatologist team or your Dr.

I’ve done this myself but unfortunately my rheumatologist team at a big East London trust haven’t done it.. though they do use a small ultrasound scanner on my joints now, once a year.