Why do we still get pain even when there is no sign o... - NRAS
Why do we still get pain even when there is no sign of inflammation? Does this mean there has been some permanent damage?
Hi Wiliby, generally the longer you have RA the more chance you have of developing permanent joint damage. Once the damage is done its done and surgery is usually the only option to correct this damage that's why consultants now attack the RA pretty early on with a regime of drugs, depending of course on how severe it is to stop the joint damage.
In my experience I've never been free from pain even now when my RA is quite well controlled and I'm living a better life than I have done in the past I still get pain in certain joints everyday. That's because and like you said the damage as already been done to that joint and no amount of medication I take now will reverse that, it will though stop any other damage occurring (at the moment)
If you have a certain joint that's troubling you a lot then you must speak to your consultant or GP who will arrange for you to visit an orthopedic surgeon if he feels the need, or even a joint injection could help, but that's usually only helpful if a lot of inflammation is present.
So basically yes,permanent damage may already be done even though the disease seems to be under control.
Take care
mand xx
Thanks Mand, can I ask a couple more questions? (if you don't mind, I'm a bit cheeky!)
Now that your disease is under control, but still have pain, does it affect your mobility? hope I make sense, what I mean is compared to the stiffness when you are in 'flare' whats worse for you the; pain or stifness?
Also, can you be left with damage in surrounding tissue, ligaments ect?
Thank you xx
Hi Wiliby, my feet were the first to be affected by RA and have had two major operations on them, the bones are mainly held together by pins and screws the op was a triple Arthrodisis. So inevitably I will always suffer with mobility problems. but like everything else some days are better than others.
I've always found the pain the worse. in a flare it just takes over my whole body.
I've also had ops to repair ligaments/tendons in both my wrists,a synovectomy operation.
If your left with permanent join damage/erosion it will usually affect tissue.tendons and ligaments. It's the tendons that generally become loose in RA patients causing them to rupture or break. My wrists though have been the more successful operations I feel, along with my elbow replacement, these have hardly caused me any problems since.However, they are very weak and If I have a flare they will cause me some problems but nothing I can't cope with.
Take care
mand xx
I got a really good answer about this during my last review (only 5 days ago!). I was expecting the consultant, but got the head rheumy nurse who had an SHO in with her, who plans to specialise in rheumatology. I was the only patient in clinic, and only realised once I got in, that they wanted to 'show me off'. This has been my only opportunity to ask questions with spectacular results. I was presented as patient with seropositive rheumatoid factor who has demonstrated symptoms & proven flares as seronegative ever since. Although I indicated factor once, I haven't done since. I explained I can hardly walk now, am anticipating ultrasound of my feet. I've been told that, 'thing's change'. My hands are a perfect flare up at the moment, and there's a lot of damage to my right, which I've been told is inflammation that won't go down, but doesn't bother me that much.
Hi Andrea, does that mean your inflammation will never go down or because your disease is active at this time?
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Hi Wiliby
Just thought I would add a litte to your responses based on an utrasound test that I had done ( for a hand problem not RA). I had no outward signs of inflammation (as far as I was concerned) but on the ultrasound it was very evident that the joint was inflamed. I was told that even though nothing was visible externally that there can still be ongoing inflammation. Doctors also are very skilled at recognising inflammation when to our uneducated eyes there seems to be no external swelling at all.
Best wishes
Thanks Lorraine, your right, I forgot on my first appointment I also didn't think I had any swelling until the consultant did an ultrasound, never thought of that 
Hi there I get so much pain in my wrist but ever time I have my blood test she said the inflammation isn't that bad but the pain is so Maybe it's not showing up on my blood test but would on a ultrasound
I was diagnosed early but still have irreversible damage to my feet and hands and hence have pain continously in those joints.Also I now walk with a stick and cannot stand for a long time. Flares tend to give pain in other joints but can recede. I didnt know I had damage to my hands I just knew they hurt!! But USS revealed extensive damage. I think the consultanats tell us when the disease is controlled pain should be less but I am not so sure!! x
Hi Wiliby
i was diagnosed with RA 20+ yrs ago and i was first treated with Gold which i was on for 2 yrs after that i was great for years up until 5 yrs ago when i had a flare up and since then like Mand said i have never been pain free, i have had mxt embrel and now on humira which has brought down my bloods which is good, but as i said never pain free and i do have mobility probs, im not wheelchair bound but if i have to go into town i have to have someone with and use either sticks or a chair. Im not always imflamed as such as as we all know there are bad and good days. I have had Ra for a long time and yes i have some joint damage but luckily not extensive.
Hopefully you will feel a little less pain soon
