Could I have RA and Ankylosing Spondylitis?
I was diagnosed with rheumatoid arthritis last year, and had a positive rheumatoid factor (which is not correlated with A.S.). I have problems mostly with my large joints- hips, knees, ankles, and shoulders. I have never had low back problems before.
I have been out of work now for over 3 weeks with severe low back pain. I wake up 2 or 3 times in the morning with severe pain right in the center of my spine in my lower back/ top of buttocks. It feels like my whole back just seizes up on me and I have trouble getting out of bed. When I'm sitting up leaning forward it eases up. Also, I can't stand and walk for more than 7 minutes at a time without terrible pain throughout my whole lower back, sometimes going down my hips. It hurts to keep my back straight or to bend backward, but bending forward feels better.
I read that AS also can cause heel pain. A few months back it hurt to walk for a couple of weeks due to pain in my heels, but I thought that was from the RA.
My primary doctor just assumed my back problems were from a muscle strain, and gave me muscle relaxers, which didn't solve the problem. My doctor took an x-ray and did say I had arthritis in my back. Could osteoarthritis feel that bad? It came on suddenly, not gradually. I've noticed my other joints flare up when my back pain is the worst, so it seems like it's probably some form of arthritis. Should I be referred to the rheumatologist for this? Is it possible I could have both RA and AS?
Have your rheumatologist go over your case totally with films and information. Primary care are not specialists, they often mistake RA problems for other things. Perhaps they could get an MRI after the xray ......be sure to tell your Rheumy everything in detail......I had the same thing happen to my lower back and they just called it degeneration. I have been out of work over 2 yrs now and not working helped my back. Can they put you on Enbrel or something similar?? I have had this joyful problem for 6 yrs and have had many many trips to the Rheumy. Let me know if I can help you at all.
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oftentired
Thursday, October 29, 2009 at 01:58 PM
How did your visit go? I hope you got some information to help you. I also wanted to tell you a couple of things. First of all, when you are young, they will want to get aggressive treating your disease. If your current meds are not helping they should take up another med. Biologics are practically a miracle......Enbrel put my body almost back to normal. I have more upper resp. infections but I would rather have it than the pain so severe that I'm vomiting. Cancer never crosses my mind. There are side effects from every medicine, I am aware but certainly don't worry about it now. If you go with the arthritis unchecked your body could end up in worse shape. I was begging for Enbrel back in the beginning. They would not give it to me until my spouse called and threatened to sue them. (I switched Drs) If you can, take a covered medical leave from your job. Either short term disability or FMLA. Protect your job at all costs unless you have someone to completely support you. It is hell out here with no job. And under no circumstances do you tell a new employer that you have RA or whatever...
you are protected under FMLA and it is a federal offense if an employer violates the policy. Protect your job because you could get better medicine and feel better. It sounds crazy but true. Fight to change your meds. Lots of us love biologics, some don't.
Hi,
I've had RA, Fibromyalgia and Sjogrens for 10 yrs and had terrible back pain. Spondylitis showed up in a cat scan when they were looking for something else. As far as biologics go, that is a personal decision. They work pretty well for me. I just had to way the benefits against the risks. Now my Rheumy is testing for Lupus after I showed up with a horrible face rash earlier this week. You can have several types of arthritis and several autoimmune diseases at one time. I hope you find something to take that will help. Better living thru chemistry!
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YES YOU CAN HAVE BOTH. I AM LIVING PROOF. THE AS IS WAY MORE PAINFUL THAN RA. HAS IT GOTTEN IN YOUR FACET JOINTS YET? GET AN MRI SOON.
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StarHill13
Thursday, October 29, 2009 at 08:35 PM
I talked to the rheumatologist's Physician's Assistant. She said that though some people can have two autoimmunes, AS and RA can't go together. That made me feel more hopeful. Though, you're telling me you have both? She should meet you, then. Why do I only get stuck seeing PAs? The doctor is always too busy, or something. Well, she seems to think my back problem is a disc, and supports my GP's process of wait and see if the physical therapy helps. I can't get an MRI, she says, because insurance companies won't pay until you've been in therapy a month. So, I'm back to just waiting and not knowing what to tell my job. No one will help me.
As for the bad hip pain, she did allow me to double my dose of Sulfasalazine. She said the doctor wouldn't even consider putting me on a biologic yet. I guess they wait 'til you're completely crippled and it's too late. Well, hopefully the 4 pills a day of sulfasalazine will help.
boneyfingers
Thursday, November 12, 2009 at 01:25 AM
Hi there, sorry you have feeling so rough. Next time you make an appointment don't let them make it with the PA. Tell them you have seen the PA twice already and you want to see the doctor this time and that is your right. They can't be too busy to see you when you call and make the appointment. I would think also the doctor would see you the first time (i'm thinking this was your first visit????) before having the PA see you. It shouldn't hurt the PA's feelings but the important thing is seeing who you want to see and are paying to see. Hope you do well on the azulfidine and get to feeling better :)
I was dx with RA in 3/1995. Also, I've had psoriasis since in my early 20's. In 11/06 I was dx with Psoriatic Arthritis. It effects certain joints including the lower spine. Also, dx with Fibromyalgia. My blood test was negative for AS. Check with you Rheum. You may need further testing. Good luck.
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StarHill13
Thursday, November 12, 2009 at 11:46 AM
That makes sense. I just went on WEbMD and read about psoriatic arthritis. I did have a rash on my left foot for a couple of years before I was diagnosed with RA. I told the rheumatologist about it on my first visit, but she didn't even look at it. Since I've been on the DMARDs, the rash went away. I also have the ridges on my fingernails. However, one of the main reasons for diagnosing me with RA was that my rheumatoid factor was elevated, which doesn't happen in psoriatic arthritis.
The PA told me my back pain wasn't from arthritis, because it would show up on an x-ray. Then, I went to a back pain specialist, and he told me it IS arthritis, and that it doesn't always show up on x-rays. Still, no MRI. I feel more confused and lost than ever now. No one will give me any answers. I got three different diagnoses from 3 different doctors, and still no one will do a test to find out what's wrong.













Thanks for replying. I asked my primary care doctor today if it could be osteoarthritis, and she said it wasn't bad enough, from the x-ray. Could it be from the RA? I thought RA didn't manifest in the back. Well, I made an appointment at the rheumatologist's office tomorrow (though they set me up with the PA); at least that's some progress. I'm bringing my x-ray with me.
What do they mean by "degeneration?" From what? Couldn't they get more specific? Doctors treat people like imbecilles. Take this pill, you'll be fine. No information. After a bottle of Flexeril, I'm pretty sure this isn't just a muscle strain.
I am so frustrated. I don't know what to tell my job. I'm thinking of going to a job website to look for a sedentary job in bookkeeping or data processing. I've been at my job for 3 years (mail clerk in a state prison), and I would lose all the good benefits, but I really can't see myself making it to 62 to get the retirement anyway (I'm 35). Even if this back problem gets better, I'ts getting harder and harder to deal with the RA hip pain with all the standing and walking.
I'm taking sulfasalazine. They haven't tried me on the biologics yet. Maybe it's time. It's kind of scary, though, with the possibility of cancer from them.