January 14, 2013
One Chick wrote in:
I’ve always had muscular issues with my back, but it’s been primarily my upper back and neck. I’m 27 and work ridiculous hours (at a job I love, no worries) that puts strain on that area of my body. Over the last week, my lower back and specifically my hips have been killing me. I’ve had some other joints involved this week as well (fingers, wrists, elbows, knees), but I’m wondering… how do you distinguish between back issues and RA hip issues? I will say that this pain feels quite different than my usual pain and feels more like it’s in my thighs and rear end than my back. Sitting or lying down in certain ways is uncomfortable or painful. There has also been some popping that seems new… Thoughts? I don’t know whether to go after the muscles and stretch or if it’s the RA.
Thank you in advance for taking the time to help her out and answer her message. (((pain-free internet hugs)))
What our members have said so far:
Michele – With RA you get so many secondary illnesses. I have degenerative disc disease that causes pain to many locations because of nerves being affected. Always best to check. What I thought was a kink in my neck led to 2 pieces of cadavar bone, 3 inch plate. 6 rivets and 3 screws in my neck. So don’t mess around with it!
Sheila – My hip and thighs go numb and hurt (along with my backside) because of a herniated disc. My co-workers used to look at me funny when I told them my backside hurt. I have a big problem with my left hip now that prevents me from reaching my lower leg or foot. My doc says that RA doesn’t affect your hip when I mentioned that I had hopes that my next round of Rituxin infusions would help with my hip.
Colleen – This will sound strange but here goes. .. I use a super ball to put pressure on the knots in my back side. I kinda half sit on a chair with the ball under me and kinda scoot it around.
Beth – From experience with both RA and things like sciatica and piriformis syndrome, it sounds like you are having strain related issues. Can you check with the HR person to see about training regarding safety if you are lifting or performing repeated motions, both of which can take a toll on all joints, but especially your back. OSHA is another place to seek advice regarding standards that need to be followed when lifting w/your back. In any case, seek medical advice as damage could be occurring that can’t be undone.
Amy – Great question…have always had hip issues as part of my RA for 10 years. Recently started back issues — baddy ones — hips, lower back, both legs. I believe it is arthritis as it gets worse when the biologic is due and clears after I get it f0r about 2 weeks. Then it all creeps back up again until the next dose. Good luck!!!!
Heather – I had very similar issues that my doctor seemed to think were not originating from my joints (he didn’t say whether he thought the issues were related to my RA or not). My doctor referred me to physical therapy, which was very helpful in resolving the pain in those areas and fixing the popping I was getting. They gave me stretches and strengthening exercises that I do when I notice the same pain creeping back again. I suggest you ask your doctor if he thinks PT might help so if you do any stretching, you’re doing the right kind of stretching!
Sher -Similar here…….just not my wrists or ankles…but def the entire back area n hips geez, NSAIDs r supposed to b taken everyday to decrease the inflammation, r u on mtx? It helps
Becca – I have RA, DDD and AVN. I have had three surgeries for popping hips from torn tendons. My hips do not sit properly in their sockets so I was told I would need at least partial replacements some day. With RA we are prone to Osteoporosis as well as avascular necrosis so I would ask the doc to do xrays to check on your hips. Back pain and damage can always radiate to hip pain as well. You just have to really pay attention to where the pain starts are then where it goes to. My inner hip and outer hip hurt when I get RA flares too.
Amandah – my rheumatologist told me that RA is not in the back, it is probably DDD (i have that as well)
Kirsten – Contrary to what many by the book rheumies think, yes RA can go into the back. It’s also known to attack the cervical spine (IE neck) especially virulently in a specific form of JRA. For me, my issues stemmed from a left leg shorter than the right, but I didn’t know that until the last few months. A shoe wedge to balance out the problem has helped, and a wedge to sit on to correct my posture has eased my back problems. One of the best things you can do to help the issues in the back and hips is to strengthen your core, thus relieving some of those muscles and bones of pressure.I’d also like to point out that despite an x-ray tech looking at my back x-rays no one ever told me that my left hip sat lower than my right and the only reason any of this has been dealt with is through my physical therapists showing me the x-ray and working off of it with me. PTs are a must for us.
Dee – I have the lower back and hip issues too. My rheumy says its RA related pain. Yoga helps me, when I can push through my pain and practice it. Hang in there!
Pennie – Training for your job with a Physical Therapist might be an idea. They could fit you with protective belts for your back if needed. Key point to remember if its outer hip pain it’s usually strain related. Direct hip joint pain will be felt on the inner part of your leg, groin area. Good Luck!
Helen – This is one of THE debated topics in rheumatology. Check out RA Warrior for lots of good information about cervical spine involvement and RA. Cervical spine issues can kill people with RA. I also have DDD, recently diagnosed. What I think should be standard practice is for us to be given ultrasounds and MRIs on a routine basis of all affected joints – including the back. It seems to me that if a joint is known to be involved and it is known that ligaments and muscles associated with the joint “might” be affected – such things as ligament micro-tears and muscle wasting – then doesn’t it seem reasonable that we be given proper tests to check for these things that can explain the pain and lack of mobility? My analogy is – its like being in a car wreck and having the attending doctor have a look- push around on a few joints – and say you’re fine. This just FLOORS me !!! Apparently ultrasounds and MRIs are not routinely used by rheumatologists in Canada. It is standard practice in many parts of Europe and is catching on in North America. We simply need better care and standards of practice that include a more thorough and objective examination of all joints, ligaments, and muscles on a regular basis. I am working toward having this assessment. We are accepting sub-par treatment and many people with RA end up disabled. That’s my 2 cents worth !!
CJ – I’m 28 and I do have degenerative disc in my neck. I haven’t had any surgery for it since its not serious. But it hurts! Got RA when I was 24.
Danielle – When in doubt see a DO for osteopathic manual manipulation. I was in a car accident in 2005 and was left with horrible neck and back issues, not to mention, nerve pain. OMM saved me after 6 years of suffering. I had been referred by a physical medicine doctor. We didn’t know it, but in 2009 is when the arthritis set in. Couldn’t tell through the other pain. https://www.osteopathic.org/osteopathic-health/Pages/default.aspx
Lorraine – I, too, have the hip & back pain & physical therapy was a godsend for me. There were days when i couldn’t stand for even a minute without being in pain & now I have been able to walk on my lunch hour with no problems. The stretches the PT will show you are something you can use anytime the pain comes back –and avoid taking yet another pill or injection for pain. Best of luck to you.
Monika – I don’t have much to add…I teach nursing and find my worst back pain days are my office days when I sit all day. A heating pad at night helps tremendously. I do best with a combination of sitting and standing/walking.
Amanda – OK I can sooo relate to this, I can actually help. — First, get an X-ray of your neck and T – region. NEXT – Beg for an MRI. The x-ray will not show anything deep and you will live with pain that you don’t have too. OK My neck issues are totally separate to my RA issues and after you have an x-ray AND an MRI of your cervical area it is VERY important that if yours is separate, then you need to make that clear at every Drs visit. OR, they will try to treat your neck pain with RA medications and therapy (and it ODES NOT WORK). NOW, it you find out that your neck is due to your RA… well that is different. BUT, lets just think for a moment that your neck is all by itself — I want you to start rolling a towel and sleeping with it under your neck, and put it around your neck when you watch TV. JAM that darn towel UNDER you Skull and get some of that weight off of your neck for a little while. — YOUR head weighs 8 – 12 POUNDS!! Think if you had a bowling ball sitting on your hand all day! If you are having issues with your neck… that is exactly what it is doing when it is hurting — Hey, THIS bowling ball hurts. OK — AFTER you have an x-ray and MRI and if you find out that you are not sick or terribly hurt — Next do this — Now that you have your towel rolled up and under your neck at night and when you watch TV, slowly stretch your neck from right to left whenever you feel it hurt — even at work. Close your eyes, and raise and lower your shoulders ten times. This will not fix the problem, you need a Dr for that… but it will help with the pain a little and keep you from going insane while you are in pain. Roll your shoulders up, down, and in circles… This helps take the weight off of your neck muscles, which have to do all the work of holding up that bowling ball we all call a head. — When I say slowly, I mean very slowly. You don’t want to “scare” the muscles from a tense position to the moving position. — Again, as I type this, I want to remind you that an X-ray, and an MRI of BOTH your cervical and your upper T-region is important before deciding anything. AFTER two injuries, my neck ALWAYS hurts, and causes my great headaches. So… I feel for you deeply. — As for your lower back, get a better chair, and keep a towel behind you while you work to force you to sit up straight. yes, it may look silly, but it does help.As for the RA… Do you know that you have RA? I have found that my RA is more in my joints, and my neck and back issues are more in the muscles surrounding the injured Disc.
Marita – I have the exact same problem I have pain in both of my hips where I’m tossing and turning all night I went to see a neurologist and he told me that I had for bursitis in both hips and gave me an injection which seem to help temporarily. I can tell you if some of the worst pain that I’ve ever experienced you can’t seem to get comfortable while you’re laying down or sitting
Robin – PsA-issues with pelvic joints, hips, knees, ankles & feet. Mtx, Celebrex& Enbrel seem to be the right combo for me, for now. Knee swelling caused damage and pelvic joint & tendons issues in the opposite side to flare. Physical therapy was a life saver! Exercises are holding the pelvic pain away and surgery on the knee to fix repairs and remove the knew lining next week. Crossing my fingers. I miss yoga…
Elizabeth – Do you have secondary fibro?? Was just in with my rheumy today. I’ve been dealing with pain that radiates from my right thoracix area of my back to my shoulder and up into my neck. It’s getting worse. Three months ago she did a steroid shot on it which didn’t touch it. So today I’m supposed to have an MRI to rule out a rotar cuff issue. If it’s not that it’s my fibro. She also would like me to have PT/masssage therapy. Don’t know if Medicare will pay for that or not. It’s expensive out of pocket to pay for such things. I would ask about fibromyalgia then go from there.
Kathleen -I’ve not read all the responses, I’m wondering if you have ever been tested for Ankylosing Spondylitis? I have this along with RA and what your describing is a lot of the pain I have. Here is some info from the Humira Website: http://www.humira.com/as/what-is-as.aspx?cid=ppc_ppd_hum_yah_ras_2464
Louise – I think it is RA related. I have pain in hips and basically all joints. Not all at same time. Sitting too long and being tired are causes in my opinion.
Elizabeth – I ask my doctor if something is RA pain or other pain, and how she thinks it should be treated. My Rheumatologist and primary doctor are a great team, and they help me out a lot with these kinds of questions.
Kim – Everything is interconnected. My back issues are the worst. While recently I was diagnosed with degenerative joint disease in the thoracic area of my back. I am sure it has to do with the way I sit all day. In fact, Right now.I have an ice pack on the upper back and lower back. It seems to work a bit. I also go to the chiropractor and have electric pulses and a bit of an adjustment and that usually works for about a week. I have never had a steroid shot there (only in my thumbs and pinky) but maybe that is the next thing I need to do. I bought a electric stimulator and it just came yesterday, so maybe having one at home will help keep the pain at bay. Good luck. P.S. of course, the temp is 18 degrees and the weather is changing with a front coming through tomorrow, and I usually feel this a day before!
Amanda – @kim– I use my Tens UNIT all the time. Even right now I have it going on my neck while typing. You are going to love having one at home. I always keep it handy. ALSO… YOU can buy the pads in different sizes off the internet for very low cost. AND then you can Pinpoint where your pain is… YOU can use your TENS UNIT on your knees, wrist, back, neck, and I have even used some very small pads on my jaw line.
Georgie – I have had 5 major back surgeries. If you pain in hip, butt, running down your leg or numbness in your foot or toes. Call your doctor ASAP. You can have a disc blow just by rolling over in bed. The longer you wait the more nerve damage you will have and it takes a very long time for nerves to heal if ever. Always be safe and call your doctor. Gentle hugs and let us know how you are doing.
Rhoda – Sounds like me in the hips. I changed beds and never sit or stand more then thirty minutes at a time . Sleeping well there I just pray real hard and hope for the best.. hope you get answers and help
Irene – well I have both RA and Osteoarthritis and muscles and bones kick your ass , God Help Us all , pain is just nuts !!
Suzanne – I feel it may be fibromyalgia, i have the same things and have had hips replaced!!!
Cheryl – Sounds to me RA.My back and hips are always aching,so Doc had me take a X-ray of my back,next time I saw her she said that my back and hips are worn out with the RA and there is nothing they can do about it!….
Laurie – sciatica~
Cherie – If it’s “true” hip pain, it’s in the groin area, where the ball and socket are. That’s what is replaced if need be. I feel that you are talking more muscle problems. This is just my opinion, not a Dr. though.
April – Gentle stretching and water therapy would be great for either. I’m with you on that it is hard to tell sometimes what is causing what.
Ange – I get bad pain in my groin and lower back when I have a flare in my hips, its horrible, can’t walk for days, I hope you feel better soon.
Penetran Plus – Have you tried Penetran+Penetran Plus?
Nikki – We all get major high inflammation levels in our bodies and that effects muscles, joints and ligaments so I think you should go after both. Do some stretching and heat and ice. I have experienced inflammed ligaments and the stretching really helps.
Debi – <3 I sit in a bath of Epsom salts. Also could be you need a Chiropractic alignment. Hard to determine whether it is RA or something else. I was in a two car accidents and I wait a few days before going to chiro because sometimes it is RA. I take extra anti-inflammatories like Aleve and Evening Primrose oil gel caps.Hope you feel better soon. Hugs
Jeannette – It just the beginning, heat.ice.pools.ocean r our friends good luck
Jo – All I can do is to echo what a lot of others have said. My Orthopod told me, before replacing my severely RA damaged hips, that true hip pain is centered in the groin. Pain on the outside is usually due to bursitis or tendinitis. Hip problems can also present as referred pain in your knee. There were a couple of statements that leave me concerned. Particularly since patients were told this by their Rheumatologists. 1) RA doesn’t affect the hips. 2) RA doesn’t affect the spine. As my rheumy told me, “why not. They’re joints aren’t they.” Just the other day my husband commented that it seemed like RA could do whatever it wanted to do. Seems true to me. Best of luck to all of us!
Stephanie – Thanks for the responses, everyone. I was mostly looking for info on how to differentiate between muscular back pain and true hip pain. Mine seems to be a mix of the two depending on activity and how the rest of my body seems to be doing. As for strain at work-I teach high school instrumental music, so the majority of the strain is playing and/or conducting, although I really don’t play very often anymore and my kids are pretty darn good at playing without a conductor! The kids are good about doing most of the heavy lifting, etc…but the stress and hours (sometimes between 50-60 hours a week or more) can be killer and no doubt lead to tension. I use a theracane for muscle knots/trigger points and it is a lifesaver. I’m a little bit paranoid and was hoping for some “no way it’s RA pain, sounds like the muscles in your back” responses, which I got. My mom had severe RA and had multiple replacements. I spent 20+ years with mostly just my knees affected, and then of course after I fell in love with a career in music and teaching BAM last year I woke up one day and couldn’t straighten my elbows and my hands hurt like crazy. I’ve been on the medication merry-go-round for awhile. It’s time to go back and see the rheumatologist, but I DO feel a little better about the hip problem now. I will continue my normal stretching routine and see if it lets up. I also have a special pillow that I use for my neck after getting pretty bad whiplash in a car wreck in September (chiropractor was wonderful!), and it helps a lot with the neck pain I get from muscle issues. Thanks again for the responses,everyone.
Stephanie – (I should note that my elbows and my hands are mostly back to “normal” now in terms of range of motion on most days…but they still hurt. I just worry a lot about the RA starting to attack new areas!)
Tammy – Jo, My Rheumatologist told me RA can affect any joint in the body which yeah would include hips which I have trouble with and lower back. The swelling causes pressure on nerves causing pain. RA also can affect the major organs of the body. Swelling and fluid can surround the heart lungs and other organs cause them to be squeezed with pressure thus limiting function. I have RA in my neck, shoulders, hands, hips, back, knees and ankles. Yeah I know its bad and I have been on every med there is except a few of the newer ones ( Orencia ). None of the other meds done anything for me or I had a reaction to it. Went to the highest dose of Remicade, Humira and Enbrel. Had a very bad reaction to Methotrexate.
Aisling – I’ve always had RA but never problems with my back til last year when i was also working a ridiculous schedule. I happened to have a part time job with a Chiropractor, so got some x-rays, which showed that the discs in my lower back had some wear – which is common in sufferers of RA. Stretches really helped with it for me. But it might be worth it to get an expert opinion.
Vee – Ms W. has covered my answer. Not all pain is RA bit RA is all pain! lol, you need to see a doctor, first. No medical person would do a DX sight unseen so forgive us. Sounds like more back strain, possible nerve damage from the job you love. You might have to rethink your career.
Veronica – I have similar issues. My rheumy says it is bursitis.
Lisa – I had similar problems last year, Bursitis and degenerate disk disease. You should go to the doctor and be seen. Best thing I did for it was PT and they had me walking on a water treadmill as I had tried to baby it so long that I had limited mobility. Don’t wait to long. Also see if you can be seen by an occupational therapist as they may have good adaptions for work and home. My rheumy said that she didn’t know if it was related to the RA but it was harder to treat because of it (traction was out)
Jessa – I can relate to your dilemma- and occasionally I feel like I get caught between my family doc and my rheumy- this happened recently with tailbone pain. I think my tailbone pain is from my RA, but I wont know for sure until I rule out any other causes and it “stands the test if time.” So most probably it is going to cost a lot of time and money to for a non-definitive answer that it’s my RA.
Carol – anyone got problems with their face
Liz – I was in hospital for pain management for sciatica as I had a lower back strain which ended up affecting my right leg when my hands a wrists started to swell and ache I was tested and diagnosed with R.A the Dr & specialist I saw for my back and R.A told me there were 2 separated issues Lucky I don’t need surgery on my back and the treatment for both condition can be managed together so don’t mark everything down to R.A have it checked the referred pain from my back is in my hips thighs and behind the knee mainly on my right side with a numbness around my knees and thighs on both legs making walking difficult.
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