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RA & Chronic Tendonitis Connection?

Hey all.  I have sero-positive RA and I've been dealing with the disease for several years now.  However, as an added problem back in October/2008 I developed chronic tendonitis in my right elbow and I've been dealing with it ever since.  The tendonitis is so bad that I can't squeeze toothpaste or pick something as simple as my shoes up off of the floor.   Even eating with a fork or holding kitchen utensils with that hand/arm is extremely painful.  To top it off, its exteremely painful to hold a writing utensil such as a pen and write.  Luckily, my employer is somewhat understanding and is dealing with the fact that I have to work with one hand even though my productivity is extremely slow. I've been seeing various doctors for this including my Rheumatologist and a Sports/Medicine physician to try to remedy the situation.  To date I've had (2) medrol injections and "months" of physical therapy and my situation is not improving at all.  If anything, my grip in my left hand is getting worse as time goes on, even with the physical therapy which there's documented evidence of from grip strength tests performed by my physical therapist.  My physical therapist and physicians can't understand why the chronic tendonitis is not improving.  I have stated several times that I felt that there was a connection between my RA and the tendonitis.  However, I can't get either one of my docs (Rheumatologist or Sports Medicine Physician) to acknowledge that there can be and most likely is a connection between my RA and the tendon issues. They keep stating that the chronic tendonitis and lack of healing of that issue "has to be" due to something that I'm doing either at home or at work physically to aggrivate the issue and prevent healing.  The thing is, due to the pain I almost never use that hand/arm for anything and I even keep it in a wrist splint most of the time.  I disagree that I'm overusing the arm in anyway.  On top of that, I did a search on the internet last night to see if there is any documented connection between tendonitis and RA and I've found many articles that prove that they are often connected.  Why can't my physicians see that there might be a connection between the two issues and that this "may" be the reason why even with all of the preventative therapy's and treatments I'm not showing any improvement?  Are there any diagnostic test (MRI, etc.,) that can prove/disprove that there is or isn't a connection between the two conditions? 
 
Is there anybody else on here with RA that is currently experiencing or has experienced chronic tendonitis in the past that they felt was connected to their RA?
 
I really need to figure this out. My current employer is closing our business operations and I am searching for a new job.  The problem is with my RA and Chronic Tenodonitis combined, I'm exteremely limited in the type of work I can perform.  I honesty don't know of too many employers who are going to be willing to deal with me only being able to work with one hand/arm.  I'm trying to get this rehabilitated so I have more employment options but I'm honestly losing ground with this tendon issue and not improving.
Ta2d2009-07-28 07:49:46My husband has chronic tendonitis too. He does not to our knowledge have RA and no one has ever suggested that he does. For him it is his elbow, his achilles tendon and he also has planter facillitis. Not all at once- it seems to go in cycles one to the other with sometimes nothing bothering him in between. His seems to be brought about by too much physical labor. This has been going on for at least  15 or more years. He gets a lot of cortisone shots and goes to physical therapy. he has had a lot of x rays and MRI's and there has never been any talk of RA- not sure if they could make a diagnosis that way. Funny thing is I have RA and I am sero negative. He was having a problem with tinnitus recently and they tested his RF factor and his was 23. The doctor didn't think that meant anything at all- but now you make me wonder.I'm in no way saying the if you have tendonitis, it might suggest that you have RA.  I'm just saying that I feel that in my case, the two conditions are related.  I was diagnosed with sero-positive RA way before my tendon issues came about.  Maybe they are not related but I know that when I'm in a flare, my tendon issues increase and worsen.  [QUOTE=Ta2d]... I've been seeing various doctors for this including my Rheumatologist and a Sports/Medicine physician to try to remedy the situation.  To date I've had (2) medrol injections and "months" of physical therapy and my situation is not improving at all.  If anything, my grip in my left hand is getting worse as time goes on, even with the physical therapy which there's documented evidence of from grip strength tests performed by my physical therapist.  My physical therapist and physicians can't understand why the chronic tendonitis is not improving.  I have stated several times that I felt that there was a connection between my RA and the tendonitis.  However, I can't get either one of my docs (Rheumatologist or Sports Medicine Physician) to acknowledge that there can be and most likely is a connection between my RA and the tendon issues.[/quote]
I am so sorry that you are experiencing tendonitis + resistance from your physicians. I do not have any insights for you, but will say without apology that in your position I would be looking for a second, third, fifth, or seventh opinion.

I decided long ago that when a doctor told me something that did not "ring true" it was past time to look for another point of view.

I wish the very best outcome for you and a STOP to your pain, Shug
It makes sense doesn't it that your immune system could be attacking your tendons? I have PsA and that is part of that arthritis. Take care.Thanks for all of the replies.  Yes, it makes perfect sense to me that tendons could be an issue with RA.  I know for a fact that when I'm in a flare I have certain tendons that give me major problems.  The sports medicine physician that I am currently seeing says that he can understand that I "feel" my tendon issues more pronounced when in a flare because of the swelling but that tendonitis is "always" due solely to overuse.  I totally disagree and I now have several articles to disprove his belief.  It aggrivates the heck out of me that my sports medicine doc and my physical therapist both keep saying that I "must" be doing something physically that is preventing the tendonitis from rehabing.
 
As a last resort I just broke down and left a message with my Rheumatologist to see if I can get a Medrol pack.  My wrists are so swollen that I don't have anywhere near full range of motion in either wrist and my thumb and index finger on my right hand are numb.  To top it off its turning out to be one of those flares where I can hardly keep my eyes open and stay awake.  I hate Medrol but maybe it will ease this up enough to get things under control.
I really sorry to hear that you're in such pain and that the treatments haven't helped.  Like Shug stated, seek a second, third or more opinions.  RA and tendonitis are linked by inflammation.  Inflammation can cause floppy and stretched tendons.  This happens with PsA and why we have tendon pain.  Inflammation and synovial fluid buildup also causes swelling around the nerve sheaths and in turn will cause tendonitis.  I've had bilateral elbow tendonitis that affected my arm, fingers and wrist.  Once the inflammation disappeared then so did the tendonitis.  Please seek a second opinion, you shouldn't be in that amount of pain and not get answers from your doctor.  Take care and keep us posted.  LindyI never had problems with tendonitis until I got RA. I fought it in my shoulders for a few years, but after many shots it is finally better. I think mine is related to the RA as my RA is finally under control, too.

Hoping you feel better very soon.I too have tendonitis in several locations and the Dr said it was due to the RA, last week I couldnt even pick up a gallon of milk.  This is fairly new for me, in the past it was joint swelling and pain.  Right now my wrist is double its size.  Trying to talk this doc into a Kenalog shot, my other Dr would give them to me but this one wont.  They really help.
 Hope you get some relief soon
Well I feel that it is of course part of the disease. That is because I have tendonitis also. Just seems the tendonitis issues are the hardest part to get a handle on. I am just steady on taking my flexeril every night and also taking prednisone and get shots. Well that gives me the use of my right arm and left foot. We are just high mantance but we are worth it.There is no doubt in my mind about the connection between RA and tendonitis. I have read many times that RA attacks the sites where the tendons attach to the bones. This would absolutely cause inflammation in your tendons.
 
I am very prone to tendonitis...plantar fascia, tennis elbow,etc. I think you need new drs because the guys you are seeing have not been able to help you even after a good long try.
Most of my RA shows it's ugly face as tendonitis. Shoulders , elbow, hips etc. Even my Dr said that I seem to manifest differently then most. Sure I get swollen joints but when the tendons act up sometimes the pain is unbearable. Shots in the area seem to help a lot [QUOTE=marian]There is no doubt in my mind about the connection between RA and tendonitis. I have read many times that RA attacks the sites where the tendons attach to the bones. This would absolutely cause inflammation in your tendons.
 
I am very prone to tendonitis...plantar fascia, tennis elbow,etc. I think you need new drs because the guys you are seeing have not been able to help you even after a good long try.
[/QUOTE]
Marian,
 
   I absolutely love my Rheumatologist and I have no desire to find a new one at this point.  He never stated for a fact that it was his opinion that my RA and tendonitis could not be connected.  However, he did state that he thought that the tendonitis might be due to something I was doing rather than from the RA.  However, I know that this is not the case.  It was my sports medicine doc that has stated that there is absolutley no connection between the two and that he deals with it all of the time and it is always due to overuse of the joint/tendon.  I think he may just want to keep my business and he is afraid that if he were to admit that it was or could be RA related I would leave him and let me Rheumy deal with it. 
 
My rheumy started me on a medrol pak this morning to see if it will help my flare and tendonitis.  Hopefully it lets up as I haven't been able to sleep in (4) days due to the tendon pain and joint swelling.
 
I'll keep everyone posted.
 
Ta2d
Ta2d2009-07-29 10:31:08
 

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