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I am 49 years old and was diagnoised with RA 3 years ago.  I have been on Methotrexate (2yrs) and am now on Humira and MTX for over a year.  Beside RA I have several herniations in my lower and cervical spine.  Up until recently (this year) my symptoms have been few and weak so I guess I was lucky.  Here's my recent dilema:

I have had pain in my right arm since January.  My Dr's keep telling me it is attributed to my cervical herniation.  I have had a recent steroidal injection in my cervical spine to combat the pain.  It didn't help, if anything I am worse.  I cannot lift 4lbs of weight without either hand giving out.

Beside the continual pain in my right upper arm (hard to type this) I feel completely exhausted lately and my mind is not clear at all.  I have trouble finding the words I am looking for and forget everything. 

Are these ALL signs of RA?  My labs are supposedly in the NON-inflamatory range, at least they were 3 months ago.  I went for blood a wk ago and have an appt monday with RA Dr. so I will see if there is a change.  Regardless of bloodwork I have not felt well and Dr. is suggesting I change meds.  Options are Enbrel, Orencia or Simponi.   She claims they are all similar but one requires IV in the office, I forget (see??) which. 

She also claims RA pain is usually symetrical, if you have pain in right hand than left should also hurt.  Has anyone ever heard of this?  My pain is not symetrical at all.  My left hand aches all the time and my right upper arm.  My back always bothers me, but it did before RA too. 

I know this is alot to digest, but I guess I am just trying to figure out if my arm pain could be RA and NOT the cervical spine because beside the arm I am tired and feel confused all the time.  To top things off I am on unemployment and trying to find work which is not easy when I feel this way.  My confidence level is very low. 

Thanks for any info/suggestions,
sick & tired,
Pam
Pam, I am so sorry that you are going through all of this.  Unfortunately, I don't have anything to offer, but I am sure others can give their thoughts on this.  I have only been at this for a little less than two years and don't have it under control yet.  Well, its controlled but there is still room for improvement.  I wish you well and hopefully, someone else on here can help you.

Pam,
RA is often symetrical in the affected joints, but not always. My left knee is bad, the right not. Were you sero-negative or positive when you were dx'd with RA? Did the Dr. explain how arm pain could be caused by a cervical herniation? Constant pain can be not only draining, but keep you from getting a good night sleep. Write down all your questions so you're sure to ask the Dr. everything you're concerned about or don't understand. My dr bases the effectiveness of the medication I'm on, by my bloodwork, so ask her why she wants to change if the bloodwork is ok. I think you have a lot of legitimate questions. Good luck. Thanks Kim.

Deidre,

I was diagnoised when a small mass was surgically removed from my foot.  It biopsied as a rheumatoid nodule.   My blood work performed by the Ra Dr came back showing signs of inflamation and a positive RA diagnosis was made.   I was put on MTX  and that was that for a year.  Than I developed another mass, same thing.  I was than started on Humeria because even though my bloodwork still remained  "normal" I obviously had inflamation.  I never really had ALOT of pain, my left hand has some deteriation because I cannot lift anything even slightly heavy with it and I get sharp pains.  I developed problems with my right arm in February, but it would come and go and I was able to still exercise it. 

All my troubles with extreme pain just started a few weeks ago.  I really feels like my body is under attack. 

I will make notes for Mondays visit and get written results of the bloodwork to investigate myself.  I never really felt like I had RA, not until a few weeks ago.....
Pam, Thanks Phats.

Snowowl, I have had several shots in my cervical this year.  The last set was 2 wks apart and were in lower and cervical.  I had alot of unpleasant side effects. Heat flasshes, headaches, and still pain.  I also have read they can cause damage to cartiledge and I don't need more of that so I am weary to try that again. 

So what I'm hearing is that my lack of sleep is probably causing my Fatigue and my unalertness.  I thought that was directly caused by the RA....

I forgot to mention I started PT last week, maybe that will help with the arm.  I do have some pain meds the DR prescribed, but I still feel alot of pain unless I take extra and than I dont like how that feels either. 

Thanks everyone for your suggestions and help.  Does anyone have an opinion of the following? I read all the literature and they are very similar and all can cause the big C.  I use the pen Humira now.

Dr. is suggesting I change meds.  Options are Enbrel, Orencia or Simponi.  

Pam

Hi Pam, welcome to the forum. As has already been said, chronic pain is debilitating. Adequate pain relief is all too often hard to come by but once achieved makes life worth living again. Have you discussed pain relief with your physician? Sometimes taking pain medication on a schedule can break the cycle. I was always very reluctant to take pain medication and would allow the pain I was experiencing to get "out of control" and then it would take double or even triple the dose to gain a modicum of relief. It was a difficult lesson for me to learn: take pain meds before the pain is -significant- and becomes manageable.

If you have not already done so, consider making an appointment with a doctor who specializes in pain control. That step, for me, was a breakthrough in RA treatment.

Best wishes, Shug

EDITED to add >>CLICK HERE<< this link to a timely article Lynn49 posted this morning.
Spelunker2009-09-11 07:44:32Pam, I am sorry you are having so much pain.  You sound a lot like me, I have the RA, the cervical and lumbar herniations, the fatigue and forgetfulness, and 2 years ago my worst pain was down my right arm.  I do believe my arm pain was nerve pain from the cervical herniation (even though it didn't exactly match where the herniation was) and I found that Lyrica helped significantly.  It also helps with Fibromyalgia, which I have and it sounds like you could possibly too with the fatigue and forgetfulness, although those can be from RA as well.  Do you have any muscle pain/fatigue? Innerglow,

Yes I do sound alot like your situation.   I'll look up Lyrica and ask my RA Dr about it monday.  If this pain would stop in my right arm than maybe I could sleep better.  And I'm right handed too which doesn't help.

"Do you have any muscle pain/fatigue? "  Yes to the muscle pain.  Sometime it is hard just to climb out of the car lately. 

I should have thought of this sooner, but decided today I would start a "pain diary".  My PT asked questions and all I could do was say, duh, IDK.  Not exactly helping my situation. 

Thanks for taking the time to help me out, its appreciated!

Pam
I just got back from my RA DR and she says the blood tests are great and there is no signs of inflamation.  I complained about all the pain I've been having and she said it could be Fibromyalgia.  She is suggesting I try Lyrica as it may be Fibromyalgia.  (innerglow called it)

I am very disappointed in my visit today as I felt she didn't give me her full attention or the time I needed.  Shouldn't she have examined me for Fibro? 

I felt like saying, "But you said it was RA??"   I feel she doesn't even take my pain seriously because my hands and fingers aren't SWOLLEN.  Well thank goodness for small favors but believe me I am in PAIN.  I am looking for a new DR, she didn't even test my grip or anything.  Come to think of it, she didn't even touch me.  She did however mention she was heading to lunch. 

I never felt like this about her before and I've been seeing her for 3 years.  Maybe she was having an off day, but it happened on the day I needed her most.  She literally was walking out the door of the exam room while writing my prescriptions.  Anyone now a good RA DR in Monmouth or Middlesex County in NJ???

Also, I took a copy of my Blood results if anyone knows how to decifer them.  What should I look at?

Thanks Pam


Pam, the RD definitely should have physically examined you, especially for diagnosis, but even just for a follow-up visit.  Unfortunately I think a lot of doctors these days are walking out the door while writing the prescriptions, but you need answers.  I can't believe how close by you actually are to me....I'll send you info on my RD in case you're able to travel up to Somerset County.
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