Can Rheumatoid Arthritis Affect the Spine?
You can’t get Rheumatoid Arthritis in the spine, can you?
(The funny noises in my neck say yes. Let’s see what the funny-sounding medical words say about RA / spine…)
The only books on Rheumatoid Arthritis that I read are ones from “legitimate” sources such as recognized university hospitals or M.D.’s who specialize in rheumatology. But, there has been a problem: the experts often disagree.
A chief area of disagreement is which joints that can be affected by Rheumatoid Arthritis. Most authors include their list. However, the different lists do not match one another or the facts that I have learned firsthand.
Rheumatoid Arthritis in the spine is one prominent example. I have read several lists which exclude the spine. I have also talked to doctors who believe that the spine cannot be affected by Rheumatoid Arthritis.
I am only reporting the RA spine facts as I read them
Well, I don’t imagine that I am equipped to argue with experts. All that I can do is report the facts as I learn them. Here are some facts about Rheumatoid Arthritis in the spine.
The doctors who write a site called Spine Universe describe in detail the manner in which RA affects spinal joints. They say that the neck is usually the first area of the spine to be attacked by RA. An excellent illustration accompanies their clear description of Rheumatoid Arthritis in the cervical spine.
Let me quote to you a report from WebMD’s emedicine since I cannot say it any more clearly myself:
“RA activity in the cervical spine begins early, with 83% of patients in prospective studies developing anterior atlantoaxial subluxation within 2 years of disease onset. Activity in the cervical spine progresses clinically and radiologically in tandem with the peripheral-joint involvement. In fact, the severity of the peripheral erosive damage is strongly correlated with the degree of structural damage in the cervical spine.”
That is 83% of RA’ers with involvement in the atlantoaxial joint within 2 years. The atlantoaxial joint is between the first and second vertebrae in the neck: C-1 and C-2. That is the joint which caused the predicament of Nicole Bradshaw that I reported here last week.
Joints in the spine affected by Rheumatoid Arthritis become unstable. Damage to supporting tissues can cause vertebrae to slip in a process called spondolisthesis. The result can be pain due to pressure on nerves caused by the slipped vertebra. The spinal cord can be compressed which can cause a wide range of symptoms.
Although it is more common in the cervical spine, the thoracic and lumbar spine can also be affected by Rheumatoid Arthritis. It is not too difficult to find examples of this in medical journals. After one study, the Journal of Bone and Joint Surgery stated, “We submit that subcervical rheumatoid spondylitis is commoner than is generally believed, though less common than rheumatoid involvement of the cervical spine.”
Question: Why can I find this information with just a few hours of research when some M.D.’s are confused about it? Is it because I have no prejudice against the existence of Rheumatoid Arthritis in the spine? Thank God for RA in my spine, I guess, which enables me to shine the light on the truth.
Recommended reading:
Nicole Bradshaw’s story: Rheumatoid Arthritis and Basilar Invagination
Ridiculous reactions to RA: So Glad Your Rheumatoid Arthritis Is Cured
Good news happens: The Truth About Rheumatoid Arthritis Will Be Told!
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It seems contradictory to me that doctors describe RA as a systemic autoimmune disease that can cause damage to everything from your toes to your lungs and your heart, but exclude the neck and spine… How much sense does that make?
I describe pain and noises in my neck and shoulders, which my rheumy doc ignores while he examines at my fingers (minimally affected so far) like they are the absolute essence of RA activity.
It is hard enough to fight my own denial and fear of what RA can do to my body. Then to have rheumy docs who ignore what I am reporting while they focus instead on blood test numbers and a very narrow perspective of a one-size-fits-all quick exam.
God bless you, Kelly, for bringing the RA Warrior blogsite to us!
It is so refreshing to have the validation that, yes, my symptoms are real, and that yes, they DO matter. You are helping me to become a more informed self-advocate when I go for those quick-exam rheumy doc visits.
Thank you,
Caysea
Caysea,
Well said.
I do not know what motivates such dr.s either.
I have read some incredible spine stories – it is definitely real.
Thanks so much for bringing this information to us Kelly. In my case, I was told many years ago by my ortho, rheumy and anesthesiologist about the danger of RA in the cervical spine.And it was something that they always checked. The anesthesiologist mentioned that all RA patients should have a c-spine x-ray before any surgery where they are going to have general anesthesia. They need to check the amount of degeneration and stability of the c-spine due to RA. He told both me and my husband that if the RA was severe in the c-spine there could be serious complications during intubation while under general anesthesia. Because of that I make sure that before every surgery I have an updated c-spine x-ray for my surgeon and anesthesiologist
Jacque,
Thank you for this good advice. I’ll try to pass this on to others. I am so thankful that your doctor was so informed. (I have heard horror stories about doctors who tell patients that “you can’t get RA” in the spine.)
Thanks for letting me know that the RA in my neck and lower facet joints weren’t just trying to make my Rheumy look stupid they had something to say! I believe they were saying “Hey Doc, we got RA no matter what you say!”. My pain management Doc says RA or OA, I have both, who cares IT’S ARTHRITIS! He’s not a fan of my Rheumy…LOL. My neurologist says she doesn’t know why I have nueropathy in my hands and feet I’m probably just depressed, I look depressed to her so she gives me the name of a shrink! 2 years on pred. I have cataracts, I’m 49 w/cataracts, no more pred for me EVER!!!!!! I may need a new Rheumy he’s only had x-rays done once in 3yrs.! Maybe if he did a full body he’d find the RA in my spine…What do you think…
Funny, Alice
Neuropathy is not uncommon. I am only guessing, but it makes sense that swelling inside of joints, especially the spine, would lead to compressed nerves. Maybe this is the cause of “burning” sensations also. I’m not sure.
I have heard the shrink comment numerous times. And,sorry about the pred. I also went a few years w/no x-rays ordered. Sometimes that’s good because x-rays are not sensitive enough to find anything until it’s bad.
Haha. Did you read this post about finding a new rheumy?
thank you warrior, you’ve again come forth with some great information,, i have terrible back problems,, i know they come mainly from the work i did ( roofing) , no doubt about that,,,but,,,,, since i was diagnosed with R A it seems it’s gotten much worse,, no doctor has said my spine is affected by the R A,,,,but i wonder ????????
Thanks for your blog. My Rheumy just sent me for a MRI on my neck after my last exam and what did it show? Severe narrowing of the spinal cord where the nerves that go to the upper extremities. Also another area where there is pressure and narrowing of the spinal cord. I have been on pred in high doses since the fall of 07 and would love to get off of it. Also doing methotrexate, humira and lodine and some days it seems like I am on nothing. Now I am going to see a neurologist about the MRI results. I am thankful that I found your blog. Some days I feel like I am the only one going through this pain and that it is all in my head.
Sorry about your neck, but glad you have an idea what’s going on. You are definitely not the only one going through this pain. I like to say: “No, it’s not in my head; it’s everywhere else.”