What Is the List of Rheumatoid Arthritis Joints?
Searching for proof for Rheumatoid Arthritis joints
Several people have recently asked me questions about which joints can be affected by Rheumatoid Arthritis. Cindy’s post is a typical example. People write that they are worried because when they complain about an RA symptom, a doctor has told them something like this: “You cannot get Rheumatoid Arthritis in that joint.”
People ask me which joints can be affected by RA and how they can prove it to their doctors. I’ve never had much luck proving anything to doctors myself, but I’ll give this my best shot.
My short answer: I have Rheumatoid Arthritis in every single joint. Two good rheumatologists and my general practitioner have told me, “Any joint can be affected by RA.” So, I know it’s possible. However, I don’t expect you to take my word for it.
My longer answer: There is a list below with lots of cool links to check out. It might also be interesting to read the posts and comments: What Is the First Symptom of Rheumatoid Arthritis? and Is There a Typical Rheumatoid Arthritis?
Often requested list of Rheumatoid Arthritis joints
List of specific RA joints, with links to the most frequently questioned:
- Rheumatoid Arthritis can affect every joint and most organs or systems. Joints include all in hands, all in feet, ankles, wrists, knees, elbows, hips, spine, jaw, vocal cords, sternum, and heel. There is a more detailed list of the ways RA can attack the body in RA 101 here.
- Spine: RA spine is so frequently discussed, it has its own post already here.
- Fingertip or distal interphalangeal (DIP) joint. An article about DIP’s in November 2005 Arthritis and Rheumatism states, “DIP erosions occur frequently.” I have found many other articles which discuss cases of DIP RA. If you are wondering why so many RA specialists are confused about this, I found a neat explanation in 1966 issue of Arthritis and Rheumatism. Antique, but fascinating.
- Feet and toes: Check out the Institute for Foot and Ankle Reconstruction with a sad photo showing destruction typical in RA feet.
- Hip: 1995 Annals of Rheumatic Diseases report: “CONCLUSIONS — Early hip joint destruction giving symptoms mostly at a very late stage is frequent in RA. Ultrasonography rather than signs or symptoms could identify patients with hip joint involvement and provide a rationale for early treatment.” Nuff said.
- “Ribs”; actually, sternum: A Medicine Net .com article says, “Costochondritis is a common form of inflammation of the cartilage where ribs attach to the breastbone, the sternum.” Read details of this condition. It can occur with RA or other autoimmune arthritis such as psoriatic arthritis or Ankylosing Spondylitis. For a little more on RA rib pain, read this vintage 1986 newspaper RA article in New Kentucky Era.
- Lower back: See this 1964 Annals of Rheumatic Diseases article: Rheumatoid Arthritis of the Lumbar Spine. It’s a detailed article with lots of x-rays of the RA lumbar spine.
- Vocal cords: RA in the larynx is called Cricoarytenoid Arthritis.
- Shoulder: University of Southern California San Diego Medical Center detailed discussion of how to treat RA shoulder.
Bottom line about RA joints
- Rheumatoid Arthritis in the spine is not rare. RA in the DIP joint is not rare. And Cricoarytenoid Arthritis is not rare. It’s frustrating to hear how people are doubted because the symptom they claim to have is thought to be rare.
- Even if a symptom were rare, how does that help if it is you that has it? I hope you will always tell your doctor where RA hurts or disables you. It may require treatment.
- I have read several books and magazine articles with lists or diagrams which restrict RA to a limited number of joints. It was discouraging to see that doctors were writing these books. They seemed so confused that I quit reading those lists a long time ago.
Recommended reading:
- Is There a Typical Rheumatoid Arthritis?
- What Is the First symptom of Rheumatoid Arthritis?
- American College of Rheumatology redefines Rheumatoid Arthritis, Part 1
- Can Rheumatoid Arthritis Affect the Spine
By the time I was 10, I had figured this out. Thanks for bringing it to everyone else’s attention.
I got the RA first. I found the “info” later. No one told my joints not to allow RA in.
Diana, why do you think this is? Why don’t doctors know what I could learn in just a few hours of research?
RA also affects heart, lungs, kidneys and brain. It doesn’t just attack the joints.
Hi Marie,
There are many posts on this site which document that as well as some of the links in the post above. This is a specific list of joints which was requested of me by readers. I do not mean to diminish RA’s affect outside of joints/ extra-articular symptoms. Please re-read the first point on the list in the post. It says: “every joint and most organs or systems.” There is a lot of info on this in RA 101 on the top menu.
RA is so complex that I need to break things down and deal with one thing at a time. Hope that helps you see why I did it this way.
It seems like just about every joint, with the exception of my ribs and vocal chords, have been affected at one time or another. My feet and hands have the most damage though. It is discouraging that the so called “experts” write books from the outside looking in, then discount anything that someone says who is living with it day after day. Some days my pain is a 7-8 just to rise from a sitting position while other days I feel good enough to put in 150 mile ride on my motorcycle. Doesn’t make sense, but that’s my life now.
Well well well. Sometimes I read your posts and I don’t know whether to laugh or cry. Four years ago, I was told by a rheumy at a prestigious hospital in NYC that the pain in my neck was osteo. My new rheumy just looked at me and said “Looks like RA to me.” But I never knew the chest in my pain, which I just ignore, might be caused by my RA too. Guess I ought to mention that next time.
Thank you Kelly, for your efforts in breaking through the fog of RA. Yes, it is a strange disease, but just maybe it is a lot more understandable than what I have been told.
Oh, and I never knew shoulders could be replaced. My sisters shoulders have been immobile for years. I don’t think her rheumy has ever suggested looking at shoulder replacements.
I have RA in my feet, hands, neck, shoulders, and sternum ( and my wrists are starting to show signs). Both hips have fractured and one replaced – possibly due to the steroids I have taken over the years for asthma and RA.
Kelly, I am very fortunate to have one of the best rheumotoligist in the country. She is awesome! I had 2 before I found her and they were very hesitant to aggressively treat my RA. I’ve been with her for 11 years now. I caught my RA early and we have been able to slow it’s progression.
That’s great to hear. 😎
That’s an excellent question and I have no idea what the answer is. I’ve actually fired doctors who I thought knew less than me. I’ve had JRA/RA since I was 4 and I’m nearly 51 now, so I’ve learned an awful lot over the years. I had one doctor tell me depression had nothing to do with RA and if I needed depression meds, I should call a shrink. My current doctors agree I have it in every joint… the x-rays and MRIs are very clear on that. Have you ever thought that some of these doctors don’t do the research because they’re so comfortable in their practice and maybe in it “for the money”? One thing for sure, they don’t really have to do research…. they just need to listen to their patients.
I love the way you put that “fired doctors who knew less”! I am wondering if that gets easier. Why does it feel so “traumatic” when you come in desperate for help & the doctor tells you something you know is wrong? I like to think I’m gaining strength from stories like yours. So, if this ever happens to me again, I’ll stand up for myself – politely. 😐
I hated looking at the picture of the foot. My toes already have nodules on them and another quite large one on my heel. I was so relieved to see that there is a name for the pain in my chest that I have occasionly. I thought years earlier that something was terribly wrong with my heart (because the pain was usually on the left side). Thanks for all your information, Kelly, it helps a lot of people!!
🙂 Mer
My rheumatologist tells me that the joints in my fingertips are painful because of osteoarthritis, as RA “doesn’t attack those joints.” Yeahright. He also tells me that RA only very rarely presents in the hip joints. That’s another “yeahright” for me, since I was once hospitalized and dosed with IV pain meds because of hip pain so severe I couldn’t sit still, stand, sit, lie down or even walk without agony. Truly that flare in my right hip was the worst I’ve ever experienced.
I like my rheumatologist; he’s thorough, compassionate, and goes out of his way to explain the disease and the treatments he’s using for me. But like so many other rheumatologists, he holds onto a number of beliefs about the disease that just don’t fit my individual case. I respect him, so I don’t argue, but I do my own research and come to my own conclusions. My hips and the joints at my fingertips are sometimes attacked by my RA. Period.
Big question, going back above to my discussion with Diana – Do you think you could ever see yourself printing out some case studies about DIP RA and giving it to him? Just curious.
Sure, I’d do that, if I had copies of studies that were conducted properly and proved my point. I honestly don’t know how he’d react, but since he’s always been open to my questions I don’t think he’d be upset. I see this doctor four times a year — knock wood. Our relationship has been pleasant and I do think he’s doing the best that he can (understanding the limitations inherent in a system like the VA). I do often wish that he could spend a little more time with me, in conversation, but like most docs, his time with all of his patients is limited.
Oh — and as for sternum pain. Reading your post made me remember a time, at least five years before I was diagnosed with RA, when I had pain there that scared me. I went to my PCP at the time. He did an ECG to make sure that it wasn’t heart-related (which it wasn’t). He said that the cartilage in that part of the body is still growing when we’re young adults, still hardening, and that it could sometimes cause pain. He told me to take Tylenol.
The pain went away not long after that. I didn’t worry about it further, and it wasn’t until now, reading your post, that I put that sternum pain into the same camp as my RA. I’m guessing that THAT particular incident may have been my first RA symptom.
hi kelly,
the same thing happened with me.once i was having back aches ….n when i complained to doc,he said this is not because of RA.is that really so?
doesnt it affect there?
Hi Rachel,
There’s no way for me to know about your back in particular. But, yes, RA can affect the spine. Click here to read more about the spine in my post about that. Then, in the post, there are some links to medical articles about RA in the spine.
In the initial phase of diagnosis, my doc always asked me if i had backache (apart from pain in other joints and muscles). Thankfully, I did not and still don’t. But the fact my doc inquired about it each time I went to him for medical review tells that it could just be one of the joints that RA affects. Of course, it needs to be examined, along with other symptoms, by the specialist.
hi kelly,
i m talking abt lower back vertebrae say lumbar region…i guess….
?
when prescribing corticosteroids become necessary?
neither i can bear aches nor side effects so wat to do?
is it right to take take steroids?
Rachel, I think that is something that is best answered by your doctor. It is important for the two of you to come up with a plan together, something you are both comfortable with. For back pain there are numerous options depending upon what it is, everything from cortosteroid injections in the joints to physical therapy, stretching, water physical therapy (which is what i do now for my AS), fusion of vertebre and even putting in a metal rod along your spine. But many of these treatments are best done for specific diagnosis’s. I always suggest the least invasive first. Physical therapy is not invasive and not very expensive/covered by insurance. I cannot do exercise out of the water because the pressure on my spine is too painful and causes damage so I do exercise in physical therapy in the water and on land they do ultrasound and massage to help relax the muscles. I hope this info helps.
Back to Wren’s point: I just developed RA at the end of Nov. 09 and was diagnosed in Jan. 10. The tips of my fingers hurt when I type now. Since X-rays taken at the end of Dec. 09 show no evidence of osteoarthritis in my fingers at that time, and I obviously haven’t developed osteoarthritis in the short period of time since then, the logical conclusion is that it’s the RA, regardless of the fact that “RA doesn’t attack those joints”…
Laurie, I hope I didn’t confuse you. RA does attack those joints. There are case studies which can be found and some other articles. The link in the post about this (which is decades old!) gives some clue as to why there is confusion in the minds of some docs. But, as Diana points out above, all they need to do is listen to their patients to find out.
Your logic is similar to mine was when it happened to me. The sudden symmetrical onset with the pain, noises, and stiffness when I already have RA everywhere else… & I didn’t just “guess” that was OA either.
Thank you so much Kelley! I really wanted and need this info before seeing my doctor and since I just started another flare up simply haven’t been up to doing the research and searches to find it, so I very much appreciate you taking the time to do so! I will be printing all of this out and taking it both to my pain doctor and my primary doctor. God bless you!
Thanks Cindy. I hope you’ll have time to print some of the links in case he thinks this is just patients’ “opinions”. You can also use a Google search for “rheumatoid arthritis” and the specific joint such as “hip” to look for more articles. Good luck! 😎
Yes, I’ve gathered quite a bit of information and I really appreciate your help. As others here have said, it’s just so frustrating to hear a doctor tell you that your symptoms are impossible. With the research I’ve already done on RA I’ve discovered answers to symptoms that have plagued me for years that the doctors could never figure out and they’re simply another symptom of RA. Part of my problem now though is that I became disabled due to an injury at work that messed up the disks in my lower back badly so I’ve lived with pain from that for 10 years, but now the RA seems to be attacking the very same area! My primary doc is telling me that workers comp won’t pay for anything to do with RA because RA can’t be caused by an injury, but my pain doc seems to think they will so they’re at an impasse because of that now. Easy way out of course would be to send them the bill and see if they pay it but my primary says he won’t even try because it’s “wrong” since RA can’t be caused by an injury. Well I don’t know if it can be or not, but I do know I wasn’t in pain before I got hurt and I am in pain now, so maybe the injury didn’t “cause” it but perhaps it is what “activated” it or something… I don’t know, I just want help.
I’m so glad you posted this, Kelly! You know, I’ve always been told my RA “started weird” because it was in the form of costochondritis. Felt like I was having a heart attack for 8 months! Anyway, I kept telling doctors that I too read journals that said RA could start that way and my original doctors wouldn’t believe me. Maybe you should be a reference for doctors so they all understand?!
I know what you mean. My current RD is the only one who ever asked me, “Does it hurt here?” I took it as a sign of a smarter doctor. :doctor:
Sometimes, I feel like yelling: “Wake up docs! RA can start anywhere it wants!” 😛
Bless You for your valuable information. I have RA in all my joints with the exception of my elbows. It’s been debilitating and in the past 3 years even with trying many, many treatments inluding Remicade, slowing the progression of the disease, its verocious symptoms and reducing pain has been minimal to none.
EARLY DIAGNOSIS IS ESSENTIAL! I also have Lupus and because I was first diagnosed with Lupus with overlapping symptoms, the diagnosis for RA was delayed a very long time. Please discuss RA with your Doctor and be sure to be tested. (demand it, if necessary). RA affects organs, as well, so become knowledgeable and get treated as soon as possible.
Thank you so much, Kelly. May you be blessed well for your service. You may be assured that I am sharing on FB, Yahoo and Wegohhealth.
Anthony
To The Renewal Of Our Lives!
Thank you Anthony. How did your elbows get a free pass? 😉 I also have RA in every joint – but that is hard for some other patients to believe, so it’s extra nice to meet you.
You are right – there are several things that delay diagnosis and I’m hoping we can improve that with education. That is one purpose for this post!
Thank you Kelly, for the great, comprehensive post. I’ve learned so much from the site, as a result of all your hard work and research. It’s weirdly comforting to be able to put together all the pieces of my “atypical” RA puzzle. Much more often, it seems I’m not so “atypical” after all. God bless!
Thanks Julie, yeah somehow it helps to at least know we are not the only ones. 😉
Thanks for the information about the breastbone….that is what got me to the doc and the start of the ra. That was last Nov. Ur website is Great!
Thank you, Terri. Would you believe I’ve met an RA doc who says that’s not possible (breastbone RA)?
I wondered about the sternum. My started popping about 3 years ago to which my chiropractor told me to stop popping it but sometimes it would hurt like it wanted to be popped. And when I did, it was much better. It IS a habit I have broken, but since diagnosised with RA some days it just all and all out hurts. I was at work and someone asked me if I was doing my “monthly breast exam” because I kept rubbing my chest subconsciously!! : ) Too funny!
Question about the finger joints. Since my RA has progressed, my fingers will hurt like they want to be popped. That is the only way I can explain the pain. So I do pop them. Does it relieve the pain? Maybe for a minute, but that is, I think, another subconscious thing I do to relieve the pain. Should I be popping them? There have been times, I just sit around with ice packs on my hand because they hurt so bad. I usually forget to ask my rheumi when I see her! So I am asking you great people! : )
Thanks in advance if you reply! : ) I have never read anything about “to pop or not to pop”!! : )
Hi Jackie,
I don’t think there is any proof about the popping causing damage – except that if a joint is in flare, you should be gentle with it. I have the same thing with my hands and my ankle – the stiffness like it’s stuck until you force it and it pops. Sometimes a minute of relief – & other times more pain. Almost all of my joints pop on their own all day long – and they have a name for these noises – crepitus. Creepy, huh?
How do you make the breastbone pop? That sounds like it would hurt? Wait – maybe you shouldn’t tell me. Haha. :-))
Yes we meet again. : ) I am laying here feeling sick to my stomach. Is it the mtx shot or my mind…one will never know…till next week!! : ) I am “researching” distracting myself from wanting to go and “worship” for a little in the bathroom!! : ) hee hee!!!
Popping my chest. Really I kinda stick my chest out and pull my shoulders back and walloobee. My sternum pops. When it pops, it is because it wants to! Not a lot of pressure on my part, it just does it pretty easy! Weird I know. It started doing this after I was in a pretty bad car wreck. Had to have shoulder surgery and it pops on that side, the left. That is where it hurts too now! On that left side. : ) Well at least I know I have no “lumps” around that area!! hee hee!! : )
Thanks for answering Kelly!! I have learned more from you and your site than anywhere else! : ) You amazing girlfriend!!! : )
Thanks for this post, Kelly. I have RA, not OA or PsA. My DIP joints often ache and throb and feel like they are being stabbed with hot daggers. While they are not as consistently sore as my other finger joints, the pain is there and it is real. I can’t tell you how many articles I have read stating that RA does not affect the DIP joints! I have read this on many reputable health websites. Where did this “myth” come from, and why is there so much misinformation out there regarding this subject?
Marie, I did learn where that came from & I’ve written about it somewhere. I’m trying to figure out where that is – over 400 pages on here! Ack! I think I remember something about RA being mis- described a century ago and the work being passed down. Regardless of what patients said, the myth held because it was in writing. I’m not sure though. If I can find it in the next few days, I’ll put it here in a comment.
Where my arthritis has appeared in joints and other wacky area’s, how it has caused me havoc:
My heart…completely encased in calcification, this required a Pericardectomy at the Mayo Clinic in MN (1/2 inch of calcification built up around heart and aorta)long surgery with my chest opened while doctor chipped this hard casing off my heart. Lots of complications, 35% chance of living, phewww made it!
Sick Sinus Node Syndrome…due to the heart being encased for so long, once the calcification was taken off my heart no longer could maintain a normal beat, pacemaker was implanted …am on my second one…bionic woman I am!
My bowels…can’t tell you what this is because the doctors can’t tell me…let’s write it off as IBD or what I like to say “Auto Immune Disease of my bowels. Colonoscopy, stain tests, swallowing a camera and all other test were done…they sent me home saying “So sorry you have such horrible symptoms but we can’t help you anymore, we have done everything.” That is so special when specialists tell you that.
The Lost Sinus…Sphenoid Disease…Auto Immune attacking places the doctors have named as lost! I guess my RA found it, this little lost sinus cavity is in the back, behind your eye’s, holds the optic nerve path and a membrane to the brain. It likes to swell up and give me life changing head aches.
Optic Neuritis…Not a joint, an eye nerve that made me loose vision…they call it “Low Vision” nice term for saying your nerve is demyelinaiting and making it look like you are in a fog that you can’t see through and colors appear that aren’t there…scary.
Episcleritis…The pain, oh the pain. My onset symptom that felt like daggers to the eye’s. Unable to see due to photophobic symptoms. Inflammation of the white part of the eye which travelled in quadrants for months.
Ears…tinnitus, what can I say, the sound “eeeeeeeeeeeeeeeeeeeeeeee” keeps me company all day and all night. I tend to keep a tv or radio on to stop me from going insane.
The Joints:
toe’s,feet, foot joints(8 screws, in one foot that is fused),ankles,knees,hips,spine,hands, wrists(fused), elbows,shoulders,neck. I just had 25 xray’s done yesterday to compare damage from 2006.
Janette, definitely not the picture they paint of RA. Sorry it’s been so rough for you.
I have RA in every single joint apart from my spine. I do get it in my DIP joints & have 2 very deformed DIP joints to show for it and I’ve repeated boughts of laryngitis which I believe to be caused by the tiny little joint in the throat. I had cameras etc put down and the ENT doc couldn’t find any cause. I often get croaky for no reason.
And as Wren said about the hips, I now have secondary OA in both hips and am in constant pain thanks to the job that RA did on them. This is the RA that has supposedly been ‘well controlled’.
When will they start listening to us, the patient that lives with this day in day out?!
Hi Gilly,
I don’t know when. I’m gonna do all I can! ‘Well-controlled’, my eye, right?
And yes, the camera can’t see the inflammation unless the CA joints are obviously inflammed at the moment the camera goes down. Also it could be a nodule which also can be worse or better at times so it might not be seen.
Does anyone else have the rib pain? But mine is under the breast and in the same place in my back, rather than near the sternum. It is swollen, and alternates between sharp pains and sore to the touch. Sometimes when I lay down, it feels like there’s a lump in the mattress. It hurts to put pressure on those areas, whether its touch or laying on it. Please, can someone answer? I don’t see my Rheumy for another couple of months, and this started about a month ago. But idk if I need to see her earlier for this. Any help is appreciated. God bless and much love to you all.
Raini
Raini, I don’t have pain like that. But I hope you’ll talk with your docs about it until you have an answer. You don’t have to wait for the rheumy just because you have RA. You can ask your General practioner if yo uhave a concern. There are a lot of things it could be & some might be serious. Take care of yourself, Raini.
I can’t even wear a bra anymore…too painful. I thought it was just fat from the prednisone weight gain, but it hurts!! lol. I always wear an overshirt so I’m not floppin’ in the wind :doh: :laugh: . Anyways, I’ve read through the comments (prolly should have done that first :-(( ) but I don’t see anything that is in the same area as mine. Thanks again for any input!
Raini
Thank you again! You seem to have all the answers to my questions. I’m in my early 20s, I had a bone scan a few weeks ago which showed arthritis in my knees, shoulders, hips, wrists and fingers. My DIP and MCP joints ‘lit up’ and I was told this pointed away from RA and more to Psoriatic Artritis. However I don’t have Psoriasis or any family history. I was worried that I would wake up one morning and be covered in Psoriasis! I just feel in my gut that it’s not PsA. Im going to see if I can do some research on DIP joints in RA and print some articles out and stick them in my bag to take to my next appointment. If PsA and the DIP joints are brought up again I’ll whip my (reputable) research out. I’m learning that this is such a complicated lot of diseases!
Thanks again
Hi Sarah, the two links in the post (at the point where DIP joints are discussed) would make a good place to start. I believe that this is reputable research. But I usually recommend patients print the actual study for the doctor if they are going to “challenge” or “inform” him in any way. So, good thinking. and good luck too. 😀
Yes definitely! I saw those two articles. I have them open at the moment but can’t seem to download the full articles. I’m going to see if I can get them through my university’s library database. I don’t want to go in there all guns blazing, but if the “DIP joints aren’t involved in RA so you don’t have have it” spiel comes out, I’ll (hopefully) have these articles. They look reputable to me, thanks so much!
You seem like you are on the right track. Would love to hear how it goes for you.
Okay, I’m sitting here crying, happy. Why? Because I was diagnosed today with Costochondritis.Thank you. Just to see it in print is such a relief.
Thank you.
Jennifer
I also have RA in every joint. My rheum. has never questioned this. He told me on my 2nd appointment that I have an agressive form of RA.
Sounds like you found a good one.
I am a 25 year old unmarried women. Whether the symptoms of RA can be reduced ?? What medications are preferred ?
Dear Arya,
There are several types of medicines that can reduce symptoms. They do not work the same in everyone. Methotrexate is probably the most prescribed. You can read more about medicines for RA here:
https://www.rawarrior.com/tag/rheumatoid-arthritis-treatment/
https://www.rawarrior.com/tag/methotrexate/
Has anyone had flashes of light in the eyes?
My unknown (idiopathic) journey started there 5 years ago. I saw a flash of light in the corner of my eye. The number of flashes increased so I saw a retinal specialist. No retinal tear. Less than 4 weeks later I woke up with a red eye and couldn’t look at my phone (photophobia). After further testing it was determined my optic nerve was inflamed. All testing, including MRI came back negative. At that time the major concern was MS.
Two years ago I noticed multiple joints were sore and constantly cracking or popping. Lymph nodes were sore, too. I mentioned it to my doctor who made some comment like “If I did an MRI on every patient with cracking joints…..” He did a sed rate and that’s it. Next doctor similar results. No testing.
About 5 weeks ago my jaw started to hurt when I opened my mouth. I didn’t think anything of it until my left great toe became swollen and red one afternoon. The thought was cellulitis or gout. No to both. I moved to another state and went to a P.A. at a teaching hospital last week since my toe is still red and sore. I told him I wanted to know if this is how it feels to be in your 50’s or is something systemic going on. He asked if I have seen a Rheumatologist and wanted to send me to one. I said “Thank you. That is what I had hoped for.” My 1st appointment is next week. Since then I have noticed my hip joints hurt for the first time and my sternum hurt when the cats decided to walk on it. I have not read about these joints and then said, “Oh, that hurts, too.” Something hurts and I look it up. I never thought of these pains being connected until last week.
Anyone else have a similar story?