Costochondritis Is Not The Same As Tietze Syndrome
Costochondritis is often confused with Tietze syndrome, a similar but less common disorder that typically involves swelling of the second or third rib that can last for months. According to the American Family Physican review, Tietze syndrome typically affects people who are younger than 40 and is considered rare, while costochondritis is more common and can affect children, teens, and adults, says Gewanter. In fact, he says, the rib cages of kids are extra flexible, so that increases the opportunity to irritate the costochondral junctions. Local swelling is typically present with Tietze’s, while it is not with costochondritis, though the RA advocate ONeill notes inconspicuous swelling with her costochondritis. In reality, whatever you want to call it, both conditions are treated in essentially the same way, says Gewanter. Tietze syndrome can subside without treatment, but over-the-counter pain medication may be used.
Rheumatoid Arthritis Medication Treatment Goals
Pinpointing how to subdue an overactive immune system has stumped doctors for decades. Seventy-five years ago, one of the only rheumatoid arthritis treatments for patients was a weekly injection of gold into the gluteal muscle. Today, there are a plethora of treatment options.
Current treatments give most patients good or excellent relief of symptoms and let them keep functioning at or near normal levels, reports the website of the American College of Rheumatology.2
Since there is no cure for the disease, the aim of treatment is to reduce pain and halt joint breakdown. The goal is to not only control symptoms, but to prevent further damage and deformities, Dr. Chi said.
Many rheumatoid arthritis treatment drugs fall into a bucket labeled disease modifying antirheumatic drugs . While most patients receive some form of a DMARD, no single drug is a guaranteed solution as patients react to the drugs differently. Scientists designed some of the drugs to fight against certain immune cells, while other drugs reduce immune mediators or block immune cell functions. Patients may be treated with a DMARD in combination with nonsteroidal anti-inflammatory drugs or low-dose corticosteroids, which reduce swelling and pain.
Common first line DMARDs include methotrexate, leflunomide, hydroxychloroquine and sulfasalazine.
If first line medications dont work, rheumatologists can pull out a list of second line medications called biologic response modifiers or biologics.
When Back Pain May Mean Arthritis
Many forms of arthritis and related conditions can cause back pain, stiffness and swelling.
About 80% of back pain is acute and usually lasts one to seven days. Otherwise, its considered chronic and may be caused by arthritis. The lower back is the most common site of arthritis back pain. Several types of arthritis are part of a group of conditions called spondylarthropathies . Spondylarthropathies can affect adults and children.
If you are experiencing pain, swelling and stiffness in the back, you may have one of the following types of arthritis or related conditions.
Axial spondyloarthritis is a chronic inflammatory disease that primarily affects hip joints and the joint that connects the bone at the bottom of the spine to the pelvis .
There are two types of axSpA: Radiographic axSpA includes damage to the sacroiliac joints and spine that can be seen on X-rays, and nonradiographic axSpA does not include damage you can see on X-rays but it may show up on magnetic resonance images .
Psoriatic arthritis is a form of arthritis that affects joints and usually the skin . For about 20 percent of people with PsA, the disease involves the spine . In some cases, bony overgrowth can cause two or more vertebrae to grow together , causing stiffness.
Getting a Proper Diagnosis
Ra Life Expectancy: Does Rheumatoid Arthritis Affect Life Span
The predicted life expectancy of a patient diagnosed with rheumatoid arthritis is problematic to accurately calculate due to the vast amount of unpredictable variables involved. As a chronic disease, RA tends to be progressive. In other words, it is a long-term disease in which symptoms tend to accumulate over time. This accumulation results in an overall worsening of the patients symptoms. Presently, doctors do not know what causes nor triggers the disease. That being said, they suspect it is likely initiated by a combination of factors including genetics and environmental influences.
Because there isnt one specific cause of the disease, there is also no known cure for RA. Todays medical technology and research, however, provide a variety of treatment options, which can prolong the lives of patients, slow the progression of disease, and provide some symptom relief.
These are just some of the factors which make it difficult to predict an exact life expectancy for RA patients. What research has found is that it isnt the disease itself which reduces the life expectancy of patients. Its the varying complications that develop as a result of the disease which cause life expectancy to shorten. For example, RA can cause respiratory and cardiovascular conditions which can compound over time and lead to a shortened lifespan and possibly eventual fatality.
Which Symptoms You Should Never Ignore
Make an appointment with your rheumatologist right away if you start having neurological symptoms, like tingling, weakness, and numbness in your arms, hands, or fingers. Also call if you have muscle spasms in the neck and shoulders, trouble walking, loss of balance, headaches, and grinding or popping sounds when you move your head. If imaging tests show instability, the next step is a referral to a neurosurgeon for possible neck-fusion surgery. If you are scheduled for any other surgery prior to that procedure, Dr. Bhatt recommends you contact your rheumatologist so he can consult with that team. The way your neck is moved during anesthesia can damage an RA-affected joint.
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Other Rheumatoid Arthritis Treatment Options
Patients can also relieve joint stiffness with low impact exercises like swimming, walking or cycling, Dr. Chi said. I generally prefer low impact, Dr. Chi stated. The more force you apply to the joints, the more damage you could do to the cartilage.
Spinal surgery may be a treatment as well. The most important indications for cervical spine surgery when rheumatoid arthritis is involved are resistant pain, neurologic deficits and/or a need to stabilize the upper cervical spine to prevent spinal cord damage.
References1. Freeman J. RA Facts: What are the Latest Statistics on Rheumatoid Arthritis? Rheumatoid Arthritis Support Network. October 27, 2018. https://www.rheumatoidarthritis.org/ra/facts-and-statistics/. Accessed June 27, 2019.
2. Duarie-Garcia A. Rheumatoid Arthritis. How is rheumatoid arthritis treated? Updated March 2019. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Rheumatoid-Arthritis. Accessed June 25, 2019.
Scher JU, Malik F, Manasson J. Using the Microbiome to Aid Psoriatic & Rheumatoid Arthritis Diagnostics & Therapeutics. Rheumatology 2018 Year in Review. https://nyulangone.org/news/using-microbiome-aid-psoriatic-rheumatoid-arthritis-diagnostics-therapeutics. Accessed June 27, 2019.
How Rheumatoid Arthritis Threatens Bone Health
RA can increase your risk of osteoporosis, a disease in which bones become less dense and more fragile, increasing the likelihood they will break.
The reason: The inflammation of RA accelerates the normal bone resorption when bone tissue is broken down to release minerals into the blood that leads to osteoporosis. Normally, the bone tissue thats broken down gets replaced, but as we age, the rate of resorption exceeds the rate of new bone growth, reducing bone mass and setting the stage for osteoporosis. RA makes it even harder for bones to keep pace. The hip, forearm and pelvis are typical sites where breaks can occur, although breaks are more likely near the joints where the RA is active.
Steroids, which are sometimes used to control RA, can especially speed bone loss.
The best way to protect bones: Eat calcium-rich and vitamin Drich foods like eggs and fish, as well as D-fortified foods do weight-bearing exercises that your doctor approves if you smoke, quit and get a bone mineral density test so your doctor can consider whether you need medication.
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What Are The Symptoms Of Spinal Arthritis
Symptoms of spinal arthritis may differ from person to person. In general, they may include:
Back and neck pain, especially in the lower back
Stiffness and loss of flexibility in the spine, such as being unable to straighten your back or turn your neck
Swelling and tenderness over the affected vertebrae
Feeling of grinding when moving the spine
Pain, swelling and stiffness in other areas of the body
Whole-body weakness and fatigue
Pain and numbness in your arms or legs if the nerves are affected
Although back pain is a common symptom, not all people have it, even those with advanced spinal arthritis. On the other hand, some may experience pain even before arthritis can be seen on an X-ray.
In certain types of spondyloarthritis, eye inflammation may occur, causing pain, watery eyes and blurred vision.
How Does Ra Cause Back Pain
RA is an autoimmune condition that causes swelling and pain in joints throughout the body. It can affect the facet joints in the spine.
The paired facet joints run all along the spine. They connect with the bony bumps that a person can feel when they run their hands down their back. Facet joints support movement and flexibility in the spine.
RA-related inflammation in the facet joints can cause back pain. In some cases, extended inflammation can destroy the facet joints. As a result, the vertebrae become less stable.
Instability in the spine can cause a vertebra to slip out of place, which usually means that the upper vertebra slides over the lower one. Doctors call this spondylolisthesis.
If slipped vertebrae put pressure on the sciatic nerve in the lower back, it can cause sciatica.
Sciatica can cause:
- loss of bowel or bladder function
- loss of coordination
- pain that radiates to the arms and legs
However, unstable or severely damaged vertebrae can also press on other vital parts of the body. If left untreated, cervical spine RA can have severe consequences, including:
As RA progresses, it is more likely that people will experience symptoms in their spine.
One study suggests that around 64.5 percent of people with RA may experience lower back pain. The researchers found that people with RA and lower back pain reported a lower quality of life, and that some were at increased risk for depression.
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Differences In Skeletal Alignment And Posture
RA with low back pain is associated with poor skeletal alignment.7 For example, a hunched back or a loss of the normal curve in the lower spine is linked to low back pain.
Poor pelvic alignmentthe angle at which the pelvic bone is positioned during standing and sittingcan also cause low back pain or make existing pain worse.
Some of the factors listed above can be modified. Taking steps to change them may be part of a treatment plan.
Rheumatoid Arthritis And Your Hands And Feet
Since RA is a condition of the joints, its obvious that it affects a persons hands and feet. But beyond pain, RA can cause other distortions and deformities if it is not treated as early as possible with disease-modifying antirheumatic drugs .
Some of the most common symptoms affecting the hands include locking joints, ulnar drift , swan neck deformities , and even ruptured tendons. All these effects can make basic life tasks such as writing, holding objects, and unscrewing lids difficult.
The hands can also be affected by muscle cramping, which can be relieved by gentle movements and warm compresses. More concerning, the swelling of RA may put pressure on the median nerve , causing numbness or carpal tunnel syndrome. See your doctor if you experience any of these.
In the feet, uncontrolled inflammation may lead to painful conditions like hammertoes , bunion , pes planus , and valgus hind foot .
In addition to seeing your rheumatologist and, if necessary, a podiatrist, you may also consult an occupational or physical therapist. These experts help you learn ways of moving that are less painful and that strengthen muscles, says Rebecca Manno, MD, a rheumatologist and adjunct assistant professor of medicine at the Johns Hopkins University School of Medicine in Baltimore.
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How To Alleviate The Symptoms Of Tmd And Jaw Pain
Jaw pain can be really unpleasant. It can make you not want to eat, talk or do anything else. These tips can help prevent and halt jaw pain:
- Switch to soft foods for a few days to rest the jaw.
- Avoid chewy candies and chewing gum.
- Avoid opening your mouth too wide when talking, yawning or eating.
- Massage the muscle around the joint.
- Avoid clenching your jaw. You may find that you do this when you are upset or under stress.
- Apply a warm compress to the jaw.
- Avoid resting your chin on your hand. This activity can put stress on your jaw and subtly push it out of alignment if you are susceptible to TMJ issues.
Exercises can also be helpful to prevent future TMJ pain. These should not be done when you are experiencing TMJ issues. If the area is painful and swollen, hold off until you are feeling better.
For one exercise, start by slowly opening your mouth. Curl your tongue up so that the tip is touching the roof of your mouth. Keeping your tongue in position, slowly close your mouth. Do this two to three times a day.
The other helpful exercise involves sitting in front of a mirror and slowly opening and closing your mouth. Assure that your jaw does not swing to one side or the other while you are opening and closing your mouth. You may need to apply pressure to one side of your jaw with your hand to keep your jaw in alignment. Do this 10 times, two to three times each day.
Surgical Treatments For Ra Shoulder Pain
If your symptoms do not respond to nonsurgical options or medicines and your quality of life has been impacted by them, your doctor might recommend surgery. The goal of surgery is to improve or restore your shoulder function and provide pain relief. Surgery options include:3
- Arthroscopy During this procedure, the surgeon inserts a small camera into your shoulder joint. The camera displays images on a screen, and the surgeon uses the images to guide small surgical instruments. The surgeon then cleans out the inside of the joint. While the procedure provides pain relief, it does not eliminate arthritis from the joint.
- Shoulder joint replacement During this procedure, the surgeon removes the damaged cartilage and bones in your shoulder. They will then place new metal or plastic joint surfaces to restore your joint function. There are different types of shoulder joint replacement surgeries, including:
- Hemiarthroplasty Just the head of the humerus bone is replaced
- Total shoulder arthroplasty Both the head of the humerus and the glenoid are replaced
- Reverse total shoulder arthroplasty A metal ball is fixed to the glenoid, and a plastic cup is fixed to the upper end of the humerus
- Resection arthroplasty A small amount of bone from the end of the collarbone is removed, leaving a space that eventually fills in with scar tissue
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What Determines Life Expectancy
RA is an autoimmune disease that makes patients more susceptible to developing other conditions. This can compromise the health of patients long-term. That being said, there are factors that can improve a patients life expectancy through mitigating the complications experienced during the disease course.
Rheumatoid Arthritis And Low Back Pain
This article describes the connection between rheumatoid arthritis and low back pain, including sciatica. Also discussed are ways to safely relieve low back pain at home when RA is present.
Rheumatoid arthritis is an autoimmune disease that causes painful swelling, stiffness, and deformities of the joints. Watch:Rheumatoid Arthritis Overview Video
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Rheumatoid Arthritis In The Spine
Rheumatoid arthritis is a disease that causes destruction of joints in the body. The disease can occur in any joint in the body and is most commonly symptomatic in the small joints in the hands and feet. When rheumatoid arthritis affects the joints in the spine, it is far more common for the neck to be affected than for the lower back.
The most common form of arthritis in the back is osteoarthritis.
Back Surgery For Chronic Pain
Surgery is usually a last resort for back pain treatment. Still, it can be very effective in helping to ease chronic back pain.
For example, your doctor may recommend a fusion procedure: This involves cutting out the diseased joint and bonding the vertebrae together, decreasing mobility. In some cases, this will alleviate the pain in that area.
Realigning and stabilizing your spine to ease pressure on your spines nerves is another approach. This can lessen pain and even improve mobility.
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Will I Need Surgery
Not unless the deformity has a big impact on your life. For damaged fingers, your doctor or a hand therapist can provide splints and exercises. Warm wax baths may ease pain. A hand therapist may also suggest new ways to use your hands that can lessen pain and protect your joints.
If youâre just starting to develop claw toe, splints or tape can help straighten out your toes.
If youâve had claw toe for a while, a splint may not be able to straighten out the joint. These tips can make it more comfortable to walk:
- Put a special pad in your shoe to reduce pressure on the ball of your foot.
- Try shoes that have an extra-deep toe box.
- Ask a shoe repair shop to stretch the toe box where you need extra room.
Comfortable shoes can also make it easier to walk with bunions.