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Joint Pain with No Inflammation??

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Posted 8/24/2007 7:31 PM (GMT 0)
I'm having lots of joint pain in my lowerback (sacroilitis), knees, and have just started having it in my elbows.

 

I can't get into a Rheum. until November, so my FP doctor ran an ANA titer, Rhemotid Factor test, CBC, and Sed Rate on me...they all came back normal.

 

Is it possible to have joint pain this badly without any inflammation? The pain feels like there's pockets of air trapped inside the joints (like I need to pop my knees really badly or something like that).

 

Thanks for your advice!

Best,

M.

Posted 8/24/2007 10:24 PM (GMT 0)
M Hi,

To answer your question yes it is possible to have that kind of pain with out inflammation.I will aslo say this that many people test negative for for ra and other types of arthritis as well,but does not mean that you do not have it.What are you taken for your joint pain?any thing?If not you may want to ask your PCP and see if he/she can give you something for the pain.Let us know how your appointment goes.
Posted 8/25/2007 12:50 AM (GMT 0)
I too have the joint pain and all my tests have come back neg. except a vit. D deficiency. If that hasn't been checked, it should be. One of the effects is joint pain. It is also common in Crohn's because of malabsorbtion. I am taking a Rx suppliment and it is helping some I think. Also, joint pain can be an effect of Crohns. They are trying to tell me I have fibromyalgia, but I don't buy it. I don't have the pressure pain points. They gave me ultram and a muscle relaxer last week but it doesn't help so far. Curley, do you know if one can ultimately end up diagnosed with arthritis without the imflamation tests being elevated?
Posted 8/25/2007 2:16 AM (GMT 0)
i have alot of pain at times with no swelling or inflamation.I have Oeteoarthritis in all my joints..........
Posted 8/26/2007 2:01 AM (GMT 0)
I have a mild form and never have swelling, so I know what you mean.
Posted 8/29/2007 4:05 AM (GMT 0)
Hi

I have one swollen joint - my sternoclavicular joint. MRI showed soft tissue swelling and no arthritis.

Other than that, I have lots of joint pain that is not accompanied by inflammation. My sed rate has always tested normal, as well as CrP.

Interesting, hsmom, about the Vitamin D deficiency. I didn't know that.
Posted 9/1/2007 2:17 PM (GMT 0)
Hi, i've had times where I have very clear, visible inflammation around one or more joints and was told my tests came back normal. I also get severe joint pain in various joints without any inflammation that I can see. I just recently went back to my rheumy because of widespread joint pains and now my hand & finger joints are bothering me too much, which is more new. He just looked at my hand & said he didnt see any inflammation; I have new visible inflammation on my outside ankle and he didnt even look at it. And in my ankle I know i have severe arthritis as per an MRI. My rheumy did, however, send me for another round of blood tests including ESR & CRP, and several others. Results should be back sometime next week.
Posted 4/13/2008 3:45 PM (GMT 0)
  I have been seeing a RA Dr. a couple of years, now when I tell her I feel it is getting worse, more pain, more joints, feet especially, she tells me she doesn't think I have RA, but that I have Fibromyalgia, because I don't have any swelling.  Bull, I don't have the symtoms of that, headaches, migrains, pressure points, she tried me on flexeril, it did nothing.  She has me on plaquanil for a couple years now, to help with the progression.  I was on oxaprozin but it stopped working, I'm on ultram now, it helps.  She tried me on arava, that caused me to have a super sensitive tongue, and a sore, split at the side of my mouth, after one week I stopped taking it.  That was over three months ago, my tongue is much better, but I am still getting the sore split at the cracks of my mouth.  I have an appointment with a new Dr. in two weeks, I don't think my current RA dr. is a good one. This is just one of several reasons why: She had me get xrays of my feet because she thought I might have Osteoarthritis in my feet, when I went to see her she hadn't gotten the xrays back, stupid xray place, I told them they had to get them to her by the following week, that I had an appt., they said no problem, we can even fax them, well the secretary couldn't get ahold of them, so my RA said, it didn't matter, she didn't think I had that anyway!  Wish me luck with the new doctor.  Blessing to all   

Posted 4/13/2008 8:44 PM (GMT 0)
Good luck with your new doctor. If they think no RA why plaquenil. If you do have RA the plaquenil is a good choice but if you are still having pain you need more. Definetly time for a new doc or at least another opinion.
Sj
Posted 4/14/2008 5:01 PM (GMT 0)
Mandolen~Something else to consider is that sometimes things don't show up right away when you are in the early stages of the disease. A good doctor will go by your symptoms, then over time labs usually catch up. I would ask for an NSAID until you get in to see the Rheumy. Take care.
Posted 4/14/2008 6:40 PM (GMT 0)
yes, it is possible..I have had blood work taken on some of my worst flare days and the tests have returned negative much to my surprise..The fingers on my left hand are starting to become deformed (crooked) and some have the rhematoid nodules on them..Just because your testing is negative or your inflammation isn't visible doesn't mean it isnt there.  Someone mentioned Plaquenil which I cannot get by without, it is wonderful for inflammation/pain if taken over time.

Posted 4/16/2008 7:44 AM (GMT 0)
I have been tested for RA and do not have it. I have severe pain in my lower back, and knees. Have had it for about 15 years ,no visible swelling or inflamation. I was recently told my bone density test was really bad and needed to take vitamin D and 1600mg of calcium a day. I was also sent for a reclast infusion . Was told I have osteoarthritis, osteoperosis and one other form of arthritis. Can't take any meds for pain. I am planning on seeing an orthopedic surgeon to see if he can give me injections of snyoval sp. (rather than knee, or hip replacement) .This was recommended by the last physiction I saw.
Posted 5/3/2008 12:59 PM (GMT 0)

I just wanted to let people know about a test that you may or may not be familiar with.  There is a test called CCP that has been recently out on the market that is more specific for RA.  As you know, not all patients with RA will have a positive RF (RA) test.  CCP is a bit more specific than the RF test that is normally used to screen people with joint pain.  If you have not had a CCP test done, ask your doctor about it.  I do autoimmune testing in a laboratory.   I am a medical technologist by trade and if I can answer any questions about lab tests,  I would be happy to do so.  I don't know all things, but I will answer what I can.

I also have joint pain, but I do not have RA.  There are so many autoimmune diseases out there that it is difficult for even a very good rheum. to differentiate.  The more common ones are "easier" to diagnose, but sometimes it can take years.  I was diagnosed with connective tissue disease when I was 34.  I am now 45, and still living with joint pain (especially my feet) and now I am having problems with my shoulders.  My doctor has put me on a short stint with prednisone, and it really is helping.  I have been dealing with this for awhile (chronic pain) like all of you, and it's a great confirmation that I am not going crazy.  Most people who do not have chronic pain think it's all in your head (or at least that is the way they treat it).  I don't like it, but you can't change the way people think.  Anyway, thanks for listening.  I hope you can get some answers.  Wouldn't that be nice?

Posted 5/3/2008 7:07 PM (GMT 0)
 Thank you for the information, hope, and understanding.  Takes one to know one Huh?

Posted 5/4/2008 5:15 AM (GMT 0)
Hi Happyscrapper,

I recently had the CPP test done, no results yet. I live in Eastern Ontario, Canada and we have to pay about 85.00 for the test. Well worth it for a confirmed diagnosis.

My question is, what is the rate of positive and false negatives. Can you be CPP negative and still have RA or is the test conclusive. My Rheumy says its kind of like the Rheumatoid Factor and I was wondering what your take was on it.

Thanks for taking the time to be here and welcome to the Forum.

Raven
Posted 5/4/2008 5:54 AM (GMT 0)
The manufacturer includes all that in the package insert, which I do not have with me now. I will find out for you on Monday and will post to this thread. When the test was introduced into our lab last year, our supervisor was telling us that it was a little bit more sensitive than the RF test. I will be able to give you more info on Monday (5-5).
Posted 5/7/2008 2:45 AM (GMT 0)
Hi, Raven.
Sorry I did not get back to you on this on monday. I had forgotten to take the package insert with me. To answer your question, the test we use is made by a company called iNova. It's called anti-CCP3 IgG test, and in the insert it says that 77% of RA patients are positive, while an average of 3% of non RA patients are positive. So about 20% of RA patients will come up negative. This may be due to IgM and/or IgA antibodies which this test does not detect. As with all testing, there are limitations. The company states that not all RA patients are positive for CCP and that your doctor needs to do other serological tests in conjunction with his/her clinical findings. I hope this helps. Any more questions, I will be happy to answer if I can.
Posted 5/7/2008 2:57 PM (GMT 0)
Thanks Happy!!
Posted 5/7/2008 6:07 PM (GMT 0)
I like the quote you have.  It's so true!

Posted 5/7/2008 10:22 PM (GMT 0)

Hi Happy,

I noticed your post and was read back to what you guys were discussing...thanks so much for all the info you shared!  Made me got back and dig out all my old labs.  Yep, got tested for the ccp...my results were >250, guess now I know why my doc said I had a very clear diagnosis of RA.  She also tested the IgA and IgM, both of those were in the normal range, But the IgE was extremely high at 1355.  Also tested for Ana, which was negative, but RA factor was 275.   Very interesting to get more insight into some of these tests, thanks again.

How are you feeling? My brother also has mixed connective tissue disease, it's been a long struggle for him as well.Like you, I think he was diagnosed in his 30's. Sure understand the feet pain, feet and ankles are really the worst for me..have flares other areas, but so far, those have been the worst.

Raven, did you get any results from your tests yet?

Take care guys,

Jody


Posted 5/8/2008 1:14 AM (GMT 0)
Thanks, Jody and you are welcome for the info. I am always happy to help where I can. I feel pretty good. How about you? I realize my pain is relatively small compared to those with RA. Are your meds helping you? I hope so.

Yes, Raven, have you heard anything yet?

You guys have a blessed day. Take care and I will be back. :)
Posted 5/8/2008 10:38 AM (GMT 0)
MaxLife, what kind of supplement are you taking? Maybe it will help me if it is available over the counter. Thanks.
Posted 5/8/2008 10:38 AM (GMT 0)
MaxLife, what kind of supplement are you taking? Maybe it will help me if it is available over the counter. Thanks.
Posted 5/23/2008 1:36 AM (GMT 0)

Happy,

Thanks for the info on the lab test anti ccp3 IgG.  I will ask my rheumatologist for it next week.  I have severe pain in my feet, ankles, knees wrists fingers and elbows and all my lab test are normal and RA and ANA are negative/normal. The only lab test that is elevated is aldolase and it is only mildly elevated.  I am in SEVERE pain. I have not been diagnosed with RA and can barely walk.  I cannot open a can of green beans with a can opener and can barely hold a cup of coffee.  Any suggestions as to where to start?  I have appt with rheum for the first itme next week.

Cauc female age 55 current meds: synthroid 100 mcg, hctz 12.5 mg, avapro 150 mg, crestor 10 mg, aciphex 20 mg, voltaren 2 a day, darvocet 2 a day, and ambien prn

diagnosed in 2004 with HTN, high cholsesterol, low thyroid, gerd.  Insomnia from the pain.  voltaren and darvocet for past 2 weeks with NO relief whatsoever. 

I am single and support myself and wouldn't get out of bed each day due to the pain except I have to support myself. I am a nurse on a same day surgery ward and on my feet 10-12 hrs a day.  When I get home in the evenings I am in tears due to this severe pain.  This cannot be normal.  Is there something I can ask the rheumatologist that will get her on the right track to finding what is wrong with me and getting me some relief?

Thanks for any advice or suggestions in advance.

Posted 5/23/2008 2:37 AM (GMT 0)

Hello, jlo.

  I am so sorry that you are experiencing severe pain! :(  I would ask about being tested for IgA, IgE and IgM as well as the IgG CCP. The CCP IgG can come up negative even in Patients who have been diagnosed with RA.  This is not to say that I think you have RA, since I am not a doctor.  But I would start by taking a copy of all the labs that have been done on you already so your Rheum. can get a head start.  That's all I can think of; if there is anything else, I will let you know.  Good luck, and God bless.

Teresa

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