Newbie with a question!

Smudge65

Hi All - I'm new so hope I'm posting in an appropriate place etc!

I'm 49 years old and have had fibromyalgia all my adult life. I've taken diclofenac and amitryptiline for that for years. Over the last year though I've had increased fatigue and my hands have been getting stiff, the knuckle joints not working smoothly any more, and over last couple of months have been getting increasing pain in hand joints, especially middle knuckle. Gripping, lifting and squeezing produce the most pain and that's every day now. I'm starting to wonder if this might be RA...

I already have pain and fatigue from the fibromyalgia in lots of places, as well as anti-inflammatory medication, so I may have missed signs of RA because of that. I had blood tests a few months ago for the increased fatigue which came back clear for inflammatory conditions, but as I'm on full dose diclofenac (anti-inflammatory) I wonder if this could have affected the results? And is it right that RA doesn't always show up on those tests anyway?

Would be very grateful for any thoughts you might have...

Thanks!

[Deleted User]

Welcome to Arthritis Care Forums Smudge65 from the moderation team

As mods we are here to help with any problems you may have on the message boards.

There are lots of lovely people here with a wide range of experiences with arthritis and the problems of living with the condition. Just join in wherever you like you will be made very welcome.

I look forward to seeing you posting on the boards.

Best wishes
Modonfriday

stickywicket

Hello smudge65 and welcome to the forum. There are literally hundreds of 'rheumatic conditions'. Most people are only aware of one – two if you're lucky. Not all are sero-positive. In fact, not all people with RA are sero-positive. I get where you're coming from when you say you fear that all the anti-inflamms might be disguising the fact that you have RA but we are not docs on here. We just live with it. Here is some info on the different types http://www.arthritiscare.org.uk/AboutArthritis/Conditions

I have both RA and OA. The rheumatologist treats the RA with DMARDS and the GP treats the OA with pain relief. I wonder why you are thinking RA rather than OA. Maybe the fatigue factor, but other things can cause that. Have you had your iron and Vit D levels checked? They are common culprits. Indeed, the amitriptylene can cause fatigue. Is there any family history of autoimmune diseases? Do you get plenty of exercise? Paradoxically, a lack of it can cause fatigue.

Do you see a rheumatologist for your fibro? They would be the best person to ask. Other than that I think a good chat with your GP as to the meaning of tests done and maybe suggestions for a way forward.

Smudge65

Thanks for the welcome ModonFriday and for your useful thoughts Stickywicket. Both much appreciated.

Thanks for the link, which I've checked out. RA seems most likely because it's inflammation and pain to both hands symmetrically, as well as the fatigue. Worse in the mornings or after resting. I've decreased the amitryptilene over recent months to see if that was creating fatigue (though I've been on them for years), but the fatigue is still a problem.

I'm thinking about going to my GP and may stop my anti inflammatories for a day or two before that, to see what it's like unmedicated... :-\ With full dose medication, I still get pain with things like squeezing the toothpaste, pushing myself up off the sofa, any kind of gripping, etc. Only seems to be my hands (my other pain issues are more familiar from the fibro, but the hands thing is new - just the last year or so and much worse over last month). My exercise is relatively good as far as fibro will allow (mostly walking). I used to do pilates too.

I don't have a rheumatologist for my fibro. I was diagnosed by one back in the 1990s, was dealt with pretty dismissively, and sent away with a leaflet! That's how it was back then! I'm hoping rheumys have improved! I am concerned that I might be making a fuss about nothing and don't want to be wasting anyone's time if it's too early to tell...

It's the hand thing that's making me take it seriously, because it's stopping me from gardening, cooking, etc. I've read about the need to catch it early to prevent lasting damage. Losing mobility and having pain in your hands is pretty debilitating isn't it?! My heart goes out to you if you suffer in that way. I'm glad to see the silver lining that red wine, chocolate and chillies are all good for it though...

Thanks again.

Smudge65

P.S. have had Vit D and Iron tested and lots of other bloods too. And I'm not aware of any family history of autoimmune diseases.

stickywicket

I think the plan to see your GP is a good one. Mine are brilliant at chatting things over when I'm not sure of something. I don't quite see what good stopping the anti-inflamms would do though as whatever type of arthritis you have it will only get worse.

I don't personally see the point in chasing the rainbow of 'no pain'. I don't believe painfree can co-exist with arthritis and we can get used to pain. We can also get used to pain relieving meds so that we need more and more to achieve the same result. I don't want that.

I'm sure you're not 'making a fuss about nothing' but autoimmune forms of arthritis can be hard to diagnose, especially the sero-negative ones. For autoimmune forms of arthritis early diagnosis is a good thing but sometimes it's just not so easy. I'd see the GP and see how he / she views it. And please let us know how you get on.

By the way, I'm not big on chillies, chocolate or red wine. White wine, whisky and a very dry cider (not all together ) are a different matter but, unfortunately, on DMARDS, I can't slurp too much of them.

Rebeccarockchick

Hi... Getting the correct diagnosis is the first part of the journey then you know what your dealing with. I think seeing your GP and going to see the Rheumy is the best thing, let us all know how you get on. I have osteoarthritis in my hands(have it in other joints too) and problems with my tendons and ligaments, i have other medical conditions to that cause all over body pain and tiredness so I know what it is like and to lose strength and to have pain in your hands. I find it hard to write, press spray cans like deodrant and use a tin opener etc. My hands can be extremely stiff and I cannot open them. I hope your next rheumy visit improves but to be honest I had a 5 min appt, got diagnosed and sent on my way with a leaflet and that was sept 2014..so fingers crossed for you ....becks

Smudge65

Saw GP today. She doesn't think it's arthritis based on my old blood test results. She's sending me for a hand xray and has changed my anti-inflammatory to naproxen (250mg twice a day)...

dreamdaisy

Hello, it's nice to meet you but I am sorry you have had to find us.

I have psoriatic arthritis (PsA) which is treated by my rheumatologist. This is a sero-negative auto-immune arthritis and it took years for the diagnosis to be made. She also diagnosed fibro a couple of years ago but I take nothing for that. The joint damage from the PsA has led to osteoarthritis and I see the GP for that - the treatment in simple, pain relief and maybe an anti-inflammatory every now and again. The meds for the PsA do nothing for the OA but that's not a surprise because they are different versions of the same beast.

RA is not necessarily symmetrical when it begins. I broke the rules with the PsA, that is supposed to begin in the smaller joints such as fingers and toes but mine opted for my left knee. Arthritis is not like mathematics - it has no rules so cannot follow any of them. A history of auto-immune troubles can be an indicator but they can start all by themselves, just for the fun of it. I suspect your GP is thinking along the lines of OA, hence sending you for Xrays - that is a diagnostic tool for OA.

I wish you well and please let us know how you get on. DD