Hi again Greg,

I have OA in my spine and in my joints right at the base of my hand where it connects into the wrist. My RA meds do nothing for the OA. I am not sure if the RA aggravates the OA, but come to think of it, I never had much trouble with OA until after RA diagnosis. Really don't know if they are connected in any way, but it is an interesting question.

The problem in my lower back is OA related. And my mom (who doesn't have RA) has AWFUL OA! She wears a pain patch. If xrays show a spur they can do something about it. If it's down to very little cartilage you can get an injection that will cushion the joint. If it's worse than that, you can get a new joint. I know it's not what you want to hear.

I don't know about RA triggering OA, but I'm sure a few ppl here do.

Your post is timely for me Greg.

I've been having a lot of problems with my feet the last few months - particularly my big toe joints. Just today I compared them and the one that hurts the most which I can hardly move is twice the size of the other one. Also my flares from hell have been pretty calm lately due to the Humira I guess but I get this god awful aching in my feet/ankles/knees at night when I get tired.

Your bringing up the OA in my feet might be my answer also. My Rhuematologist has never mentioned OA to me but the OA diagnosis is on my paperwork every time I visit.

I've never had any x-rays or any other type of test for this. Also I've never know if there is a relationship between RA and OA.

My right big toe and right thumb have doubled in size since the RA. When I complain to my rheumy that the pain is awful in those joints she tells me it's due to OA. When I tell her that I never had pain in those joints before the RA diagnosis she seems at a loss for words. On Thursday I'll ask her if RA worsens the OA but I'm quite sure it does. The problem with not knowing if the pain is from OA or RA is that we could be giving up on our RA meds prematurely or take more meds than needed. In my case I have OA in my big toes, thumbs and knees. Now that I'm on the Enbrel my pain in other joints is gone and almost gone in my knees. Why add anything if the left over pain is from OA? I may as well stick with the Enbrel and find the best NSAID possible for the "RA aggravated osteo arthritis".

OA is visible on xrays. That would be a good place to start - get xrays of your feet.

Out of no where I suddenly got bunions both on the outside of my big toes and tailor bunions on the side of my little toes. This coincided with my biggest flare since onset that had my hands claw like unable to close and very painful. The one bunion was very painful almost gout like and had a red bump on it.
At my last RD visit on Saturday he was examining my feet and said no RA changes- this is OA.
I think it's kinda funny that I suddenly developed OA in my feet.

Yes, bcatz is right. OA does show up on x-ray. I have also had horrible problems with my feet for years and years. It has kept me from getting the exercise I need. (I just ordered a DVD on Tai Chi; hopefully I can do that!).

I feel like both my RA doc and my podiatrist have thrown in the towel on my feet. It's like they are both essentially saying "well, you have OA in your feet." Like, there is nothing they can do about that.

My biggest problem is that it bothers me most in the joint where you get bunions. I got a bunion bootie (too expensive), but it strangely does seem to help. I recommend getting a size smaller than you think you need because they stretch with time. I also only try to walk every other day. I just have too much pain when I try to do that (or anything) every single day.

I don't have a clue if RA is associated with OA in any way. At this point, it doesn't matter.

Interesting, thinksRAs... I can honestly say, I never noticed my bunion problem until I started taking Orencia. I quit that after three months, but it sure seemed to be connected, to me. I had never had bunion problems before that. Almost immediately after my first Orencia shot, I got other weird lumps and bumps on joints that I hadn't had before.

Hi Guys,
The Podiatrist was positive I have OA is my big toes. He was able to tell the upon examination, the lack of mobility, the large bone or bunion growing above the toe, etc.... The knees and thumbs have already been confirmed to be OA with x rays, I'm really just going on a personal observation that joints with OA are now noticeably suffering when prior to RA they wren't. I was just wondering if anyone else had the some experience or knew of any medical research that connects the 2. There probably isn't any but it doesn't matter so long as I'm aware that the relief I get from the Enbrel may not as strong on these joints and I'll need to find other ways to control the pain and stiffness there, I'm looking into Celebrex to replace my Lodine and started a thread on it:
http://www.dailystrength.org/c/Rheumatoid_Arthritis/forum/20395905-anyone-have-nsaid-stop

Nope, RA meds don't work on OA and vice versa. They both affect joints but in completely different ways with different causes. You have to treat them separately. The Enbrel may be lowering your inflammation levels which can lessen pain all over.

So far I just have OA in my spine. I never had a problem before being dx'd 6yrs ago at 37. A 40yr old shouldn't have the level of damage I do from osteo. I have very few vertebrae & discs not affected. It's too unstable for surgery. All they can do is treat the pain. A spine dr said my imaging looks like I played full contact sports. My theory is the inflammation from the RA tends to speed up the process. But I don't think there's any connection in medical books.

My thumbs & toes are from tendon involvement from RA not osteo. I have a bunion on my right toe & my left is 75% numb from nerve impingement. My podiatrist said the bunion is RA since its actually the ligament pulling the joint out of place. OA isn't inflammatory & shouldn't cause swelling. If your toes are doubling in size there has to be a reason. I'd definitely ask for more tests.

Xrays do look different. I think Jen used the best analogy. RA eats bone & OA grows bone (like spurs). RA looks like something has been gnawing on your bones & OA is loss of cartilage.

Since I also have inflammatory issues in my spine & muscles, my drs don't bother differentiating anymore. RA & OA pain feel differently. With the spasms & nerve impingement, I have about 4 different types of pain that are all treated differently. The trick is figuring out what's causing what. That can turn into a full time job for awhile but gets easier as time goes on.

Take care,
Emerald

Very timely post. I saw my rheumatologist for the first time on the 7th.
He ordered x-rays of my feet, hands and chest. Results showed "no significant synovial disease" but did show mild signs of OA in all the places that have been hurting. I've been put on plaquenil and will return in 2 months.
I did find this on wikipedia: "Local osteoporosis occurs in RA around inflamed joints. It is postulated to be partially caused by inflammatory cytokines" Also "X-rays of the hands and feet are generally performed in people with a many joints affected. In RA, there may be no changes in the early stages of the disease, or the x-ray may demonstrate juxta-articular osteopenia, soft tissue swelling and loss of joint space. As the disease advances, there may be bony erosions and subluxation..."

It does seem that in the early stages X-rays may not pick up on synovial damage, but MRI and ultrasound might?

I already have symetrical subluxation on my thumbs. I'm 43, a little young for OA in so many joints I would think. So yeah... I bet its related somehow.

I think, to put it in laymen's terms, RA opens the door, then OA runs in and steals all the electronics and jewelry. Maybe Jen, AKA 51% will show up. I think she has both, and has the goods on the connection.

You have a new RA diagnosis. Seems a bit odd to me that OA would crop up as suddenly and drastically as RA has for you, right at the same time.

Alto,
That is the point I'm trying to make to my rheumy. I agree that the OA was probably there for a while but it caused me almost no discomfort until RA came along. I think you hit the nail on the head when you said RA opens the door. It opens the door for the OA to became irritated or inflamed. That seems to be what happened to me and some others who have chimed in.

Sounds about right in your last post as far as I am concerned also. But I have no proof of OA other than my symptoms.

Thanks Canton, CT. We are trying to figure out if our RA has aggravated the OA or sped up the OA. I obviously had this OA in my joints for some time but they never hurt until RA came along. None of us know why for sure and there is nothing in medical studies. I'm hoping maybe you know why or have a theory.
Thanks,
Greg