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Old 02-03-2012, 11:47 AM   #1
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Results - inflammatory response/myofascial pain

I saw a back specialist due to severe neck/back/lower back pain. I have rheumatoid arthritis but I wanted to know if this pain was related to something else....this is what he wrote on the notes.

"Her symptoms are related to the generalized inflammatory response with diffuse myofascial pain symptoms."

In the office he told me that the pain is due to the inflammation to the synovial joints in the spine.

Can anyone help me understand what his notes are saying? Is the pain from inflammation? Would this mean that the pain is related to my rheumatoid arthritis?

Thanks....I don't see my doctor until mid March...any input would be appreciated.

Zeyda

 
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Old 02-03-2012, 12:20 PM   #2
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Re: Results - inflammatory response/myofascial pain

I was thinking about you, wondering how you were doing. I'm going to ask a buddy (Jenny) from the "Spinal Cord disorder" board to pop in on your thread to comment on your post. She knows much more about RA than I do. Luckily I do not have it, so haven't had to learn about it. (I operate on a "need to know" knowledge base! )

The facet joints in our spines are synovial joints, so I would imagine that they are subject to the same issues people with RA have in their other joints. When the degenerative process is present in the spine, the facet joints are often affected. This can causes changes in the surface of the joint, creating little bony overgrowths, (osteophytes) and uneven, jagged edges. This can cause the joints to wear, which can lead to instability at that spinal segment. As this process is going on, the muscles that support the spine intensify their effort to hold the spine upright, a process called "guarding." The muscles cramp and stay in a cramped up position, rather than releasing and going back to their normal consistency. This can result in myofascial pain...knots in the muscles, spasms, etc.

I can tell you that regardless of the cause of inflammation, it can reek havoc on the spine in a variety of ways, and can leave the patient in a great deal of pain. You know how an enlarged joint in the hand or foot looks? This same process can happen with the facet joints...so the joint can enlarge. When this happens, it can end up causing a nerve to become compressed. The enlarged area takes up some of the space that is needed for the spinal nerve to exit the spine, and it results in pain.

 
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Old 02-03-2012, 12:45 PM   #3
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Re: Results - inflammatory response/myofascial pain

HI!! Thanks again!! I just went back to my original posts and I may have already asked the same question and you may have already answered me )-: …sorry for sounding so lost, but today I got the copy of the office notes that I requested a month ago. My question to both my primary and Dr. Pigeon “is the pain on my neck/back/lower back” caused by my rheumatoid arthritis?

I want to be able to talk to my primary with a good understanding about what's going on and I feel that the back problem is related to the RA…but it just sounds like they are all going around the problem and not being specific. Since I don't understand the terminology, I may be going around in circles with my questions too.

It just seems that most doctors don't come out and make everything clear for the average person. Thank you again for coming to my rescue (-:

BTW....I took my mother to them and she's seeing Dr. Schwab. He's giving her the Supartz Joint Fluid Therapy. Her right knee is bone on bone and she hasn't be able to walk....we have two more shots to go and Dr. Schwab is very hopeful that she'll be able to use her knee again.

Zeyda

 
Old 02-03-2012, 12:50 PM   #4
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Re: Results - inflammatory response/myofascial pain

I can't remember your specific symptoms. Does you pain run down your leg, or is it more localized in your back?

 
Old 02-03-2012, 01:02 PM   #5
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Re: Results - inflammatory response/myofascial pain

The pain starts on the base of the head, neck, shoulders, spine and the lower back, but it's not a shooting pain down my leg. When its worse, I can't walk straight or get out of bed from the pain. When I started taking Etodolac (Nonsteroidal anti-inflammatory) in October, it helped so much with the pain (wonder if that's because the pain is due to the inflammation of the joints like you explained back in one of your messages to me in November).

Like now that I'm sitting at my desk, the pain on the spine gets so bad that it feels hot in certain spots....along with not being able to turn my head to either side without being in a lot of pain.

 
Old 02-03-2012, 03:27 PM   #6
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Re: Results - inflammatory response/myofascial pain

Hi Pearl...I'm Jenny. I not only have the spine issues(and 2 major spine surgeries)and severe long term OA, I got aggressive RA about 7 years ago.

Most arthritis in the spine is OA. Ra does affect the spine and can develop anywhere but it generally hits C1 and 2 at the top of the spine. I have it there. You get that same hot, "eat the bone" pain as you do elsewhere.

That is the primary difference between OA and Ra. In OA, the cartilage starts the degeneration and when the body tries to fix itself, it makes bone in all the wrong places...the bone spurs(osteophytes) of OA. That makes for major pain and can eventually cause the joints to fuse together.

RA on the other hand, causes inflammation of the lining of the joint(synovium) and that in turn causes the bone to "erode" ...it eats the bone. It's that inflammation that causes the hot, red joints of Ra. But there are "synovial joints" in the spine as Teri said(facets are the main ones)so wherever you have a synovial lining, you can get Ra.

So an MRI of your spine can see if you are making bone spurs or whether the Ra is eating at the joints. Chances are, it's OA. But either way, it makes the surrounding tissues swollen and inflamed as well.....that myofascial pain problem.

What are you taking for your RA? One of the little secrets of RA, is that the new biologic drugs for Ra are also being tested as pain meds for chronic spine pain. If you aren't taking something like Enbrel, you may want to ask your doc about it. Not only will it slow or possibly stop your Ra, it may very well stop most of the pain in your back.

So even though it probably isn't RA in your spine, your RA meds may help it significantly. I'm on a cousin of Enbrel, Orencia and although I am waiting for surgery on my lumbar spine(and possibly the cervical too...again), I don't really hurt that badly due to Orencia. My legs are numb but my low back doesn't hurt. I first took Enbrel about 6 months after my last neck surgery and the neck/back pain disappeared almost immediately but it didn't help my Ra. Went on Orencia and it did help the Ra and it helped the spine pain tremendously.

Have you had an MRI done yet? Can you get a copy of the report and post it?

I will watch for your posts if you want to post here or you can come over to the Spinal Cord Disorders board or you can find me on the Arthritis board...back/neck people there too...with Ra and OA.

Hope this helps.

hugs............Jenny(fused C3 to T1)

 
Old 02-03-2012, 04:50 PM   #7
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Re: Results - inflammatory response/myofascial pain

Thanks, Jenny. That was a clear explanation of some of the differences between OA and RA.

 
Old 02-03-2012, 05:50 PM   #8
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Re: Results - inflammatory response/myofascial pain

Thanks Teri....the other main difference is that OA will only attack joints whereas RA can attack internal organs such as the lungs, heart and eyes. RA can kill but OA just cripples.

Jen

 
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