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Have rheumatoid arthritis, neck pain, headache and shoulder pain. How to treat these problem?

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Practicing since : 1999
Answered : 550 Questions

I have RA. I have had bothersome neck pain for three months. I can't sit for long, my neck and left shoulder really hurt and I get headaches and pain across the base of my skull. My doctor thinks its a pinched nerve and sent me to a PT. My PT thinks its c3-c4 damage from RA. Pt, acupuncture and meds aren't helping. What should I do next?
Posted Fri, 22 Feb 2013 in Lupus
Answered by Dr. Divya Agarwal 16 minutes later

If you have had long standing RA then involvement of the cervical spine is a well-known possibility.
MRI of the cervical spine can diagnose it.

Treatment depends on what we find on the MRI. It could mean more aggressive treatment for RA or under some circumstances some surgical intervention.

My other question would be whether your RA is under control as far as other joints and your ESR is concerned.

Hope this helps you.
Above answer was peer-reviewed by
Follow-up: Have rheumatoid arthritis, neck pain, headache and shoulder pain. How to treat these problem? 11 hours later
Diagnosed with RA over ten years ago, I have mostly been in remission. I had a severe flare a decade ago, have mostly been on minocycline then tried plaquenil and sulfasalazine. I have recently started methotrexate due to increased activity in the last 9 months - I have had fatigue, joint pain in my wrists, inflammation in my fingers, and a left hip bursitis. I have also had intense foot ramps at night. All of this keeps me awake. The neck pain is relived by hot yoga and other treatments but resumes when I sit or drive or lie down. The pain is on my left side of my neck and shoulder and canlimit my range of movement at times. My doctor doesn't seem to think I need to do an MRI or xraynof my neck yet, but thenpainnis really distracting and it's going on three months and I have a career and family to take care of. Any other thoughts?
Answered by Dr. Divya Agarwal 2 hours later
The most likely is cervical myelitis secondary to c1 c2 involvement.

The best approach would be to rule this out, as it can lead to serious problems.

The other possibility is cervical spondylosis, for which exercises and medication like gabapentin may help.

Hope this helps. Let me know if you have more concerns.

Above answer was peer-reviewed by
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