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surgery and RA link?

I had rotator cuff surgery in April 2021 and was diagnosed with RA less than a year later. At times I think the RA started long before I was diagnosed but at other times i wonder if the surgery had triggered it. Though I had been dealing with different types of pain for years the overwhelming fatigue did not start till after the surgery. so my question is are there any links between surgery and RA or has anyone else had the same experience?

  1. My RA diagnoisis came about 1.5 years after a hip replacement. I'm sure I had some symptoms of overall inflammation prior to the surgery: unexplained episodes of fatigue and frequent tendonitis. About a year after the replacement, I had a significant problems with hip tendonitis. I had a fenestration procedure (poked several holes in the tendon) hoping to increase healing. I basically "fell off the RA cliff" after that procedure. Rather than just increasing a healing inflammation to the tendon, I went into a full blown flare. Prior to the procedure, neither the doctor nor I knew I was headed for RA. I believe RA was inevitable, but the procedure pulled the trigger. I've heard the analogy - RA is loaded into the gun, perhaps genetically. Then an illness, infection, stressor, etc pulls the trigger. Also, I believe it can be harder for us to heal from surgeries because of the constant level of inflammation and differences in our immune systems. I had a major shoulder repair 3 years after RA diagnosis. My surgeon was very conservative with immobilization, PT and NSAIDS. My healing was slow, but by 6 months I was very happy with the results! Jo

    1. Hi . To expand a little on what Jo said, while there is no known cause of RA, there is some evidence that some sort of stressful or traumatic event (including physical) can serve as a trigger. This article from our editorial team goes into further detail: https://rheumatoidarthritis.net/causes. That said, it is not rare for people to have RA (or at least symptoms) for years before getting a proper diagnosis. How are you doing since the diagnosis? Have you found a treatment that helps? Wishing you the best. Richard (RheumatoidArthritis.net Team)

      1. thanks for the response. I had tried to reply to your question before but was unable to for some reason. I have been doing weekly Enbrel injections about 2 years now. I also take 2 tramadol daily. the Enbrel lowered my pain level significantly although i always have some level of pain and it increases along with activity level Fautige is a major problem too

      2. Hi . Thank you for the reply and glad the system finally let you post it. Unfortunately, depending on the severity of the case, it is not rare for the pain and some symptoms to not completely go away. I'm glad that the Enbrel is taking care of most of it. Fatigue is often more of an intransigent problem. I want to share with you this article from our contributor Daniel on fatigue: https://rheumatoidarthritis.net/living/morning-fatigue. I also recommend reading the excellent discussion in the comments section, which includes some information I found on recent research on the foundations of autoimmune related fatigue. Wishing you the best. Richard (Team Member)

    2. My diagnosis came four weeks after a surgical procedure. The way the doctor explained it to me, my body treated the surgery as a trauma, and overly responded to it. The surgery did not cause the RA, rather it was just the right thing to bring it out - it was just a matter of time.

      Bummer, too - as the surgery was long awaited (fifteen years!) to address a chronic pain issue. I had a solid week of feeling great before RA symptoms showed up.

      1. , I am sorry a surgical procedure meant to improve your quality of life triggered an RA flare! I tend to describe situations like yours just as your doctor did. We don't fully know the 'why' and 'how' of why this happens to some individuals, but I do hope continuing research will help us get to the bottom of those questions and, hopefully, in the future, be able to mitigate this overreactive immune response to every day procedures like vaccinations and surgeries.


        I know it may seem like a silly question, but did the surgery at least address your initial chronic pain issue?


        Best, Erin, Team Member.

    3. To echo what many others have said, it can be possible. But this is very had to rule out as so many things can cause RA to ignite. But any stressful or traumatic event to the body/mind, and surgery is a big one, can make the body go haywire. What is most important is what can you do now for it? Staying focused on what caused it is ok, for some time. Though to wonder isn't going to help matters in the long run. Taking action to heal is what would be the best to focus on. How you do that will be personal between yourself and your doctors. Hope that helps and best of luck. -Effie, team member

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