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Is Your RA Pain Symmetrical?

We often notice valuable discussions taking place within our community forums or Facebook page that we like to highlight as a part of our Headlines. Below is a discussion on the symmetry of RA pain that we thought our community members would find interesting. Please note that the opinions represented here are solely those of their authors.

Community Question-Does everyone hurt on both sides at the same time or can you have pain in your left knee and not your right one? I have been told that my left knee, of which I have had 2 previous surgeries on unrelated to RA, can not hurt more then my right one. Can the left one hurt and swell up more then the right one because it has been compromised?

Response from Mariah Z. Leach:

Generally RA pain is symmetrical, meaning that if one side is affected the other side is usually also affected. However, that has not always been my personal experience. My right knee tends to give me more trouble than my left, and my right shoulder hurts sometimes while my left one rarely does. Conversely, I have more trouble with my left toes than my right ones. So I have to admit that it can be confusing to figure out the source of these pains! But my conclusion is, at least for me, RA pain is not always symmetrical!

Response from Andrew Lumpe:

My experience is much like Mariah’s. While generally symmetrical, I’ve found that one side may flare and get damage. Only later down the road may the other side join the “party”. There can also be a situation where you have one hurt joint, say the right elbow, and you start overusing the left elbow to make up for it.

Tell us – Is your RA-related pain always symmetric?


  • Antonia Maritima
    5 years ago

    Because my symptoms started asymmetrically, my initial diagnosis was Undifferentiated Mixed Connective Tissue Disease. It was hard to tell if I had Lupus or RA. Over the past year, though, the symptoms have shown on both sides, although seldom at the exact same time. It seems as though they swirl around and across my body in a tornado…first–and always–my neck, then my right wrist and fingers, my left fingers, my left and then right hip, left knee–much worse (always) than my right knee, both ankles and feet, and right toes.

    I told my brother (with whom I share a home) that if I had had this kind of pain in my teens or twenties, I don’t think I would have made it.

    With the RA diagnosis, I’ve been able to start a biologic with reasonable success. I feel more normal than I have in a long time, but I still have breakthrough RA pain.

    [This is my first post to I’m a 50+ licensed social worker who used to work as a psychotherapist. I no longer do much face to face work. The pain has broken some of my ability to empathic. I can still do it, but can’t do it full time.

    [The brother I mentioned became a CNA to care for me when I need the help. He also works in a skilled nursing facility. I’m lucky that way.]

  • Angie
    5 years ago

    When flares are not symetrical, it is called palindromic rheumaism.

  • ggjojo555
    5 years ago

    I am 47 yrs old and was diagnosed 7 years ago with Palindromic which usually leads to RA. My flares are only one joint, but let me tell you, when I do have a flare, it is so intense. I also seem to get unusual flares like in my eyes and jaw.But thankfully, they usually last 24 hours then I’m back to normal. I have been on Humira for almost a year now and my doctor thinks it may not be working any more. I just had special blood work that was sent to California to see if it is working. I will know in a week. I was on Methotrexate for the first 6 months of Humira but went off because of extreme fatigue. I really,really don’t want to go back on it if I can help it. The doctor is talking about putting me on an infusion called Actemra. Anyone on this medicine?

  • Connie Hansen
    5 years ago

    LOL … sounds like my Surgeons notes, but describes where I hut:

    Bilateral A/C Joints and C Spine are in constant pain.

    Left Elbow, Wrist, Hand and Finger pain almost constantly. Occasional pain in Right Elbow, Wrist, Hand and Fingers. Bilateral Carpal Tunnel Surgeries in 2008 did help relieve the pain in both Hands.

    Arthroscopic bilateral knee surgeries in 2007 relieved pain in Right Knee, but pain continued in Left Knee.
    Left Knee, Ankle, Foot and Toes are in constant pain.

    Rarely have a flare of any kind of the Right side below C-Spine.

    Bilateral Hips Replaced in 2003 eliminated pain in hips.

    It’s almost as if my right side is near normal, while the left side is very sick. I miss out on so many “normal” things in life … I miss being “normal”.

  • Elaine Harley
    5 years ago

    Right knee and left shoulder require replacement.
    Arthroscopy on right shoulder and seems to be fine.
    I don’t understand how a blanket statement such as “The disease is symmetrical” can be made.
    Ridiculous. And I don’t say that simply based on my own experience.

  • Elaine Harley
    5 years ago

    Oh. My left wrist now too…

  • Sharon
    5 years ago

    My RA has never been what I consider symmetrical. Although it has affected both sides, it has seldom been at the same time. It seems more like a “catch up” situation, and occasionally it would be mostly my entire body would flare at one time.

  • Norreen Clark
    5 years ago

    I found out for myself when first diagnosed with RA 35 years ago the pain seem to be worse then, then now. You need to research as much as possible for your disease. The right foods, when to say enough is enough I need a few hours to myself for rest. A couple doctors, look into there research. There names are Dr. David Perlmutter and Dr. Mark Hyman. And I always ask God for his help and always grateful for the health I have. God Bless.

  • Barb Anderson
    5 years ago

    Rheumatoid disease is new for me; I was officially diagnosed with RA just two weeks ago. So far, my RA has not been symmetrical at all. It started with pericarditis and also pain in my left shoulder. Since then it has affected my left foot, both knees (but seldom at the same time or with the same intensity), both hips (again, seldomly simulataneously or with the same intensity), my right wrist, and my left index finger. The problems in my hips and knees come and go, but the pericarditis, shoulder, foot, wrist and finger problems are constant and I sincerely hope they do not become symmetrical as the disease progresses.

  • Kathy P.
    5 years ago

    My RA is frequently asymmetric. I have damage to my right knee, so it always hurts, but hurts a lot more with a flare. I work with my hands, and being right handed, my right hand usually hurts more than my left, even though my left has more physical damage from the RA.

    I think the operative phrase here is, “generally symmetric.” Because we guard one, the other side gets overused, then the other side starts hurting similarly because we’re compensating for the side that originally began with hurting more.

    It’s a case of the chicken or the egg.

  • Wren moderator
    5 years ago

    My RA has always been symmetric, if it means that the same joints on opposite sides of the body are affected. But while, say, both of my knees can and do flare, they have never flared at the same time. That’s how it’s been for most of my joints, except for the ones in my feet and hands. Those are the most symmetrical of all. Sigh.

  • Dawn Peel
    5 years ago

    My RA pain was symmetrical during each attack I experienced. My first attack involved both hands, wrists and fingers. Once the initial attack subsided my right side hurt constantly and my left side not as much. The same after my knees were attacked. The left side had more residual pain than the right. This is not to say that the both sides do not hurt but they may not hurt as much or at the same time.

  • Detje Bea
    5 years ago

    my experience is also like yours. my left knee has been bad but not my right one. my toes on my right foot but not left. I am so happy I found your blog.

  • Teresa Perret
    5 years ago

    I think I frequently flare in symmetrical joints but one side will be so much worse than the other so I don’t really notice it so much. For instance my hips are flaring right now, and both are stiff with diminished mobility, but the right is so painful that I barely notice the left is stiff as well.

  • Patricia
    5 years ago

    I have both OA and RA. I’ve had OA much longer than I have RA, and for me personally, there is a difference in the pain of these two things. My left knee was badly injured in an accident over 40 years ago; OA set up in that knee long ago. I have been told several years ago (before RA) that I would at some point need knee replacement. I was also told that I would know when it was time, because I would be in pain most of the time in that knee and be having to take pain meds daily. Recently, that knee has been hurting more, but still not enough for me to be constantly taking pain meds. When I had the initial RA flare, I hurt in EVERY joint of my body! Both sides equally. Perhaps it would be a good idea to have your Rheumatologist evaluate to see if the pain you are having now is OA.

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