That's a tough call, but it certainly could represent either disease or even a combination of both. If the symptoms are similar to what you had preop 5years ago, then it may be a
primaryPrimary amyloidosis
Primary biliary cirrhosis
Primary hyperparathyroidism
Primary insomnia
Primary lymphoma of the brain problem with the back such as
recurrentRecurrent cystitis disc injury (if any part was left) or problem with the hardware (if any was placed) or even futher degenerative disease due to aging or RA. However, the swelling in the ankle and leg point more towards a primary joint problem rather than back disease. In addition, the RA in itself can be causing the back pain. Given your medical/surgical history, I would recommend getting it looked at by your doc (start with the rheumatologist) and consider having your lower back reimaged with an MRI. An EMG may also be helpful in pointing out if there is new or active nerve disease caused by a bad back/disc/RA, etc... Good luck.