According to the Mayo Clinic, "Back pain is a common complaint. Most people in the United States will experience low back pain at least once during their lives. Back pain is one of the most common reasons people go to the doctor or miss work."
Back pain can have many causes but chronic lower back pain has been shown in a recent study to be associated with spondyloarthritis at a rate that is "strikingly high" (click here for the news item).
When diagnosing ankylosing spondylitis or related disease where back pain is present, it is important to distinguish the underlying cause. Specifically, is the back pain inflammatory in nature or mechanical?
VIDEO: Inflammatory vs. Mechanical Back
Pain - Dr. Michael Weisman
A segment from Dr. Michael Weisman's Spondylitis Educational Seminar presentation (to the right) given in Denver, CO in 2008 describes the differences between mechanical and inflammatory back pain. Inflammatory back pain is the variety associated with ankylosing spondylitis and other spondyloarthritides.
When determing if the back pain is inflammatory in nature and related to a disease such as ankylosing spondylitis, the following is often taken into account:
- Onset of pain is usually under 35 years of age
and is insidious
- Pain persists for more than three months
(i.e., it is chronic)
- The back pain and stiffness worsen with
immobility, especially at night and
- The back pain and stiffness tend to ease
with physical activity and exercise
- NSAIDs are very effective
in relieving pain and stiffness
in most patients
Note that inflammatory back pain by itself should not
be used to diagnose ankylosing spondylitis.
Instead it is a very important characteristic
which the physician considers along with
other findings such as x-ray or MRI evidence
of sacroiliitis, the detection of the gene marker
HLA B27, or the history of another related
physical finding such as Iritis.
Please visit the following resources to learn more about ankylosing spondylitis and related diseases: