Let’s face it, back pain is terrible and unfortunately for us, very common. According to the 2016 Global Burden of Disease Study, low back pain is the number one cause for disability globally.
So we know back pain is common and debilitating, but the question is, what is the difference between regular and autoimmune back pain?
There are two broad categories: mechanical back pain and inflammatory or autoimmune back pain. Many but not all autoimmune diseases cause back pain. For example, rheumatoid arthritis usually does not cause back pain. Sometimes these disease are very difficult to diagnosis because they progress very slowly. Often times it takes years to decades to diagnose. Yes you heard me, DECADES. Unfortunately, if left untreated, it can cause irreversible spinal damage: joint erosions and spinal fusion also known as ankylosis. Prompt treatment with a disease modifying anti-rheumatic agent (DMARD) often can slowdown or prevent joint damage.
Autoimmune back pain
As I was mentioning before, mechanical and autoimmune back pain are completely different. Mechanical back usually improves with rest, worsens with strenuous activity, and usually begins later in life. People that have autoimmune back pain experience the opposite. Here are some of the key features.
- Usually pain starts during the 2nd or 3rd decade of life. People usually experience symptoms before the age of 45
- Onset is gradual for the most part
- Symptoms have been ongoing for more than 3 months
- Exercise improves the pain
- Rest really doesn’t help. The pain usually worsens with rest
- Anti-inflammatory medications like naproxen or ibuprofen helps the pain
- Pain wakes you up during the second half of the night
- Pain and prolonged stiffness in the morning. Typically, stiffness lasts more than one hour
- Alternating deep buttock pain
Risk factors
Autoimmune disease rarely occur in isolation. The following are some of the risk factors pointing towards a diagnosis of autoimmune back pain.
- Personal history of uveitis. This is a type of inflammatory condition that affects the eye.
- A personal history of psoriasis.
- Having a history of dactylitis in your finger or your toes, aka “sausage digitis”.
- History of inflammatory arthritis: redness, swelling, and stiffness in any joint
- Any first degree relative with any spondyloarthritis (SpA)-associated condition? This means mom, dad, siblings, or your children. SpA-associated conditions include:
- Axial spondylitis also known as ankylosing spondylitis
- Psoriasis
- Psoriatic arthritis
- Reactive arthritis
- Crohn’s disease
- Ulcerative colitis
If you think you could be suffering from autoimmune back pain, please seek your local rheumatologist. But do not jump to conclusions. There are many other diseases that can mimic inflammatory back pain that are not autoimmune in nature.
References
Vos T, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016 Oct 8;388(10053):1545-1602.
Sieper J, et al. The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis. Ann Rheum Dis. 2009 Jun; Suppl 2:ii1-44.
http://www.asas-group.org/publications/ASAS-handbook.pdf
Medical Disclaimer
This information is offered to educate the general public. The information posted on this website does not replace professional medical advice, but for general information purposes only. There is no Doctor – Patient relationship established. We strongly advised you to speak with your medical professional if you have questions concerning your symptoms, diagnosis and treatment.
