If your patient’s back pain is not improving and is inflammatory in nature, your patient may have an undiagnosed rheumatic disease – axial spondyloarthritis (axSpA), including ankylosing spondylitis (AS) – that primarily affects the spine, which can make them highly prone to spinal fracture.
Inflammatory back pain is a hallmark of axSpA and other closely related diseases within the spondyloarthritis family of diseases.
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Inflammatory back pain is usually characterized by a dull ache, difficult to localize, and felt deep in the buttocks or lower back. It may persist for three months or longer. This back pain is frequently associated with stiffness and spasm of the paraspinal muscles and inflammation of the sacroiliac (SI) joints. In some cases, axSpA symptoms can also start in the neck or peripheral joints such as the hips, shoulders, or knees.
Prolonged inactivity usually worsens the pain and stiffness, while exercise and physical activity tend to ease them. Pain may awaken the patient at night. Some patients find it necessary to exercise or move about for a few minutes before returning to bed and may have difficulty getting out of bed in the morning.
Patients with AS may have a fused spine and an 11 times higher risk of spinal fracture.
Inflammation of the entheses, where joint capsules, ligaments, or tendons attach to bone, is a hallmark of axSpA and other forms of spondyloarthritis. This can be felt in multiple areas of the body from the shoulders down to the feet. Two areas of the foot can be affected: the Achilles tendon at the back of the heel and the plantar fascia at the base of the heel.
Inflammation of an entire digit (a finger or toe).
Inflammation of the eye. It is a serious complication that requires immediate medical attention from an eye doctor. Symptoms often occur in one eye at a time, and they may include redness, pain, sensitivity to light, and skewed vision. If left untreated, it can lead to blindness.
These conditions are also associated with axSpA and related diseases, and can serve as additional clues.
Learn more about axial spondyloarthritis, ankylosing spondylitis, and the group of diseases known as spondyloarthritis.
The Spondylitis Association of America (SAA) can assist in the search for a rheumatologist by providing our free Rheumatologist Directory: A Patient-to-Patient Recommended List. This booklet contains a state-by-state list of patient-recommended, board-certified rheumatologists.
We proudly offer a wealth of educational materials on axial spondyloarthritis, ankylosing spondylitis and related diseases — all vetted by our Medical and Scientific Advisory Board.
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