In a proportion of individuals, chronic back pain could be a sign of autoimmune disease. Inflammatory back pain and spondyloarthritis continue to be under-recognised and individuals suffering with such symptoms often do not receive appropriate treatment.
What is spondyloarthritis?
Spondyloarthritis is a condition associated with inflammation in the spine, joints and tendons. It usually presents as chronic back pain and most individuals have had back pain for years before the condition is diagnosed.
How common is spondyloarthritis?
It is believed to be far more common than previously thought, with an estimated 1 in 200 individuals suffering from this condition, so do get checked if you are concerned.
What are the symptoms of spondyloarthritis?
Unlike the common mechanical back pain, patients with spondyloarthritis have pain that is much worse at night and after periods of rest. There is usually considerable stiffness in the back and joints in the mornings. Patients often report pain and stiffness during long car or train journeys and long-haul flights. Most importantly, the pain and stiffness eases with movement. Such back pain is described as inflammatory back pain and there is associated stiffness in the hips and shoulders. Some patients also report bouts of tendonitis, with Achilles tendonitis and heel problems being the most common.
Are there other related conditions?
Spondyloarthritis is often seen associated with psoriasis, chronic bowel issues, Crohn’s disease and colitis. Sometimes there is a family history of these additional conditions.
How is spondyloarthritis diagnosed?
In the appropriate clinical situation, blood tests and a special MRI scan of the spine and hips (with STIR sequences) is used to make a diagnosis.
How is spondyloarthritis treated?
For a vast majority of patients diagnosed to have spondyloarthritis, treatment consists of specific anti-inflammatories and stretching exercises. Yoga and Pilates can also be beneficial for some patients. The National Ankylosing Spondylitis Society (NASS) has a number of useful resources on its website to help patients diagnosed with this condition to self-manage symptoms.
Some patients with severe disease require special medication called biologic therapy to ease symptoms. These biologic drugs have revolutionised the management of severe spondyloarthritis, giving patients the opportunity to enjoy near-normal lives.