The Distinguishing Factors of AS symptoms and back pain caused by mechanical causes Healthline

0
380 views


  • Ankylosing Spondylitis (AS) is one type of arthritis that can cause an inflammation in the spine.

  • It is most often affecting your lower back and can impact the function of spine.

  • Therapy and certain medicines such as biologics can assist.

Ankylosing Spondylitis (AS) can be described as a type of arthritis with inflammation that frequently affects the lower back which can cause stiffness, pain and, in extreme instances, an enlargement (joining to) of the bones within your spine.

The reason behind AS isn’t known. It is caused because your immune system targets healthy cells within the body. The immune system’s response triggers inflammation.

The inflammation is the reason behind the aching, stiff feeling that many people suffering from AS experience throughout their back. Because of this, it is also known as an inflammatory back pain.

The inflammation is affecting more places beyond the lower back. It may cause joint pain as well as impact other organs, like the eyes. It can also be associated with other conditions, including Irritable bowel disease which can affect between 5 to 10% of people who suffer from AS.

Mechanical back pain is a different kind of back pain.

The reason for this type of pain is due to changes in structure and function in the back. It may occur frequently or only occasionally and may result from daily tasks such as lifting weights too heavy or sleeping in a bad position.


Stiffness and back pain are the most frequent symptoms of AS. However, lower back stiffness and pain are not enough for a physician to identify and diagnose AS. This can lead to that there is a delay in establishing the link between lower back discomfort and AS.

In a

Study from 2016

Researchers looked at 12 years of data relating to the way rheumatologists and doctors determine AS. They discovered that the average of 306 daysnearly a whole yearfrom the initial diagnosis of back pain until being diagnosed with AS from primary care physicians.

It took on average just 28 days to get a rheumatologist determine an AS diagnosis once a patient was sent to the doctor. While not all individuals who suffer from back discomfort have AS however, someone who has chronic lower back discomfort that does not have an reason may need to consult an expert.

Some reports aren’t as positive. According to one report it can take as long as 10 years of seeing specialists and doctors in order to receive the AS diagnosis.

There is evidence that suggests the time between first back discomfort as well as AS diagnosis is decreasing.

In a study for 2020 the researchers discovered that, Between 2007 and 2017 AS diagnosis rates rose. It could mean that doctors might become more adept at diagnosing and recognizing AS instead of simply assuming that it’s an issue with mechanical back pain.



The distinction in between physical back pain and inflammation back pain can be difficult.

According to CreakyJoints they recommend asking yourself these questions to determine if you are suffering from an inflammatory or mechanical back discomfort:

  • Do you feel more uncomfortable when taking a break or sitting for long durations?
  • Did it start before the age of 40?
  • Is it enough bad that it wakes you in the middle of the night and keep you from sleeping?
  • Do exercise and movement generally make discomfort feel less so?
  • Do you think that pain will improve when you are taking an anti-inflammatory nonsteroidal drug (NSAID) such as Ibuprofen?
  • Do you have other symptoms that are associated with other symptoms that are associated with back discomfort, for example inflammation of the bowel eye inflammation or pain in joints of your legs or arms or Psoriasis?
  • Do you feel more uncomfortable in the initial 30 to 45 minutes after waking up?
  • Does it last with periods of being off and on for more than three months?

If you answered”yes” to all of the questions above, then you might be suffering from inflammatory pain.

AS typically begins within the lower back however, it may develop to other parts of the back and trigger additional symptoms. According to

National Institutes of Health (NIH)

The indicators to look out for are:

  • stiffness, pain, and inflammation in joints that are not as painful, for example, feet, knees, shoulders or the ribs
  • Loss of appetite
  • Abdominal discomfort
  • Vision changes that change
  • eye pain due to uveitis
  • difficulty breathing deeply (a indicator that your ribs could be affected)
  • fatigue
  • skin eruptions
  • loose bowel movements
  • weight loss

The following table can aid you in determining if your back discomfort is most likely to be to be inflammatory or mechanical:


Certain factors, also known as risk elements, could make you more susceptible of developing AS-related back discomfort.

According to

the NIH

Some risk factors are:

  • Age The most common form of AS is in people who aren’t yet 45.
  • Genre: AS is more likely to be seen in males than in females.
  • Genetics An ancestor’s history with the illness may increase the risk.
  • Other reasons: Having inflammatory bowel disease or psoriasis put you at a higher risk.



If you are having back discomfort properly diagnosed will assist in the treatment outcome.

Mechanical back discomfort will usually improve as time passes and rest is recommended. For cases that are severe or moderate there may be a need for more treatment, however you should notice improvement after treatments, as per Creaky Joints.

Treatments can include:

  • Therapy for heat and cold
  • Physical therapy
  • Losing weight
  • shifting position
  • Avoiding smoking
  • light exercise
  • steroid injections

If you are experiencing back discomfort is caused by inflammation The above methods will not perform. This is because, regardless of treatment, your body’s immune system will continue to produce an inflammation response. This means you’ll still feel discomfort. Furthermore, since AS is a chronic disease the symptoms could get worse over time, leading to more serious issues.

Treatments for AS may include a variety of methods to relieve symptoms and slow or prevent the progression of the disease. According to

the NIH

The medications are:

  • Biotechnology
  • janus kinase (JAK) inhibitors
  • corticosteroids
  • Over-the-counter non-prescription NSAIDs

AS can also be treated using physical therapy and surgery.


Mechanical back pain can be because of physical strain or insufficient spinal align, or sleeping in an awkward posture. The inflammation that causes back pain, like due to AS is when the immune system causes inflammation that attacks joints of the back.

Although both may feel similar and could be mild or severe You can search for indicators that indicate your back pain could be the result of inflammation. Certain signs are chronic pain, as well as the appearance of other signs.

The treatment for both conditions is different. It is likely that you will notice your mechanical back pain ease with rest and a few basic treatments. Inflammatory back pain due to AS requires ongoing treatment and monitoring to treat the cause of inflammation in order to alleviate symptoms and slow progress of the disease.