Lower back pain can be a sign that you have an incurable condition – and doctors have urged people to see their general practitioner.
Back pain is a common problem among adults, some of which have been plagued continuously for years.
According to the organization CreakyJoints, around six percent of people with chronic pain are diagnosed with axial spondyloarthritis, or axial SpA for short.
It is estimated that one in 200 adults in the UK has an axial SpA.
However, according to the National Axial Spondyloarthritis Society (NASS) charity, there is a widespread lack of awareness.
The condition usually begins in late teenage and early 20s, but can take an average of 8.5 years to be diagnosed.
If left untreated, it can cause vertebrae in the spine to fuse together, making everyday activities like putting on socks too painful.
In the worst case, new bones can form in the body.
The pain often first appears when someone is in their twenties, when building relationships, a career, and struggling with symptoms
Dr. Raj Sengupta
Although Axial SpA can be branded as “arthritis only,” the impact on patients when they come to terms with an incurable and progressive disease is staggering.
Treatment focuses on relieving patients’ pain rather than stopping the disease from getting worse.
Dr. Raj Sengupta, a medical advisor for NASS, told the Daily Mail, “It is heartbreaking as a rheumatologist to see patients in a clinic who have had back pain for years and the cause is attributed to sports injuries or work.
“I will see up to five of these patients a week.
“The pain often first appears when someone is in their twenties, when building relationships and careers, and struggling with symptoms. This can lead to psychological problems and further damage to the spine. “
The condition affects the joints of the spine and causes pain in the lower back and hips.
But another common feature of the condition is pain in the buttocks similar to sciatica, which can lead to misdiagnosis.
Is it back pain or something more serious?
Everyone has back pain every now and then.
But you can have axial spa if you have back pain that:
- Starts before the age of 45
- Lasts at least three months (can be switched on and off)
- Feels worse at night, generally the second half of the night
- Improves with activity and exercise, and worsens with rest
- Responds well to nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, and naproxen
- Often occurs with “alternating buttock pain”
- Often occurs when the flexibility of the spine is limited, which can become severe enough to prevent people from doing their daily activities
Dr. Sengupta, also a consultant rheumatologist at the Royal National Hospital for Rheumatic Diseases in Bath, said: “In Axial SpA, the major joints are the sacroiliac joints, which are above the buttocks, and inflammation in these joints is one of the most important functions.
“The buttock pain radiates from the joints and can go from side to side – this is a classic sign of axial SpA – or just stay on one or both sides.
“The problem with gluteal pain is that it’s often mistaken for sciatica, a common condition caused by irritation of one of the two sciatic nerves that emerges from the spinal cord.
“Sciatica causes pain and tingling in the buttocks and radiates down the leg to the feet, but with axial spa treatment, the buttock pain does not radiate directly to the leg and knee.
“Some people are told they have sciatica when they actually have sacroiliac joint inflammation caused by axial SpA.”
Axial SpA can be divided into two states; non-radiographic spondylitis and ankylosing spondylitis.
The main difference is that non-radiographic spondylitis tends to be the early stage of the disease and doesn’t show up on an x-ray.
This also explains why it can take years to diagnose, since x-rays show no damage until the disease worsens into ankylosing spondylitis.
Some people with non-radiographic spondylitis have inflammation visible on an MRI and can get an early diagnosis.
A blood test can also show if there are high levels of inflammation markers or a gene called HLA-B27, which is found in about 80 percent of axial SpA patients.
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