When it comes to back pain, it’s easy to make excuses for why we’re hurting. We often blame aches and stiffness on too much exercise, or maybe an awkward sleeping position. When I first became a father, I suffered from back pain. Eventually, I realised the way I was sitting while bathing my daughter in the tub was to blame.
As a doctor, I was 99% sure I had figured out the correct cause of my back pain—and that I didn’t have an underlying health condition that needed treating. For most Americans, though, that kind of “self-diagnosis” isn’t recommended. It can also be potentially dangerous: Some chronic back pain shouldn’t just be waved off or treated daily with over-the-counter pain relievers. Instead, the pain should be something to discuss with your doctor, as it could be a symptom of a more serious health problem.
While there are many reasons for chronic back pain, one such potentially serious health condition is ankylosing spondylitis (AS). AS is a form of inflammatory arthritis that, when severe enough, can make the spine inflexible and severely limit mobility. One of the most common symptoms of AS is lower back pain.
Because it’s possible to manage the symptoms of ankylosing spondylitis, finding AS early can go a long way in reducing the risk of long-term damage to the spine. The problem: AS isn’t usually diagnosed until a person has had it for several years. That’s partly because it can take several years before the damage to the vertebrae (bones of the spine) can be seen in an X-ray. Plus, AS is most common in men under age 45—a group that tends to not visit the doctor as much as others.
But there are some warning signs that that could mean you have AS. Your back pain may warrant a discussion with your doctor and a rheumatologist if it:
- First started before you turned 45
- Began with no apparent cause
- Is worse at night and gets better upon waking up
- Improves with exercise or with non steroidal anti-inflammatory medicines (NSAIDs)
- And does not improve with rest
If the above describes the back pain you’re currently experiencing or have had in the past, do your back a favour and schedule a visit with your doctor. He or she can refer you to a rheumatologist, who is best prepared to test you for ankylosing spondylitis and other inflammatory rheumatic diseases.
Andrew Koenig, D.O., F.A.C.R., is a rheumatologist and the Inflammation/Immunology Group Lead for North America Medical Affairs at Pfizer, Inc
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