Back pain is extremely common, and most people experience low back pain at least once in their lives. It remains one of the top reasons for doctor visits and missed work. While there are many chronic back pain causes, recent studies show that chronic lower back pain is linked to spondyloarthritis at a strikingly high rate. This is why understanding Ankylosing Spondylitis back pain and spondylitis back pain is important when symptoms persist.
When evaluating ankylosing spondylitis or related conditions, doctors look closely at the type of pain a person is experiencing. Specifically, they check whether the discomfort is inflammatory back pain or mechanical in nature. Many people with spondylitis aches and pains do not realize that their symptoms follow a specific inflammatory pattern.
The lower back and buttocks area experiences dull deep pain which usually affects the sacroiliac joints that connect the spine to the pelvis.
Morning Stiffness: The body experiences intense stiffness which appears during morning hours and after periods of rest but becomes more flexible when the person starts moving.
Neck Pain: The condition causes stiffness which leads to pain that moves from the lower body toward the upper body.
The peripheral joints, which include hips, shoulders, knees and feet, experience pain and inflammation that affects both sides of the body.
The condition known as enthesitis causes pain which develops at the points where tendons and ligaments connect to bones while affecting the Achilles tendon at the back of the heel and the plantar fascia at the bottom of the foot.
A segment from Dr. Michael Weisman’s Spondylitis Educational Seminar presentation (to the right) given in Denver, CO in 2008 describes the differences between mechanical and inflammatory back pain. Inflammatory back pain is the variety associated with ankylosing spondylitis and other spondyloarthritides.
Doctors usually consider the following signs when determining if the pain is inflammatory and possibly related to AS:
| Feature | Mechanical Back Pain | Inflammatory Back Pain |
|---|---|---|
| Typical Age | Any age (often 20–60) | Usually under 45 |
| Onset | Often sudden (after injury/strain) | Gradual (insidious) |
| Rest | Improves the pain | Worsens the pain |
| Exercise | Usually worsens the pain | Improves the pain |
| Morning Stiffness | Minor (lasts <30 mins) | Significant (lasts >30 mins) |
| Night Pain | Rare (except with position change) | Common (wakes you in second half of night) |
The symptoms present in this case suggest spondylitis back pain, but they do not fulfil the requirements for ankylosing spondylitis diagnosis. Physicians need to perform x-ray/MRI tests for sacroiliitis evaluation and HLA-B27 testing and iritis symptom assessment to establish an accurate diagnosis of ankylosing spondylitis.
For individuals seeking further clarity and community guidance, joining an Ankylosing Spondylitis Support Group, exploring Ankylosing Spondylitis Treatment Information, or connecting with an Arthritis Support Network can offer valuable support and education throughout their journey.
