Low back pain is a type of pain that almost everyone can experience at least once in their lifetime. While some of us experience this pain very severely, some of us experience these pains at a lower intensity. One thing to keep in mind is that this type of pain may be a sign of rheumatism, which can involve the spine and the joints inside the hip. Although this type of pain is often on the hip, it can also occur in the lower lumbar region and in the entire spine and neck region over time. The typical example of rheumatic low back pain is Ankylosing Spondylitis (AS).
What are the Characteristics of Rheumatic Low Back Pain?
The characteristics of rheumatism-induced low back pain are the pains that are frequently seen in the society, especially the mechanical pains originating from hernias. Pain caused by rheumatism usually occurs in the 20s, but can also be seen up to the age of 40. Non-rheumatic pains mostly occur after the age of 40. Pain caused by rheumatism is long-lasting. In general, we interpret the pains that exceed 3 months mostly as rheumatism origin. Mechanical pains often subside within 1 month of onset. Pain caused by rheumatism often increases at night after the patient sleeps, and patients often wake up in pain in the morning. These pains decrease as the patient starts the day and walks. However, hernia type pains that we interpret as mechanical often occur when the patient moves or starts his daily work. Mechanical pains decrease as the patient rests. This is the most important clue to separate the two types of pain.
Is There a Blood Test in Differentiating Low Back Pain Caused by Rheumatism?
When we listen to patients with low back pain caused by rheumatism, we can think of such pains. But we need to prove it, that is, to confirm what we think. For this, we often get help from blood tests. Inflammation tests in the blood are elevated in the majority of rheumatic low back pain. In addition, genetic testing known as HLA B27 can help in the diagnosis in needed patients. However, we do not apply this genetic test to everyone. In pain of mechanical origin, blood tests are completely normal.
Although blood tests help us in pain caused by rheumatism, we make the diagnosis clearly with imaging methods. Although we can make the diagnosis with a simple X-ray in long-lasting disease, we often need to receive Magnetic Resonance (MR) support for diagnosis in patients with new or early stage complaints. Since there are typical images for the disease, we can easily make the diagnosis. We can also apply to the MR method in pains of mechanical origin, but the findings in them are very different.
What are the Treatment Methods for Rheumatic Low Back Pain?
Painkillers and anti-inflammatory drugs called NSAIDs are the first choice drugs in the treatment of AS, which is a typical example of rheumatic low back pain. If the patient’s complaints do not change despite the use of these drugs alone or in combination, biological treatments can be started considering the clinical condition of the patient and the severity of the disease.
