Health: When backpain is really arthritis

By Dr Ellie Cannon, November 5, 2012
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I was taught at medical school to remember that “what’s common, is common”. So if a patient comes into clinic with a sore throat, the chances are it is simply that — a sore throat.

Picking out the unusual diagnoses from seemingly common symptoms is one of the challenges of medicine, particularly when you are in general practice.

Back pain is a really common symptom to see in clinic and usually has no sinister cause. But there are some unusual diagnoses that present as back pain for doctors and patients to be mindful of.

While lower back pain can be caused by physical injury, or slipped discs, for five per cent of sufferers, the pain is due to inflammation caused by a form of arthritis normally seen in young people.

Since back pain is so common, the problem can go undiagnosed for years and lead to long-term damage. But it can be treated.

Called axial spondyloarthritis, or axial SpA, it primarily affects the sacroiliac joint (the junction between the spine and the pelvis). Identifying the difference between this pain and mechanical back pain is vital, and there are a range of signals to look for.

Typically, symptoms first appear in young people in the prime of their lives — this alone should ring an alarm bell — and often they have back pain or stiffness that has lasted for over three months. This is certainly a trigger to go to the GP.

It is common for axial SpA patients to experience pain in the morning which improves with exercise but then worsens with rest. If these symptoms sound like a familiar pattern, a trip to the doctor will be necessary for some blood tests as well as a referral to get an MRI scan.

Diagnosis of this condition has been known to take as long as 10 years for some sufferers, but vigilance from doctors in looking for uncommon causes of a common symptom, should hopefully improve the care that sufferers receive.

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Last updated: 4:05pm, November 5 2012