Can Back Pain Be a Symptom of Axial Spondyloarthritis (AxSpA)?

Back pain is a symptom of numerous conditions and something that most people will experience at some point in their lifetime. The pain can make movement, work, and daily activities difficult. One of the causes of back pain is axial spondyloarthritis (axSpA). This condition is a type of chronic inflammatory arthritis that affects the spine and sacroiliac (SI) joints.

This article will explore when back pain can indicate axSpA, the potential causes of back pain, and treatment options for back pain.

What Is Back Pain?

Back pain is one of the most common medical issues in the United States. It can feel like a sharp, stabbing pain, or it can be a constant dull ache. Back pain can be caused by injury to the back from an accident or fall. Or, back pain can be caused by changes to the spine from degenerative conditions like arthritis.

The back is a complex structure with many parts working together to support the entire body. A problem with any one or more parts of the back can cause pain. The parts of the back include:

• Vertebrae: Many small bones stacked on top of each other that surround the spinal cord
• Intervertebral discs: Pads in between the vertebrae that absorb pressure
• Spinal cord: A collection of nerve fibers that run along the spine, transmitting nerve signals between the brain and the muscles, organs, and other tissues
• Muscles: Body tissue that gives the back support and strength
• Ligaments: Connective tissue that connects bone to bone
• Tendons: Connective tissue that connects muscle to bone

Back pain can present in many different ways and with varying symptoms. Some people have pain in one spot on their back, while others have generalized pain. The pain can move (radiate) to other areas of the back and body.

The pain can worsen after resting for a long time or it can get worse after activities that involve lifting or bending. It all depends on the cause and location of the pain.

Is Back Pain a Symptom of Axial Spondyloarthritis?

Back pain is a common symptom of axSpA. "Axial spondyloarthritis (AxSpA)" is an umbrella term that describes several types of inflammatory rheumatic conditions that cause arthritis, like ankylosing spondylitis. It is a unique type of arthritis because the symptoms come from inflammation in the entheses, the areas of the body where the ligaments and tendons attach to bones.

The two primary symptoms of axSpA are pain and stiffness in the back and hips. The symptoms can be felt elsewhere but are mainly felt in the back. Back pain from axSpA largely comes from arthritis inflammation but can also stem from vertebral fusion.

AxSpA typically causes low-back pain, and it tends to start in early adulthood. It gradually develops and is worse after rest. Those with the condition tend to be stiff in the morning and find symptoms improve with activity.

Treatments and Management of Back Pain

AxSpA is a chronic condition that does not have a cure. However, there are several medications healthcare providers prescribe to help manage back pain and other symptoms. The most common medications used for axSpA are:

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil (ibuprofen) and Aleve (naproxen)
• Biologics, which include tumor necrosis factor (TNF) inhibitors, such as Humira (adalimumab) and Remicade (infliximab), and interleukin-17 (IL-17) inhibitors, such as Cosentyx (secukinumab)
• Janus kinase (JAK) inhibitors, such as Rinvoq (upadacitinib)
• Corticosteroids, such as prednisone

The other mainstay treatment for back pain caused by axSpA is exercise. Many people with axSpA see a physical therapist for a customized exercise plan that focuses on posture training, strengthening, and flexibility.

When to See Your Healthcare Provider

Back pain can be a symptom of so many different conditions or injuries that it may be difficult to determine the exact cause. A healthcare provider can evaluate and diagnose the pain, which will then lead to a proper treatment plan. See a healthcare provider if back pain is new or does not improve after a few weeks.

Other times someone should see a healthcare provider if they have back pain and it is accompanied by:

• Incontinence
• Difficulty urinating
• Fever
• Unintended weight loss
• Weakness or numbness in the legs
• Any back pain that occurs after an injury
  

Summary

Back pain is a common symptom that most people will experience during their lifetime. It can be caused by many different things such as injury, accidents, and degenerative conditions like arthritis. AxSpA is a type of arthritis that affects the spine and hips. One of the primary symptoms of this condition is back pain. Treatment with medication and exercise can be helpful to manage the pain.

If you have unresolved back pain, contact your healthcare provider. They will be able to assess if it is caused by axSpA or something else. If it is axSpA you will need to take medications and start working with a physical therapist to maintain back mobility and reduce pain.