What’s Causing Your Back Pain

• July 1, 2024
• Dr Peter Landsberg

Last updated on April 23, 2024

Back pain is a prevalent and often debilitating condition that can significantly impact a person’s quality of life. While occasional back pain may be attributed to ageing (for example, spinal stenosis), muscle tension or muscle strain, lifestyle factors, severe or chronic pain as well as unexplained weight loss may signal an underlying medical condition.
In our latest blog post, we explore the diverse causes of chronic low back pain and shed light on specific conditions that rheumatologists can effectively diagnose, treat, and potentially assist you with pain relief.

Common Causes of Chronic Back Pain Diagnosed and Treated by Rheumatologists

• Ankylosing Spondylitis: An inflammatory arthritis primarily affecting the spine, ankylosing spondylitis can cause stiffness, chronic low back pain, sharp pain, and fusion of the spine’s vertebrae.
• Rheumatoid Arthritis: Rheumatoid arthritis, an autoimmune disorder, can also affect the spine and lead to chronic or constant pain.
• Psoriatic Arthritis: Psoriatic arthritis, occurring in individuals with psoriasis, can affect the joints, including the spine, causing persistent pain.
• Reactive Arthritis: Often triggered by infections, reactive arthritis can cause inflammation in the lumbar spine and other joints.
• Systemic lupus erythematosus, an autoimmune disease, can affect the joints, including the spine.
• While fibromyalgia primarily involves widespread musculoskeletal pain, it can contribute to persistent back pain.

Diagnostic Approach to Back Pain by Rheumatologists

• Medical History: Rheumatologists begin by taking a detailed medical history, including the onset, duration, and characteristics of back pain. Understanding the patient’s overall health is crucial in identifying potential sources of chronic back pain and rheumatic conditions.
• Physical Examination: A comprehensive physical exam helps rheumatologists assess joint and spinal cord function, identify areas of inflammation, and evaluate the patient’s overall musculoskeletal health.
• Imaging: X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans can provide detailed images of the spinal cord and surrounding structures. These imaging studies aid in diagnosing conditions such as ankylosing spondylitis or disc-related issues.
• Blood Tests: Rheumatologists may order blood tests to detect markers of inflammation or specific antibodies associated with chronic pain and autoimmune conditions.
• Specialised Tests: Tests like the HLA-B27 genetic test for ankylosing spondylitis can confirm or rule out specific conditions causing back pain.

Medical Treatment Options for Chronic Back Pain

• Medications: Rheumatologists may prescribe a nonsteroidal anti-inflammatory drug (NSAID), disease-modifying antirheumatic drugs (DMARDs), muscle relaxants, or biologics to manage inflammation and support you in gaining pain relief.
• Physical Therapy: Tailored exercise and physical therapy programs designed by physical therapists can help you exercise regularly, improve flexibility and poor posture, strengthen muscles, and may improve acute pain and chronic pain relief.
• Transcutaneous Electrical Nerve Stimulation: TENS, short for Transcutaneous Electrical Nerve Stimulation, employs electric current to activate nerves and help to relieve pain.
• Lifestyle Modifications: Rheumatologists guide patients on lifestyle changes, including maintaining a healthy weight, adopting proper posture, and incorporating low-impact exercises to manage, prevent, and potentially relieve pain.
• Injections: Corticosteroid injections directly into affected joints or around inflamed nerves can provide targeted relief. Rheumatologists may use these injections to manage acute pain, ease pain, and reduce inflammation.
• Surgery: In severe cases where conservative measures are insufficient, surgical intervention may be recommended by your rheumatologists who will work closely with orthopaedic surgeons.

Are you experiencing constant back pain or severe back pain? Speak to a rheumatologist in Brisbane today and discover compassionate healthcare professionals.

FAQs

What are the most common causes of back pain?

Common causes of back pain include muscle strains, herniated discs, degenerative disc disease, spinal stenosis, scoliosis, and conditions like arthritis or osteoporosis. Poor posture, injury, and lifestyle factors can also contribute to back pain.

How does rheumatology address chronic back pain?

Rheumatologists use a comprehensive approach to back pain, including medical history, a physical exam, and tests, to identify the cause and help lessen pain. Treatment may involve medications, transcutaneous electrical nerve stimulation, physical therapy, and, if necessary, surgery.

What conditions related to chronic back pain can rheumatologists treat?

Rheumatologists treat various conditions causing chronic back pain, including inflammatory arthritis (e.g., ankylosing spondylitis), osteoarthritis, and autoimmune diseases like lupus.

What role do medications play in rheumatology treatments for chronic back pain?

Medications prescribed by rheumatologists, such as muscle relaxants, NSAIDs, DMARDs, and biologics, target inflammation, manage back pain, and slow disease progression in conditions like rheumatoid arthritis.

How does physical therapy contribute to the treatment of chronic back pain in rheumatology?

Physical therapy can help to reduce chronic or acute back pain, improve poor posture and flexibility, strengthen muscles, and enhance joint function, assisting with spinal stenosis, autoimmune conditions, and chronic back pain.

Can rheumatologists recommend lifestyle modifications for managing chronic back pain?

Yes, rheumatologists often suggest lifestyle changes to help reduce pain like maintaining a healthy weight, proper posture to support your spinal cord, and physical therapy or low-impact exercises to complement medical treatments and improve overall well-being.