That acute lower-back pain could be spinal arthritis

PUNE: For two years, Joel (34) had been laid low with back pain and found no relief in physiotherapy, painkillers or traction.

The source of his trouble was bilateral sacroilitis, inflammation of the joint which connects the spine with the pelvis, a classical manifestation of ankylosing spondylitis, a form of arthritis that affects the spine.

The condition often remains misdiagnosed as ‘simple’ back pain for years, said experts.”More cases of ankylosing spondylitis are now being diagnosed by physicians.Initially, these cases were missed. The incidence of ankylosing spondylitis is more in men than in women. The prevalence of ankylosing spondylitis in the population is 0.1% 0.9%,” said orthopaedic surgeon Parag Sancheti.

The disease is more commonly seen in young adults. “We see about 12-14 cases in a month mainly in the 20-40 age group. Patients are generally thin of build and mostly men,” Sancheti said. The early signs are, low back pain, multiple joint pains, morning stiffness, reduced chest expansion, he said.

Sancheti hospital will be raising awareness in and around Pune about arthritis through lectures and camps between October 12 and October 20.

Rheumatologist Pravin Patil said, “Ankylosing spondylitis symptoms, especially in the early stages, can be very similar to common back problems.Many people put up with the pain for some time before seeking help. Also, widely available pain killers like Brufen, Combiflam and Voveran mask the symptoms of ankylosing spondylitis.”

Orthopaedic surgeon Kiran Shete agreed. “Ankylosing spondylitis is a disease of young adults. It is a systemic disease.” Severe hip pain and stiffness are common complaints in patients suffering from it.

“I have been treating anky losing spondylitis patients for several years. They are being diagnosed more commonly now. They come with severe hip pain and stiffness. Some need hip replacement surgery at around 25 and 40 years of age. The best exercise for them is swimming and yoga,” said joint replacement surgeon Mahesh Kulkarni who plans to start a support group for such patients.

The disease has a strong family or genetic linkage because 90% carry the gene HLAB27.Smoking and tobacco chewing can cause acute flare ups, said orthopaedic surgeon Ramesh Ranka.

“It is a chronic condition with episodes of acute flare ups. It affects the spine, peripheral joints mostly lower limb or weight-bearing joints. Early diagnosis can prevent joint fusion, reducing chronic pain and developing disabling postural deformities,” Ranka said October 12 is Arthritis Day.


Author: Dr. Ramesh Ranka

Director- Ranka Hospital, Master in Orthopaedic Surgery (K.I.M.S),  MS (Orthopaedics - Gold medal)