Chronic Back Pain


ปวดหลังเรื้อรัง

ปวดหลังเรื้อรัง อาจเป็นโรคข้อรูมาติสซั่ม

Back pain with different severity degrees can be caused by a wide range of medical conditions. Acute back pain can be treated effectively if accurate diagnosis can be timely made. However, if back pain progresses to chronic and severe pain without adequate response to given treatments, it might strongly indicate arthritic disease, called ankylosing spondylitis. Ankylosing spondylitis is defined as an inflammatory disease that, over time, can cause some of the small bones in the spine (vertebrae) to fuse. This fusing makes the spine less flexible, resulting in stiffness and chronic back pain that can largely interfere with quality of life. If warning signs and symptoms of ankylosing spondylitis arise, medical attention and treatment must be sought immediately.  

Causes And Risk Factors

Definite cause of ankylosing spondylitis remains unknown, although genetic alterations seem to be involved. People who have the HLA-B27 gene are at a greatly increased risk of developing ankylosing spondylitis. However, other contributing factors are certain infections and exposure to particular substances. Men are more likely to develop ankylosing spondylitis than are women while onset generally occurs in late adolescence or early adulthood.

Get To Know Ankylosing Spondylitis

Spondyloarthritis is a group of diseases characterized by inflammation in the spine (spondylitis) and joints (arthritis). Ankylosing spondylitis is one type of spondyloarthritis, defined as a long-term inflammation of the joints of the spine. In severe cases, the body attempts to heal by forming new bones with calcium deposits which gradually fuse sections of vertebrae. This fusion can stiffen the spine, leading to less flexibility, severe back pain and inability to move. In some patients, stiffness of other joints might be present e.g. ankle, knee and hip. Other manifestations of other organs that are induced by chronic inflammation besides spine and joints often include red eyes, blurred vision, pain in the heel or arch of the foot and psoriasis –an autoimmune disease that manifests in the form of scaly red and silvery skin patches.

 Diagnosis

Diagnostic tests of ankylosing spondylitis usually involve:

  • Medical history: The doctor conducts medical reviews to identify pain location, pain intensity and duration as well as to collect patient’s medical history.

  • Physical examination: During physical examination, the doctor might ask the patient to bend in different directions for testing the range of motion in the spine. The doctor reproduces the pain by pressing on specific portions of the pelvis or by moving the legs into particular positions.

  • Blood tests: Blood tests can check for markers of inflammation and the HLA-B27 gene which is a major factor to develop the disease. Nonetheless, people who have this gene might not have ankylosing spondylitis and vice versa, patient can develop the disease without having this gene.

  • X-ray: X-ray is an imaging test to identify the location of inflammation and fusion as well as wear and tear of the spine.

  • MRI scan: An MRI uses radio waves and a strong magnetic field to provide more-detailed images of bones and soft tissues. With high degree of accuracy, MRI scans can reveal evidence of early disease and help to plan treatment as well as monitor treatment outcomes during follow-ups.

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