Low back pain is a very common problem all over the world. There are dozens of reasons for low back pain.
The majority of low back pain occurs due to "mechanical" reasons such as structural disorders, slipped disc and herniated disc. Most of this type of mechanical pain is triggered by factors such as straining the waist area, such as lifting something heavy or moving excessively. Again, most of these mechanical pains decrease with rest.
However, Inflammatory low back pain occurs insidiously, without any strain or trauma. The most distinctive feature of inflammatory low back pain is; It worsens with rest and decreases with movement. It is almost the opposite of mechanical back pain. Inflammatory lower back pain is also known as inflammatory lower back pain in medical terms. The inflammation in inflammatory back pain is different from microbial inflammatory conditions such as infection or abscess. In inflammatory back pain, there is "germ-free" inflammation produced by the body itself. Therefore, most of the inflammatory low back pains are defined under the inflammatory rheumatism group called Spondyloarthropathy, popularly known as "inflammatory lower back rheumatism" or "spine inflammation" disease. This Spondyloarthropathy group of diseases includes diseases such as Ankylosing Spondylitis (Suna Pekuysalin disease), Psoriatic Arthritis (rheumatism of psoriasis), and Reactive Arthritis due to Inflammatory Bowel Disease. By the way, not every inflammatory back pain definitely means Ankylosing Spondylitis.
Inflammatory back pain is definitely a condition that should be taken into consideration. Especially in patients younger than 40 years of age, if morning stiffness and lower back pain are experienced for more than 3 months, and if the lower back pain worsens with rest and decreases with movement, these symptoms are most likely caused by inflammatory lower back pain. Rheumatologists pay particular attention to morning stiffness. Restriction in movement lasting at least 30 minutes in the morning is an important sign of inflammatory waist disease in the lumbar region. Many patients say that just opening their eyes when they wake up in the morning is not enough to be ready for the morning. When the patient wakes up in the morning, he/she has difficulty in personal care and wearing clothes. � Many describe feeling a stiffness in their lower back only 2 hours after arriving at work. These patients experience severe pain or lumbar stiffness in the second half of the night, especially between 03:00 and 05:00 in the morning. If he wakes up because of his need, he may realize it while going to the bathroom, but if the pain is very severe, he may also wake up because of the pain. The characteristic of inflammatory back pain is that it decreases during the day and disappears completely in many people. It is relieved by movement and exercises, and many patients give similar descriptions such as "it is as if I am a different person during the day, my pain or stiffness disappears completely, but when I wake up in the morning, I feel like a 90-year-old."
Another feature of inflammatory low back pain is that it responds to anti-inflammatory drugs, which we define as NSAII. If inflammatory back pain is not controlled, it becomes a progressive disease because it can progress in an insidious manner. That's why "inflammatory rheumatism", known as Ankylosing Spondylitis with its inflammatory back pain, is a disease that we, as Rheumatologists, try to make an accurate and definitive diagnosis as soon as possible. If inflammatory lower back pain is not treated in time, it can lead to fusion in the spine. Ankylosing Spondylitis is not just an inflammatory lumbar rheumatism. You may walk around with heel pain for years, and may be accompanied by neck pain and sometimes hip or rib pain for years. Patients who are thought to have low back pain for a long time should be reviewed by a Rheumatologist if their back pain still persists. A patient who has had "mechanical" pain for years may actually develop Spondyloarthropathy, known as inflammatory low back pain. Unfortunately, most of the patients diagnosed with Ankylosing Spondylitis in our country have been diagnosed with "mechanical" disc herniation for years, and some of them have undergone back surgery but did not benefit from it. That's why we should pay attention to low back pain, especially in young people, and diagnose whether it is inflammatory as soon as possible.
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