How Common Is RA Back Pain?
When back pain is RA related,inflammationin the cervical spine is usually the cause.
The spine is affected when RA progresses.
Paul Bradbury/Getty Images.
In other words, inflammation in the back and spine may indicate a more advanced disease.
However, the damage can be seen onX-raysas early as two years after diagnosis.
A 2015 report suggests that more than 80% of people with RA have some cervical spine involvement.
Effects of RA on the Back
RA causes inflammation in joints.
Thecervical spinehas seven vertebrae, or bones.
RA inflammation typically affects C1, also called the atlas, and C2, also called the axis.
C1 and C2 are the uppermost vertebrae and they have synovial-lined joints like those of the peripheral joints.
This causes swelling and pain and joint erosion over time.
RA can also affect thefacet jointsof the spine.
They connect to the bony bumps you feel down your back.
The facet joints support the movement and flexibility of your spine.
RA can cause the facet joints to become inflamed resulting in neck and/or back pain.
Sometimes, chronic inflammation can cause damage to the facet joints and make the spine less stable.
C1 and C2 also are unique vertebrae that do not have discs between them.
This can lead toosteoporosis, also known as low bone mass, that increases the risk of bone fractures.
When RA affects the spine it typically involves the synovial joints at the neck.
These joints are similar to peripheral jointsthe primary throw in of joint affected by RA.
The facet joints located along the back of the spine can also sometimes be affected.
Inflammation from RA can make the vertebrae unstable, increasing the risk that they will slip out of place.
An unstable or damaged vertebra can press on other vital parts of the body.
It can also cause severe pain, deformity, and loss of height.
The first thing they need to do is determine whether back pain is acute or chronic.
If your healthcare provider thinks there is facet joint involvement, amedial branch nerve blockmight be done.
If the pain resolves, this confirms facet joint involvement.
A medial branch nerve block involves injecting anesthetic near the small medial nerves connected to a specific facet joint.
More than one level is injected.
This procedure is for diagnostic purposes only.
For most people with RA back pain, treatment is non-surgical and will include a combination of therapies.
Non-surgical treatments may include:
Spinal injectionscan also be quick way to relieve RA back pain.
This usually involves a corticosteroid or anesthetic in the nerve region affected by RA inflammation.
The effects of the medication may last weeks or even months.
A surgeon can discuss all your options and the pros and cons of each method.
Summary
Back pain in common in those with RA.
Treatments can help with pain management and/or to slow the progression of RA.
2015;2015:1-12. doi:10.1155/2015/252456
Kothe, R.Low back pain in rheumatoid arthritis.
Z Rheumatol (2017) 76: 869. doi: 10.1007/s00393-017-0363-8
American Association of Neurological Surgeons.Vertebral compression fractures.
American Academy of Orthopaedic Surgeons.Spondylolysis and spondylolisthesis.
American Association of Neurological Surgeons.Minimally invasive spine surgery.
Cleveland Clinic.Back health and posture.
Updated April 16, 2019.
