To Which Doctor for Back Pain

Back pain is a widespread common ailment. Especially young people do not attach great importance to it. But with them the pain can be a symptom of a serious disease: Bekhterev’s disease. And this can only be clearly diagnosed by a specialist. Muscles and ligaments, nerves and vertebrae: back pain can have many causes. Almost one in three Germans regularly suffers from pain in the lower back. If the pain is persistent, we reach for a heat patch or have our family doctor give us an injection. And we resolve to lift properly in the future, to ensure correct posture, to do gymnastics or finally to buy a new mattress. In fact, many sufferers are negligent in dealing with their back pain. Younger people often take it lightly – after all, low back pain is often the receipt for incorrect lifting or one-sided strain. And when office workers stare motionlessly at a screen for long periods, their necks can start to sting.

Interpret symptoms correctly

Back pain can be divided into radicular and pseudoradicular pain. In radicular back pain, a nerve is mostly irritated. Because back pain can have many everyday causes, it is a nonspecific symptom-and that’s what makes it so treacherous when ankylosing spondylitis is the cause. This inflammatory rheumatic disease usually begins between the ages of 20 and 40 and primarily affects the spine. Accompanying symptoms are severe pain at night in the lower spine, a twinge in the neck and limited mobility, especially in the morning. Due to a malfunction in the body, inflammatory processes occur that cause ossification in the axial skeleton – i.e. in the spine, thorax and between the ribs. The body becomes more immobile, the joints stiffen. Often, the disease begins in the pelvis in the sacroiliac joint area and manifests as pain in the buttocks, especially during prolonged sitting. The pain may radiate to the back of the thighs. The hip, knee and ankle joints may also hurt and swell – usually on one side. Because of the non-specific symptoms, sufferers often have to go a long way before they receive their diagnosis. This is made more difficult by the fact that ankylosing spondylitis has a wide range of symptoms, such as inflammation of the eyes or – less frequently – of the lungs, heart, intestines or skin. But because they fall under the specialties of different physicians and are not seen in context, ankylosing spondylitis is often not inferred as a common cause. As a result, it is not uncommon for it to take six to eight years before the disease is clearly identified. However, early diagnosis is crucial in order to be able to combat the symptoms permanently and effectively.

Competent medical specialists

The diagnosis by the specialist can only be as good as the information about the complaints allows him. The orthopedist will take a closer look at the statics of the body and the mechanics of the musculoskeletal system – just right for classic back pain caused by incorrect posture, tension and lifting too heavy. Bechterew’s disease, however, as a rheumatic-inflammatory disease, falls into the area of the rheumatologist. And the detailed description of other diseases or symptoms that are perceived as strange puts the rheumatologist on the right track. Anyone who is regularly plagued by pain in the lower back, without having any explanation for it, should make detailed records of it and supplement these with information about their general well-being. Insomnia and fatigue can also indicate ankylosing spondylitis. The more precisely the rheumatologist can trace the individual medical history, the more precise his diagnosis will be.

Ankylosing spondylitis under control

In many cases, targeted back training is a successful way to relieve back pain. In the past, the fate of Bekhterev’s disease patients was predetermined: The incurable disease resulted in an extremely curved back and joints with severely restricted mobility. However, the use of so-called biologics can stop the development of the inflammatory processes and the resulting ossification of the axial skeleton. In combination with regular physical exercise, such treatment enables patients to lead an active and satisfying life. A prerequisite, however, is the early recognition of ankylosing spondylitis.If left untreated, the inflammation can lead to permanent damage to the spine. Therefore, if you experience recurrent back pain and morning joint stiffness, you should seek advice from a rheumatologist.