: Insights and Information introduction Population studies have shown that chronic back pain is among the most common problems that cause patients to seek medical care and can be a fairly common complaint among athletes...
: Insights and Information introduction Population studies have shown that chronic back pain is among the most common problems that cause patients to seek medical care and can be a fairly common complaint among athletes also. Recent data from NHANES 2009-2010 report the frequency of chronic back pain (defined as being present on most days for at least three months) to have risen in frequency to 19.3% of the population between the ages of 20 and 65 years, inclusively. Whenever dealing with athletes and back pain, providers should have awareness of inflammatory back pain (IBP).
Spondyloarthropathies (SpA) are a wide group of inflammatory rheumatic diseases with distinct clinical and genetic characteristics. According to their clinical presentation, patients have predominantly axial or peripheral SpA. A major genetic predisposition was suggested in the ยด70s and confirmed latterly by discovering the Human leukocyte antigen B27 as responsible for the disease susceptibility.
Ankylosing spondylitis (AS), a type of SpA, is an autoimmune disease that mainly involves spine joints, sacroiliac joints (SIJs) and their adjacent soft tissues, such as tendons and ligaments. The New York criteria provide classification criteria for ankylosing spondylitis (AS) and require definite radiographic evidence for sacroiliitis on a plain x-ray. The realization that sacroiliac inflammation occurs in advance of and does not always result in radiographic change led to the ASAS (Assessment of Spondyloarthritis) criteria for the classification of axial spondyloarthritis (AxSpA).
These criteria have had a major impact on the diagnosis and understanding of axial spondyloarthritis. The recognition of non-radiographic (nr) AxSpA is an advance that is benefiting many patients who were previously not diagnosable. Thus, spondyloarthritis is an umbrella term that includes both ankylosing spondylitis and nr-AxSpA.
It is also sometimes used to describe individuals with only peripheral joint disease that does not affect the spine. Everyone with ankylosing spondylitis should meet criteria for the diagnosis of AxSpA, but many with AxSpA do not meet criteria for ankylosing spondylitis. AxSpA differs from AS in several major respects.
If you are experiencing symptoms that may be related to axial spondyloarthritis, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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