The more you rest, the more your waist hurts. Beware of "spondyloarthritis"

Long-term low back pain, and the longer you stay still, the more severe the pain. Experts suggest that this may not be mechanical lumbar muscle strain, but spinal arthritis, which is a rheumatic immune disease that is most common in young and middle-aged men and is easily misdiagnosed or missed.

Mu Rong, chief physician and professor of the Department of Rheumatology and Immunology at Peking University Third Hospital, told reporters that low back pain is medically divided into mechanical and inflammatory types. Mechanical pain, such as lumbar muscle strain, is usually distributed in the muscles on both sides of the human spine; spinal arthritis is inflammatory, and is usually manifested as "lower back pain" or even sciatic pain. As the disease progresses, it gradually develops upward and can reach the neck.

"For lumbar muscle strain, the more you move, the more severe the symptoms; for spinal arthritis, the more you move, the less severe the symptoms." Mu Rong said that there are obvious differences in the characteristics of pain between spinal arthritis and lumbar muscle strain. Spinal arthritis is caused by the local accumulation of inflammatory substances, so the more you stay still, the more painful it is. For example, after sitting or sleeping for a long time, the blood circulation is unable to remove the inflammatory substances in time, which will cause the pain to worsen.

Mu Rong said that patients with spinal arthritis often do not feel much pain when they lie down at night, but as inflammatory substances slowly gather in the lesions, the pain is most severe at 2:00, 3:00, 4:00 or 5:00 in the morning. However, getting up and taking a hot bath or moving around can relieve the pain to varying degrees. If left untreated, spinal arthritis can last for several months or even intermittently for several years.

"Spondyloarthritis has a longer diagnosis period than other rheumatic diseases and is easily delayed in diagnosis. This is because most patients and non-specialist doctors are often unaware that this type of low back pain requires treatment by a rheumatologist." Mu Rong pointed out that spinal arthritis has a certain family genetic tendency and "lower back pain" often occurs, especially in young men. If the elders in the family have conditions such as hunchbacks in old age and low back pain when they were young, they should pay attention to screening for spinal arthritis.

"For patients with spondyloarthritis, taking nonsteroidal anti-inflammatory drugs is often the first choice. Some people have misunderstandings about anti-inflammatory drugs. Anti-inflammatory drugs are not antibiotics or antibacterial drugs, but are used to reduce inflammatory responses." Mu Rong introduced, "For patients who do not respond well to traditional anti-inflammatory drugs, they can choose to take targeted drugs. Biological agents for the treatment of spondyloarthritis used to be very expensive. With the inclusion of drugs such as interleukin-17A inhibitors in medical insurance and their official implementation on March 1 this year, the prices have been greatly reduced, which will effectively improve the accessibility of drugs."