Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "

Case study ( 7356 views as of December 21, 2024 )

Randy is a 26-year-old college graduate who has recently been hired at a financial company. Since his late teens he has had low back pain which is getting worse since he is working full time and sitting at a desk job. Last month he had pain and redness in his left eye and an eye doctor told him he had uveitis (inflammation of the middle layer of the eye) which might be associated with back arthritis. His doctor has sent him to an arthritis specialist who has put him on medications for arthritis and referred him to a physiotherapist.

Randy’s pharmacist is worried about the use of these medications as they can cause stomach ulcers. On follow up with the arthritis specialist, Randy has been given information on biologics but he wants to see how he does with physiotherapy and the anti-inflammatory medications first.

Randy’s condition could benefit from seeing a rheumatologist and an ophthalmologist. To strengthen Randy's back, he could benefit from seeing a physiotherapist and a personal trainer. Randy could also ask his doctor as to the benefits of massage therapy and yoga.

Author: Dr. John Wade

Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "

Case Introduction

Ankylosing Spondylitis and Back Pain

Presented by

Dr. Kam Shojania

MD, FRCPC

Rheumatologist

Ankylosing Spondylitis ( 33 engaged.)

Open and print the educational action plan for conversation with your Healthcare provider.

Treatments

Back Strengthening Exercises To Help With Ankylosing Spondylitis

Practitioner help from:

Aaron English

Athletic Therapist
Arthritis Diet - What To Eat If You Have Ankylosing Spondylitis

Practitioner help from:

Erin Meloche

Registered Dietitian
Treating Ankylosing Spondylitis with Biosimilars

Practitioner help from:

Dr. Jude Rodrigues

Rheumatologist

Treatments

Benefits of Yoga For Ankylosing Spondylitis

Practitioner help from:

Heather Greaves

Yoga Instructor
Back Pain and Ankylosing Spondylitis - Treatment Options

Practitioner help from:

Dr. Jude Rodrigues

Rheumatologist
How a Clinical Pharmacist Can Help Manage Your Ankylosing Spondylitis

Practitioner help from:

Tammy Maure

Pharmacist

Conversation based on: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "

Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "

Dr. Duncan Miller MD Family Doctor, Vancouver, BC 13 December 2019 Broadway Plaza Family Practice Vancouver

A few conditions that may cause long-term Lower Back Pain could be: trauma, arthritis, scoliosis or a disc-injury. If you are interested in treatment for Lower Back Pain, seeing a Physiotherapist or Chiropractor could help.

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
- Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 16 May 2022
  
  If you're overweight, it's important to manage your diet, weight, and exercise to limit reduce extra weight on your joints, which can decrease the symptoms of psoriatic arthritis.
Dr. John Wade MD, FRCPC Rheumatologist, Vancouver, BC 07 December 2019 Artus Health Centre

Ankylosing Spondylitis is a long term disease that typically effects young men in the spines. The disease causes back inflammation and stiffness, as well with regions of the spine to fuse together. If you are interested in treatment for your Ankylosing Spondylitis, seeing your Family Physician could help, as they may refer you to a Rheumatologist.

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
- Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 16 May 2022
  
  is Polymyalgia Rhuematica does not respond to a low dose corticosteroid called Prednisone.?
Dr. John Wade MD, FRCPC Rheumatologist, Vancouver, BC 07 December 2019 Artus Health Centre

A few conditions that may cause long-term Lower Back Pain could be: trauma, arthritis, scoliosis or a disc-injury. If you are interested in treatment for Lower Back Pain, seeing a Physiotherapist or Chiropractor could help.

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
Dr. John Wade MD, FRCPC Rheumatologist, Vancouver, BC 14 May 2019 Artus Health Centre

nkylosing Spondylitis Symptoms Ankylosing spondylitus affects about one in a thousand people. It runs in families, and it is associated with certain genes, such as HLAB27, which is the most common gene in ankylosing spondylitus. It typically occurs in men between the ages of 20 to 30, but also occurs in women and children. Ankylosing spondylitis symptoms include pain and stiffness in the joints in the lower back, spine, hips, knees, shoulders, ligaments and tendons. It can be worse in the morning, causing 30 to 60 minutes of stiffness in the spine. Some people experience inflammation of the tendons of the heels, feet or eyes. Over time, the inflammation can cause permanent damage to the joints.

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
K. Michael 06 August 2015

The case introduction video mentions that there is a genetic component to ankylosing spondylitis. Does that mean it's diagnosed by a blood test ?

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
- AllieS 13 June 2016
  
  Identifying the genetic disposition to a condition requires some DNA analysis that can't usually be done by blood alone - samples would need to be sent into a specialized lab so particular genes can be identified. In the case of back pain like Randy's, I would think assessing his postural tendencies would also give some insight into factors that might exacerbate the pain he experiences.
K. Michael 22 June 2015

Many companies are now renovating their office spaces to encourage their staff to get up and move around more frequently. This is due to the rise in back issues amongst office workers

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
- ShirleyG 14 July 2015
  
  This should be encouraged in more work places to ensure staff are keeping mobile.
Dr. Jason Kur MD,FRCP Rheumatologist, Vancouver, BC 23 April 2015 Artus Health Centre

Rheumatoid arthritis is an autoimmune disease that affects the joints and it can cause pain, disability, and loss of function.

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
- K. Michael 30 September 2015
  
  I had a number of back issues following my car accident and had significant back pain. 7 years later I still frequently do the stretching exercises my physiotherapist provided me with for my back.
- K. Michael 20 July 2015
  
  A dietitian can recommend foods that are good for arthritis sufferers. As well as which foods to avoid
- ShirleyG 14 July 2015
  
  Is there any natural treatments for Rheumatoid arthritis ?
Chantal Sayers Vancouver, BC 26 February 2015

Are the symptoms of ankylosing spondylitis the same in women as they are in men?? I'm just wondering if they present with different symptoms?

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
Julianne Petersen Acupuncturist, Vancouver, BC 03 February 2015

This person could benefit from having regular Acupuncture and Cupping Therapy on the back. They can both improve blood circulation to the spine and reduce inflammation. Blood is the penicillin for the body, so everything the body needs and uses to help with health conditions, comes through the circulation.

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
- Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 05 February 2015
  
  I have use acupuncture for my low back on a chronic L5 issue and find it helps reduce the swelling and inflation when it is inflamed.
ShirleyG 30 January 2015

What other symptoms can be a sign of Ankylosing Spondylitis ? Is there something that should be monitored in children ?

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
- Yuan Lew, MSc MBA 01 February 2015
  
  I think it doesn't start until late 20s or so.
ShirleyG 30 January 2015

How common is Ankylosing Spondylitis in women ? It is my understanding that it is found mainly in young men but can also be found in women ?

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
- K. Michael 15 April 2015
  
  I wonder why ankylosing spondylitis is on the rise amongst women ?
- Yuan Lew, MSc MBA 01 February 2015
  
  I just read a recent study that more diagnosis of Ankylosing Spondylitis are made in women now and it is rising. I believe the awareness is there now to rule things out. The majority of people with back pain do not have ankylosing spondylitis. However, if back pain persists without relief from other mechanical back pain strategies, then it's something to bring up to your physician.
Yuan Lew, MSc MBA 24 January 2015

@kimberley, yes, I believe biologics can decrease an individual's ability to fight infections.

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
Carrie Cooke 15 January 2015

Uveitis can cause permanent vision loss - does the Arthritis cause Uveitis, or is it just a symptom of Arthritis?

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
- K. Michael 08 July 2015
  
  This is a good question. What correlation is there between the back arthritis and the Uveitis ?
Yuan Lew, MSc MBA 01 January 2015

From my layman understanding of ankylosing spondylitis, it can take many years of debilitating pain before a definitive diagnosis of AS. This disease affects mostly young men, I strongly encourage any young man with chronic back pain to be an advocate for himself and learn more about AS.

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
- K. Michael 04 January 2015
  
  In my experience men are more likely to ignore back pain and not seek treatment
Yuan Lew, MSc MBA 21 December 2014

What are the long term implications of taking biologics? Can patients become unresponsive to one brand after a few years and have to switch?

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
- K. Michael 23 December 2014
  
  I believe that patients taken biologics have to be carefully monitored. Not sure if they eventually become ineffective but they do put you at greater risk of catching certain diseases
K. Michael 17 December 2014

Seeing a physiotherapist would help Randy learn exercises to strengthen his core and reduce his pain from the ankylosing spondylitis

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
- Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 25 April 2015
  
  Exercise is a big part of strengthening and have flexible muscles.
- ShirleyG 30 January 2015
  
  If there is severe and prolonged pain in the spine, would core strengthening help or could it be something that may further injure the back ? Should strengthening be monitored by a Physiotherapist and/or a Personal Trainer to ensure the individual is exercising/stretching properly ?
Yuan Lew, MSc MBA 11 December 2014

Randy should consult an rheumatologist as soon as possible to pursue whether he has ankylosing spondylitis. The disease is usually confirmed many years after (irreversible) disease onset. If there is no indication but symptoms persists for a long period of time, Randy should return to the rheumatologist for follow up again. Initiating biologics sooner than later may help in slowing down ankylosing spondylitis progression. Some patients have also reported to anecdotally that they benefited from lowering gluten intake.

Reply to: Arthritis and Back Pain - Ankylosing Spondylitis " Randy a 26-year-old college graduate "
- Carrie Cooke 15 January 2015
  
  Seeing a specialist right away will help get a baseline even if there is no definitive diagnosis yet. It sounds awful to be in so much pain. He is so young, and if there is something they can do to ward off further deterioration, or at least find some good pain management then I just don't understand why someone wouldn't do it right away.