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#372472 01/12/10 03:42 AM
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Hi all.

So this is going to be my first post here. I hope I can gain some perspective and understanding about whatever it is that's going on with me.

I am a 25 year old student / young professional. I don't remember having any long-standing back problems in my life. I had the odd strain and pull but it was rather self-limiting. Over the last two weeks, though, I've been waking up with quite a sharp pain in my lower back. I went to the doctor and they gave me a series of stretches and 'best practices' for back health; which I suppose is better than nothing.

I've been reading that AS is something that comes on gradually. I must say that my pain arrived quite fast - one morning I was fine and the next I was in pain. I wake up around 5 hours after falling asleep with bad back pain which disturbs my sleep for the remainder of the night / morning; but isn't really enough to get me out of bed. Once I do get up, my pain fanishes in literally minutes.

Essentially I am interested in differential diagnoses. What else other than AS could be causing back pain specifically in the morning? I'm guessing there are other possibilities. I've becoming aware of my particularly bad posture while sitting at my home computer. I also work in an office and am at a computer all day. One possible explanation that I thought was logical was the fact that I've gained weight in my mid-section. I feel that my belly is pushing up against my spine because the sheer size of my stomach is becoming so big. What do you think of this possibility? I hear that AS can cause people to lose weight, but I'm thinking that it might give me an advantage, heh.

I believe that jumping to the conclusion of AS so soon after getting pain is frankly rather silly. I just don't think I've had the pain long enough (but I guess you never know).

Anyways, thanks for reading my post. I'm sorry that I may not be able to contribute as much as I would like because I'm really not well-educated about AS. Forgive me if I'm more of a taker of information than a giver (at least for the beginning).

Cheers smile

Last edited by t_star; 01/12/10 03:44 AM.
t_star #372478 01/12/10 07:16 AM
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Hi T_Star and Welcome,

Don't worry about taking information - there is so much here, it is great.

Sorry, not being a medico I can't really add much perspective to your symptoms, only to say that in my case AS came on gradually over many years.

There is so much that can be wrong, I guess your Doctor will be trying to whittle it down to a diagnosis.

All the best,

James


I ache, therefore I am

t_star #372486 01/12/10 08:54 AM
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my inflammatory arthritis (which may be a form of spondy (even AS) or some other form of autoimmune inflammatory arthritis, doctors still working on it, both "came on suddenly" and "has been slowly progressing". what i mean by that is quite suddenly with no musculoskeletal problems that i was aware of (or so minor i just brushed them off), in winter 1998, had an episode of rib pain like nothing i had ever experienced, after a week or two it settled down, then a few months later (july 98), i was hit with horrific dq tendonitis in my left wrist and 2 weeks after that my left upper back became a nightmare which to this day is still a problem to be managed (was actually out of work with a flareup of that this fall and winter but its slowly getting better) and a month and a half later (sept 98), my right dq tendon joined in the party. then again, about 2 years later (oct 00), the SI kicked in, in a big way, from no symptoms to on the floor in spasms and using a walker for a week or two and dealing with the aftermath of that. then the feet kicked in maybe a year or so after that, never an issue, and then one day.......and finally after years of orthopedists and PTs treating the tendonitises and torn tendons and SI, a physiatrist told me she was pretty confident that i had a rare form of autoimmune inflammatory arthritis that might not even have a name. but going to a rheumy turned up empty, so continued with PT and physiatry (physical medicine, rehabilitative medicine) until in the summer of 2006, when my right hip and 2 weeks later, my left ulnar wrist became involved in a big way, too big to just keep going on the way i had been. and in the summer of 2007, the hamstring tendons where they attach at the knees. and all along the spine (neck and thoracic) just a little worse each year. and other lesser tendon issues that i just kind of treat as they come up: a torn rotator cuff, a torn bicep tendon, etc) describing it so you see for me both "sudden for each new body part" and "slowly progressive for each one to become involved".

don't know if your issues are a chronic musculoskeletal / arthritis problem or not? only doctors would be able to sort that one out, and it could take a short time or a long time for them to know. but even if they don't know, like they didn't for me for years, doctors and especially PTs may be able to give you tools to improve your symptoms. i've mostly managed mine (even with it being a chronic arthritis) with heat and ice and exercises and avoiding the things that make it worse. since mine is a chronic illness, i've also needed drugs, and that's where the doctors and dx come in to play, i think. i will say, even with mine being a chronic arthritis, the management of symptoms in the same way as everyone else has been helpful. this means, finding a good bed (mine's a lot better than the old one but not perfect so rather than recommend mine, would suggest you search "Beds" on this site), a good chair (for me, the swopper chair (a stool on a spring, you can google swopper) really helps to strengthen my back muscles and force me to sit with good posture (it has made more difference than almost anything for my back), a good car seat (my old 1995 saturn is better for sitting than any of the newer cars i trired back in early 2000s when hubby needed a new car). what works for you would probably be different than what works for me, but i do think from the conversations on here that many of us find the right bed, chair, car seat to make a difference. and i'd suggest going to PT to learn exercises for your back muscles, even if the problem is a chronic musculoskeletal problem, keeping the muscle strong through PT can make a difference.

i am a professor at a university and interact closely with many young college students. it amazes me how so many complain of back pain, like i didn't have til i was in my mid to late 30s. and when i've shared what i've shared with you just now and they watched their sitting posture and started exercising, they saw a huge improvement. sitting so much, in bad chairs especially, is so not good for us.

and it could also be a mechanical spinal problem.

the best way to differentiate is to see doctors, even if the dx takes a while.

so, yes, hard to tell the cause, but doctors may have a better idea.

but i do understand the "not moving makes it worse, moving makes it better"....



sue

Spondyloarthropathy, HLAB27 negative
Humira (still methylprednisone for flares, just not as often. Aleve if needed, rarely.)
LDN/zanaflex/flector patches over SI/ice
vits C, D. probiotics. hyaluronic acid. CoQ, Mg, Ca, K.
chiro
walk, bike
no dairy (casein sensitivity), limited eggs, limited yeast (bread)
t_star #372509 01/12/10 03:05 PM
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Originally Posted By: t_star
I believe that jumping to the conclusion of AS so soon after getting pain is frankly rather silly. I just don't think I've had the pain long enough (but I guess you never know).


Two weeks of low back pain that goes away within minutes of getting moving is not normally enough to indicate AS. Has your doctor suggested that this is the problem? Do you have a family history of this disease or of chronic back problems?

t_star #372510 01/12/10 03:14 PM
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Hi there and welcome to KA. smile

What you may be experiencing (and I am by no means a doctor or expert) is strain due to sitting at your computer all day, or it could be early signs of AS. According to the NHS Website (I've linked that for you) , these are the signs to look for in AS:

"The main symptoms of ankylosing spondylitis are:

"back pain and stiffness,
"buttock pain,
"joint inflammation (arthritis),
"enthesitis (painful inflammation where tendons or ligaments attach to bone), and
fatigue."

"Back pain and stiffness are usually the main symptoms of ankylosing spondylitis. The pain tends to differ from other types of backache. If you have ankylosing spondylitis, you may find that:

"your pain gets better with exercise, but not with rest,
"your back is particularly stiff in the morning, lasting for more than 30 minutes after you start to move around,
"you wake up in the second half of the night with pain and stiffness, and
"you have pain in your buttocks, sometimes on one side, and sometimes on the other.
"As well as causing symptoms in your back and spine, ankylosing spondylitis can also cause arthritis in your hip, knee and other joints."


Bear in mind that we are not all alike and can have quite divergent symptoms. If you're a woman, it could vary even more, but those listed above are a pretty good start. I'm hoping that what you're experiencing is strain due to bad posture/ergonomics at your computer, or a bad mattress. I wouldn't wish this AS on anyone.

Hugs,


Kat

A life lived in fear is a life half lived.
"Strictly Ballroom"

Inanna #372573 01/12/10 10:25 PM
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Thanks for the replies everyone.

JimmyWA: I think my doctor will eventually wittle it down to a diagnosis. Perhaps it's just a matter of time.

Sue22: Thank you for your in-depth story. I think my computer at work is fine; the monitor is up really high on a kind of platform so it forces me to keep my back straighter and my neck looking almost on a slight upward angle. I agree, 25 is too young for back pain! Or is it? Apparently not...

Stormy: My doctor hasn't stated that it's the problem. I found this site on my own research. And I don't really have a family history of back problems, no. Heart problems yes, but that's a whole other can of worms ... (I think .. you never know how these medical conditions can be related).

Inanna: Thank you for the detailed symptom synopsis. I can certainly understand the back stiffness. I don't think I'd be able to tell the difference between 'arthritis pain' and 'enthesitis pain'. Are there any hallmark differences? I certainly don't have buttock pain though.

Actually, another thing I ment to mention is that the pain is really in the middle of my back; not the lower back pain that I often see people noticing. Does the specific location make a difference?

Thanks for everyone's help!

t_star #372630 01/13/10 01:55 PM
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Hi there, the location of the pain can make a difference when doctors are trying to pin down a diagnosis. "Classic" AS generally starts in the sacroiliac (SI) area and is evidenced by buttock pain (sciatic nerve problems are often an early sign of SI inflammation). That said, and as I noted earlier, there can be a diverse array of early symptoms. Some people have pain in their necks first. My thoracic area (mid/upper back) was one of my first hot spots (along with my SI), but has never (touch wood) gone beyond stiffness and a sickening ache. And there's a spot around my Occiput (just below where the skull sits on the top neck vertebrae) that's caused me trouble for just as long. It all started with general back pain in my teens for which I attended at a chiro, and progressed over about 20 years to my diagnosis.

The difference between enthesitis pain and arthritis pain can be difficult to pinpoint. We all kind of learn to know in our own bodies. The enthesis points are where the ligaments/tendons join to the bone on either side of the joint. So, the location of the pain can be helpful, but not always. It's all so darned subjective and maddeningly arbitrary at times.

Hope that helps.

Hugs,


Kat

A life lived in fear is a life half lived.
"Strictly Ballroom"

t_star #372656 01/13/10 05:56 PM
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Hi t_star...and welcome!

I was always able to find an excuse to my pains growing up...sore knees in school were because I played basketball. Sore back was because of poor posture...sore hips and SI were because of being pregnant and having big babies...sore jaw was cos I clench at night...sore shoulders because I sleep on them funny. Symptoms always moving around...only constant was SI joints. My brother was diagnosed first...and prompted me to see a rheumy...where they diagnosed me. He has it more severe than I do, and we suspect that my Mom has it too, although she just says it's age. (sigh)

Hope you find the cause of your soreness, and are able to get some relief.

So,,,pull up a chair, grab a coffee...and read! Lots to see here...and don't forget to post! smile

Cheers,

Steph


t_star #372663 01/13/10 06:21 PM
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my SI pain is mostly a pain in the butt.... literally! only when its really bad does the lat muscle (lower back) spasm strongly, but always a pain in the butt, to some degree. also pain the thoracic spine (mid to upper back), not too bad, just an ache if i've been sitting or standing or laying too long. and my neck, cervical spine, can get this hot burning sensation if sitting too long. and that occipital pain kat mentioned, i used to get that along with my migraines, remember asking hubby "to squeeze my neck", that was the first pain i had, that and the burning in the cervical spine when sitting and working with head down for too long, 10 years or more maybe before i considered that i had problems, as those pains would go away if i just got up and moved around and stretched my neck.

for me, a lot of my problems are tendon and ligament problems, tendonitis or torn tendons or ligaments if worse. but no matter how bad they get, its always localized right where they attach to the bone, the enthesis, even when i've needed cortisone shots. always at the attachment points.

and as steph described, took awhile to realize i just couldn't explain it all away, though my mother is still trying to explain her's all away and she's 20 years older than i am, but not as bad off.



sue

Spondyloarthropathy, HLAB27 negative
Humira (still methylprednisone for flares, just not as often. Aleve if needed, rarely.)
LDN/zanaflex/flector patches over SI/ice
vits C, D. probiotics. hyaluronic acid. CoQ, Mg, Ca, K.
chiro
walk, bike
no dairy (casein sensitivity), limited eggs, limited yeast (bread)
Sue22 #372678 01/13/10 09:06 PM
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that occipital pain kat mentioned, i used to get that along with my migraines, remember asking hubby "to squeeze my neck"

Sue, I'd forgotten about that. I knew by the time I was 18 and in theatre school that if someone held my head on each side and pulled up, the pressure in the back of my skull would ease. When I started working with student chiros at the Canadian Memorial Chiropractic College, they started doing that for me as well. Not because I asked them to, but because they knew that based on my description, it would help. I get atypical optical migraines that I am certain originate in the occiput because although I don't get pain with them, there is pressure back there that increases during the migraine. Nobody can figure out why I get them and the neurologist I saw in November said I was normal. Yup I'm normal in the way that I get atypical optical migraines. Whacky. crazy But colour me relieved!

I also knew by the time I was 18 that if I laid down on a bench and one person grabbed my feet and pulled while I held onto the armpost by my head, the stretch would ease my thoracics.

Odd, the things that come back to you sometimes. I'd forgotten about that until I read your post.

Warm hugs,


Kat

A life lived in fear is a life half lived.
"Strictly Ballroom"

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