This guest post is by Philip Robinson. Philip is a rheumatologist working in the Ankylosing Spondylitis clinic at the Princess Alexandra Hospital in Brisbane. He is also completing a PhD in the genetics of Ankylosing Spondylitis at the Diamantina Institute of the University of Queensland.
By Dr Philip Robinson, Rheumatologist
So, firstly I would like to thank Irwin for giving me this opportunity to write on a subject I feel very passionately about. Irwin is fantastic for all the work he puts into patient education and teaching.
I have seen a number of patients recently who haven’t been diagnosed with their Ankylosing Spondylitis (AS) for many, many years, the most recent was about 25 years.
Now this is an extreme example, but the average time from when a person gets their symptoms to when they are diagnosed is about 8-10 years, depending on what study you look at and whether you are a man or a woman.
There are a number of factors which influence this.
Firstly, back pain is really common in the community, and so people hear about back pain all around them. This tends to “normalise” this in their mind, and they also see people complaining of back pain and not getting help. This will tend to make people not seek help for their back pain.
Often, people also don’t understand that all back pain isn’t the same.
A lot of back pain is mechanical. A lot may be caused by wear-and-tear.
There are other types of back pain that aren’t as common. One example is Ankylosing Spondylitis.
There are effective treatments for AS, and not only expensive ones (such as the TNF inhibitors). Appropriate exercise can make a big difference. And, about 1 in 3 people with AS go into remission (yes, almost all of their symptoms go away) with just non-steroidal anti-inflammatory drugs (NSAIDs).
(Please note you shouldn’t use non-steroidal anti-inflammatories for ankylosing spondylitis, or any other type of chronic back pain, without a doctor supervising the treatment. All medicines have risk and benefits which need to be individualised to the patient.)
One of the other reasons why it takes a long time to be diagnosed is that family doctors see a lot of back pain too and sorting out the early AS from the wear and tear back pain can be very difficult.
The chance of having early AS increases if you are young (what does that mean? – well in this context it means before the age of 45 years), and have had back pain for longer than 3 months.
If this is the case then talking to your family doctor about it is a good idea.
So my question to you is, how do we make sure people who may have early ankylosing spondylitis know about this important topic and get the help they need early?
Philip Robinson uses social media to help improve awareness of rheumatic disease.
Please follow Philip on twitter @philipcrobinson
