Evaluating Inflammatory Versus Mechanical Back Pain in Individuals with Psoriatic Arthritis: A Review of the Literature

Grinnell-Merrick, L.; Lydon, Eileen; Mixon, Amanda M.; Saalfeld, William

doi:10.1007/s40744-020-00234-3

Cited by 9 publications

(7 citation statements)

References 109 publications

(182 reference statements)

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“…Patients often complain of long-standing back pain with an insidious onset before any other symptoms. The rheumatologist needs to differentiate between inflammatory back pain (IBP) and mechanical back pain (MBP), as both of them may occur in axPsA patients and their accurate differentiation allows for appropriate treatment administration [ 30 , 37 ] ( Table 2 ). Patients with IBP usually complain of lower back stiffness in the morning for at least 30 min, with no improvement at rest, sometimes waking patients at night or early in the morning, with an improvement in symptoms after starting physical activity and a good response to non-steroidal anti-inflammatory drugs (NSAIDs) [ 15 ].…”

Section: Resultsmentioning

confidence: 99%

MRI Findings in Axial Psoriatic Spondylarthritis

et al. 2023

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Psoriatic arthritis is a significant medical condition with a high prevalence, a wide variety of non-specific symptoms, and a high degree of overlap with other spondylarthritis disorders, particularly ankylosing spondylitis. Hence, knowledge of the magnetic resonance imaging (MRI) manifestations and a multidisciplinary strategy are required for the better management of these patients. We searched publications from the last 10 years and focused on the most relevant ones which discussed the classification criteria, the MRI characteristics of axial psoriatic arthritis, the importance of MRI for follow up, and the reliability of skin and synovial biopsy. Axial spondylarthritis can be diagnosed and followed up on using the well-established MRI technique and, additionally, a biopsy. The analysis and concordance between them can provide new directions for future studies.

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Section: Resultsmentioning

confidence: 99%

MRI Findings in Axial Psoriatic Spondylarthritis

et al. 2023

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“…However, there is limited, clear evidence of LBP and arthritis interaction. Non-mechanical causes, such as rheumatologic origin, lead to increasing pain severity [ 16 ]; moreover, mechanical LBP was associated with low physical activities, psychological symptoms, and functional limitations [ 17 ], which are significant moderate associations in people with rheumatoid arthritis [ 18 , 19 , 20 ]. Although there are conflicting results of inflammatory indicators in people with LBP, most previous studies indicated inflammatory components in people with LBP [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Risk Factors Associated with Low Back Pain in the Saudi Adult Community: A Cross-Sectional Study

Alhowimel

Alodaibi

Alshehri

et al. 2021

IJERPH

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Worldwide, low back pain is common and linked with many risk factors. There is a lack of studies in the Saudi Arabian community on low back pain prevalence and risk factors. Therefore, the present research will investigate the prevalence of low back pain in the middle-aged and elderly community population and examine the risk factors contributing to low back pain in Saudi Arabia. The present paper is a cross-sectional study of the community living in Riyadh and the surrounding areas in Saudi Arabia. Data were collected between October 2019 and April 2020 via trained research assistants. A total of 276 participants were included in the analysis. The prevalence of low back pain was 27.9% (n = 77) among the participants included in this study. All participants reported low back pain severity with a mean of 4.35 ± 2.19 on the pain rating scale. Older age, arthritis, hypertension, anemia, osteoporosis, and a history of fractures were all associated with having LBP. Low back pain is highly prevalent in the Saudi community adult population living in Riyadh and its surrounding areas. More than a fourth of the sample reported experiencing back pain. The study outlines several modifiable risk factors (BMI, education, employment status, marital status, and smoking status) and unmodifiable risk factors (arthritis, hypertension, anemia, osteoporosis, and a history of fractures) associated with low back pain in the study sample.

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“…To screen for peripheral arthritis, practitioners should evaluate patients for swelling and tenderness, which can be indicative of synovitis and inflammation, as well as commonly affected joints, such as feet and hands, knees, wrists, ankles, and shoulders [24]. Axial arthritis can be an indicator of higher disease severity [49] and commonly presents with slowly developing inflammatory back pain (IBP) [50][51][52]. IBP is defined by the Assessment of SpondyloArthritis international Society as chronic back pain for at least 3 months, with onset before the age of 40 years, pain that causes waking during sleep, and stiffness that improves with activity [53][54][55].…”

Section: Key Clinical Features For Differential Diagnosis Of Psamentioning

confidence: 99%

“…IBP is defined by the Assessment of SpondyloArthritis international Society as chronic back pain for at least 3 months, with onset before the age of 40 years, pain that causes waking during sleep, and stiffness that improves with activity [53][54][55]. Since patients present with back pain in general medicine settings for a variety of reasons [56], it is important to distinguish IBP from mechanical back pain, the latter of which is an injury or structural abnormality in the lower back [50,57]. Axial PsA is associated with a particularly high incidence of sacroiliitis, which can present as bilateral and symmetric, based on genetic status (HLA-B27).…”

Section: Key Clinical Features For Differential Diagnosis Of Psamentioning

confidence: 99%

Differentiating Psoriatic Arthritis from Osteoarthritis and Rheumatoid Arthritis: A Narrative Review and Guide for Advanced Practice Providers

Saalfeld¹,

Mixon²,

Zelie

et al. 2021

Rheumatol Ther

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Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects multiple organ systems and is characterized by skin and joint manifestations. PsA is frequently undiagnosed and/or misdiagnosed, especially because of the similarities in clinical presentation shared with other arthritic diseases, including rheumatoid arthritis (RA) and osteoarthritis (OA). An accurate and timely diagnosis of PsA is crucial to prevent delays in optimal treatment, which can lead to irreversible joint damage and increased functional disability. Patients are usually seen by a number of different healthcare providers on their path to a diagnosis of PsA, including advanced practice providers (APPs). This review provides a comprehensive overview of the characteristic features that can be used to facilitate the differentiation of PsA from RA and OA. Detailed information on clinical manifestations, biomarkers, radiologic features, and therapeutic recommendations for PsA included here can be applied in routine clinical settings to provide APPs with the confidence and knowledge to recognize and refer patients more accurately to rheumatologists for management of patients with PsA.

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Evaluating Inflammatory Versus Mechanical Back Pain in Individuals with Psoriatic Arthritis: A Review of the Literature

Cited by 9 publications

References 109 publications

MRI Findings in Axial Psoriatic Spondylarthritis

MRI Findings in Axial Psoriatic Spondylarthritis

Prevalence and Risk Factors Associated with Low Back Pain in the Saudi Adult Community: A Cross-Sectional Study

Differentiating Psoriatic Arthritis from Osteoarthritis and Rheumatoid Arthritis: A Narrative Review and Guide for Advanced Practice Providers

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