AS: GETTING YOUR DIAGNOSIS
(AND THE CARE YOU SHOULD EXPECT)
Back pain is very common but in most cases the pain is said to be ‘mechanical' - that is, related to the way the muscles, ligaments, discs and bones work together. For a small number of people, the pain is due to inflammation in the back.
Back pain caused by an underlying inflammatory arthritis is treated very differently so it’s important to get a clear diagnosis.
What are the early symptoms of AS?
If your GP suspects you may have AS, they will want to know if you have any of the following:
- Low back pain that started before the age of 45 years (particularly if it started before 35 years as this further increases the likelihood of AS)
- Waking during the second half of the night because of symptoms
- Buttock pain
- Symptoms that improve when you move around
- Symptoms that improve with non-steroidal anti-inflammatory drugs (NSAIDs), for example, ibuprofen and aspirin
- A close relative (parent, brother, sister, son or daughter) with spondyloarthritis
- Any other type of arthritis
- Pain or swelling in your joints that was not caused by an injury
Will I see a specialist?
Doctors who specialise in arthritis and related problems of the joints are called rheumatologists. They typically treat patients with medication and physiotherapy. If you require surgery at a later stage, you should be referred to an orthopaedic surgeon.
Your GP should refer you to a rheumatologist if:
- Your back pain started when you were under the age of 45 and
- The pain has lasted for longer than three months and
- You have four or more symptoms from the list above
What tests might I have?
If you have three symptoms from the list, you should have a blood test to see if you have the HLA‑B27 gene variant. If the test is positive, you should be referred to a rheumatologist for a diagnosis. A diagnosis of AS should not be ruled out on the basis of a negative test result as a large number of people with AS are HLA-B27 negative.
If you do not meet the criteria to see a specialist but you suspect you may have AS, seek repeat assessments from your doctor as new symptoms develop.
Getting your diagnosis:
GP and personal perspectives
Listen to Poppy and Paul discuss their journey to diagnosis. Dr Danny Murphy also explains the path to diagnosis from the GP perspective