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
- Psoriasis
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.
What to expect from your GP
Dr Danny Murphy explains more about the role of your GP in the diagnosis and management of your AS
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
April 2018
