Back pain is a common symptom of psoriatic arthritis due to inflammation of the joints in your spine. Over-the-counter medications may help relieve pain, but other treatments include steroid injections and physical therapy.
Psoriasis is an autoimmune condition that usually causes inflamed and patchy areas of skin. Some people with psoriasis develop psoriatic arthritis (PsA). PsA can cause back pain or pain in other joints, such as your:
Back pain may develop by itself or in combination with inflammation in other joints. PsA can develop even without skin symptoms typical of psoriasis.
Read on to learn more about the connection between PsA and back pain.
PsA develops in about
This autoimmune reaction leads to inflammation that can irritate pain receptors and send pain messages to your brain. It can also cause symptoms like stiffness and swelling.
When this inflammation affects the small joints between the vertebrae in your spine, it’s known as spondylitis. This affects about 1 in 5 people with PsA, according to the Spondylitis Association of America.
PsA that affects your spine is called
- gradual onset
- improvement with exercise
- pain at night
Your pain might develop in your:
- lower back
- joints between your pelvis and spine (SI joints)
Other features of back pain from PsA can include:
- stiffness in the morning
- no improvement with rest
- symptoms that flare up for days to weeks and then get better for some time
Back pain is common among people with PsA, but it’s also common in the general population.
Back pain can be either mechanical or inflammatory. Mechanical back pain results from repeated stress on your spine, such as after carrying heavy objects for many years.
A doctor may also order a blood test to look for inflammatory markers in your blood or genes linked to psoriasis.
Having inflammatory changes to your spine alone doesn’t mean you have PsA. Ankylosing spondylitis (AS) is another type of arthritis that commonly causes inflammatory back pain.
Doctors can look for other clues that your pain is likely due to PsA, such as:
Treatment for PsA involves making lifestyle changes and taking medications.
Lifestyle changes that may help minimize your disease activity include:
- attending physiotherapy or occupational therapy
- staying physically active with low impact exercises like swimming or yoga
- quitting smoking if you smoke
- losing weight if you have overweight or obesity
- lowering your alcohol intake
The first type of medication doctors usually recommend is nonsteroidal anti-inflammatory drugs (NSAIDs). These medications are available as tablets, creams, or gels.
If NSAIDs don’t help reduce your symptoms, a doctor may recommend other medications, such as:
- steroid injections
- traditional disease-modifying antirheumatic drugs
- biologics such as tumor necrosis factor inhibitors
- bisphosphonates to strengthen your bones
You may need surgery if your joints become severely damaged.
PsA usually doesn’t affect your life expectancy. The outlook for people with PsA is highly variable. Some people only ever develop mild joint and skin symptoms, whereas others develop severe symptoms that drastically affect their quality of life.
People who have
In a 2018 study, researchers found that axial PsA was associated with more significant disease activity and a greater effect on quality of life than PsA affecting other areas.
Here are some frequently asked questions people have about PsA and back pain.
How common is back pain in people with psoriatic arthritis?
Can low back pain be an early indication of psoriatic arthritis?
Back pain can be the first or among the first symptoms for people with PsA. In some people, imaging tests might show evidence of inflammatory changes around the spine
Are the effects of psoriatic arthritis on the spine visible on an X-ray?
X-rays remain one of the
Back pain is a common symptom of PsA. Many people with back pain also have symptoms in other joints, such as the small joints in their hands or feet.
The outlook for people with PsA varies significantly. A doctor can help recommend lifestyle changes and medications that may help relieve your symptoms.