Is it unusual to have RA in your lumbar spine?

(I'm 26, so it's unlikely to be osteoarthritis, although not impossible.)

It is suspected (by my GP and my osteopath) that I have inflammation in my sacroiliac joints and facet joints. Rheumatologist is not convinced and said that RA in the lumbar spine is rare but has conceded that my high pain levels plus very restricted lower spine movement is puzzling, therefore needs further investigation. I'm waiting to get a date for an MRI scan.

Is anyone else in similar position? How do you manage the pain? It's just unbearable, especially when trying to get comfy in bed. <sigh>

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  • I was diagnosed with OA of my lumbar spine at aged 26 (had surgery at age of 34) so it is possible, and have now been diagnosed with ankylosing spondylitis which by what you are describing is pretty much how I have been for the last 24 years of my life. I also have it in my neck . I have spent thousands seeing chiropractors and physio's over the years because at the age of 28 I was told that I had to learn to live with it although "it" wasn't given a name until last week! Over the years, because I was never given a proper diagnosis apart from the OA, I just treated it myself, with Ibuprufen, paracetamol and hot water bottles. I was prescribed amitriptyline for back pain but had to come off it as it gave me palpitations. I have now found a lovely physio who has convinced me that exercise is the key, along with gentle massage. She found some very gentle yoga exercises on YouTube which I am able to do. It hurts but the benefits are immense. I rest when it's too bad and then get moving when I can. I hope this helps. Clemmie

  • I've also found that if I am lying on my side, pillows along my back help to support it. Tens machine has also helped in the past but as Clemmie says I think that gentle exercise and weight control is key. I have allowed my weight to get out of control and it has definitely made it much worse.

  • Did your rheumy talk about the different spondyloarthritis conditions? As these do tend to affect back more than classic RA. Hope you get MRI soon and a firm diagnosis.

    In the meantime, as well as talking to GP about pain control by chemical means do also try out other things. Many people find a body pillow really helps at night, as do hot wheat packs. You can also ask to be referred to a pain clinic if there is one in your area, as they help show you how to manage as best possible. I have osteo in lumbar spine (RA elsewhere) and yes it hurts! But only rarely now and usually because I've done something stupid, like sit slumped on a soft sofa all afternoon.

    Keep nagging to get that scan.

  • Hi, I know how you feel. I too suffer.

    Pain in the lower back. Had MRI and the L3, 4,&5 discs

    Were arthritic and I do have RA. Also they were slipped

    And pressing against nerves in spine. Curent treatment not a fix are shots of prednisone to releve inflammation

    and pain.good luck and hope your pain eases up.

  • Hi crash doll

    Sorry to hear you are suffering I've had back problems since I was a teenager and diagnosed with RA at 26. I am 47 now and just had my first MRI which shows OA, degeneration of lumbar discs 3,4,5 and inflammation in the Facet joints ( luckily no trapped nerves) I have seen a physio for 5 months and if I do the exercises he prescribed twice a day the pain in my groin stays away but my back is very stiff first thing and when I stand still. I have a flare in my right wrist, having more IV Rituximab next week but as soon as I'm less sore I am going back to the gym and going to give Yoga a go. I did it years ago and it was brilliant for backache. I hope your MRI isn't too long away ( I waited 6 weeks). Let us know how you get on. Take care Kiki

  • Ankylosing spondylitis seems more likely in that position and in your age group. Has this been considered?

  • I'm inclined to agree with the answers already posted & the ideas to relieve the symptoms. I have been diagnosed with cervical spondylitis but suspect I also have the beginnings on ankylosing spondylitis as have been experiencing similar milder symptoms of cs in my lower back & intend bringing the subject up with my Rheumy at my next visit. Since I started suffering with this back pain I've recently been researching & it would seem that the UK doesn't generally recognise that RA can present itself in the spine, conversely the USA does!

  • You could have a type if RA call Spondylitic arthritis. It tends to start at a younger age like you. Look it up it might fit what's going on with you.hope you get some relief.

  • Inflammation in sacroiliac joints is a hallmark of ankylosing spondylitis, and your age fits well with that (onset before age 30). AS can also affect any part of your spine and you can also have enthesitis (inflammation at the point where tendons join onto bone). For an ankylosing spondylitis diagnosis, you have to show actual damage on the sacroiliac joints, but if there is inflammation showing on the MRI in the right places, then it can lead to an axial spondylitis diagnosis, which is considered pre-AS. Treated early it may never get to visible damage on xrays.

  • Interesting replies. Thank you, it has given me a lot to think about.

    I have atypical RA. I'm seronegative with a persistently high ESR but normal CRP. I present with minimal swelling but scans have shown synovitis and I have experienced multi site joint erosions. My rheum said she would have thought my condition would be less aggressive, given my negative blood tests. I'm on humira, leflunomide and MTX just to keep me functioning.

    I've had RA symptoms since summer 2009 and was dx in November 2009. Funnily nought though, my back symptoms did not start until 2012. I assumed it was my right hip and so did my rheum, she said that RA in hip is not uncommon. I was given physio and (eventually!) an MRI for 'hip pain'. After getting the all clear re: my MRI, I just assumed it was minor muscular pain and felt like a major hyperchondiac. I did once ask if it might be a spine issue but rheum said it rarely affects the spine, so I left it alone till things got horrendous. My osteopath said that most people with as sacroiliac joint problems think it's their hip/s. I do feel a tad foolish though!

  • Silly iPad won't let me edit.

    I was checked for HLA B27 (had to google that!) at dx and I was negative. I do have a family history of inflammatory bowel disease and there is a familial link with seronegative arthritis - according to both rheum and gastroenterologist - so maybe I am back to my original dx of unspecified seronegative inflammatory spondyloarthritis after all! Although current rheum still feels quite strongly I have RA. Who knows?!

  • Before my diagnosis of RA, I had severe pain that was diagnosed as sacroiliac joint dysfunction. It hurt when I sat too long and especially when I was in bed. I had 3 steroid injections that didn't last. I then had 2 radiofrequency ablations. The first ablation took the pain away for about a year. After the 2nd one, that pain has not returned. That was 2 years ago. Not sure if it all was related to my recent RA diagnosis, but I had an MRI at the time that showed inflammation.