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Back Pain in 2nd & 3rd Decades of Life

Medical Author: William C. Shiel Jr., MD, FACP, FACR

I am a rheumatologist. We are medical doctors that are responsible for the non-surgical treatments of conditions that involve the muscles and joints of the body. We do not perform surgery, but refer patients for consideration of surgical procedures to orthopaedic surgeons when appropriate.

In the course of treating many patients over the years, I have come upon many instances in which a patient had received unnecessary surgery for conditions that could have either been diagnosed or treated without surgery.

It is unfortunately too frequent that we diagnose spondylitis after a patient has already undergone a surgical procedure of the low back.

Back pain in adolescents and young adults is commonly attributed to injury resulting from athletic activities. Guess why...because this it the time of life when humans typically are most involved with sports. The fact is, however, that it is very possible that the two events can be true and not related.

Spondylitis is one of the most common arthritis conditions that involves the spine, especially in young adults. Spondylitis is a form of chronic inflammation of the spine and the sacroiliac joints. The sacroiliac joints are located in the low back where the sacrum (the bone directly above the tailbone) meets the iliac bones (bones on either side of the upper buttocks). Chronic inflammation in these areas causes pain and stiffness in and around the spine. The tendency to develop ankylosing spondylitis is genetically inherited from the parents and not related to activity.

The optimal treatment of ankylosing spondylitis involves medications that reduce inflammation or suppress aspects of the immune that cause inflammation, physical therapy, and exercise. Surgical procedures are not part of the basic management for this condition. Furthermore, the spondylitis condition can also affect the eyes, heart, lungs, and occasionally the kidneys. Therefore, it is particularly important that an accurate diagnosis is made as soon as possible.


Last Editorial Review: 5/29/2007






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