Mechanical vs Inflammatory Back Pain

Is your back pain the result of an injury (mechanical) or is it caused by a medical
condition (inflammatory)? Answer these 5 questions and talk to your doctor.

Have your symptoms appeared gradually over time?
Has the pain lasted more than 3 months?
Do you wake up with a stiff back?
Do you feel better after exercising?
Have you celebrated your 40th birthday yet?

Based on your answers, your back pain may be inflammatory.
There are several causes of inflammatory back pain. For some people,
it’s caused by Ankylosing Spondylitis. Talk to your doctor to determine
if you should see a rheumatologist – a specialist qualified in the
diagnosis and management of inflammatory conditions like AS.

Based on your answers, your back pain may not be inflammatory.
That makes it less likely you have a disease like Ankylosing Spondylitis.
It’s still important to talk to your doctor to understand what is causing
your back pain. Your doctor may recommend that you see a specialist
to diagnose and manage your symptoms.

What is Ankylosing Spondylitis?

An•ky•los•ing Spon•dy•li•tis, or AS, is a lifelong autoimmune disease, and form of arthritis, that causes inflammation, pain, and stiffness, mainly in the spinal joints. AS symptoms can be confused with symptoms of mechanical back pain, which are primarily in the lower back. AS symptoms often start in the lower back and can be difficult to diagnose.

Mechanical Back Pain vs. Inflammatory Back Pain
What could my symptoms mean?
Mechanical Back Pain. Caused by a specific injury or strain to the back, like lifting too much weight. Mechanical back pain is very common, occurring at least once in 85% of adults younger than 50. Mechanical back pain can be distinguished by:
  • Being alleviated by bed rest
  • Lasting less than 4-6 weeks
Inflammatory Back Pain. Caused by inflammation in the spinal joints, and not a result of any specific injury. The back pain associated with AS is inflammatory in nature. Some symptoms to help determine if your back pain can be related to an inflammatory condition like AS are:
  • Back pain and stiffness worsen with rest or inactivity, with pain often occurring at night or early in the morning
  • Back pain and stiffness tend to be eased by exercise or movement
  • Back pain lasting more than 3 months (chronic)

Disease impact

In the early stages of AS, the pain and stiffness often starts in the lower back, but over time, it may move up the spine and into the neck. Patients with active disease experience pain, swelling, and discomfort, and may experience morning stiffness.

AS symptoms vary from person to person, and can have a wide range of effects. One person's experience could be completely different from another person's. For some people, over time, AS can lead to fusion of spinal joints. In the most severe cases, AS can result in a forward-stooped posture. Learn more about AS symptoms and common areas of the body that are affected.

Who's at risk?

Historically, it was thought that AS was more common in men than women. But recent research suggests it may be equally common in both sexes. Disease onset usually occurs before age 35 – peaking around age 28. A family history of AS can also increase the risk of developing the disease. Learn about other AS risk factors and potential AS causes.

Unfortunately, diagnosing AS can be difficult. That's why it's important to learn as much as you can about the disease and to talk to your doctor about your back pain.

Important Safety Information About HUMIRA® (adalimumab)1

What is the most important information I should know about HUMIRA?

You should discuss the potential benefits and risks of HUMIRA with your doctor. HUMIRA is a TNF blocker medicine that can lower the ability of your immune system to fight infections. You should not start taking HUMIRA if you have any kind of infection unless your doctor says it is okay.

  • Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections. Your doctor should test you for TB before starting HUMIRA, and check you closely for signs and symptoms of TB during treatment with HUMIRA. If your doctor feels you are at risk, you may be treated with medicine for TB.

  • Cancer. For children and adults taking TNF blockers, including HUMIRA, the chance of getting lymphoma or other cancers may increase. There have been cases of unusual cancers in children, teenagers, and young adults using TNF blockers. Some people have developed a rare type of cancer called hepatosplenic T-cell lymphoma. This type of cancer often results in death. If using TNF blockers including HUMIRA, your chance of getting two types of skin cancer (basal cell and squamous cell) may increase. These types are generally not life-threatening if treated; tell your doctor if you have a bump or open sore that doesn’t heal.


What should I tell my doctor BEFORE starting HUMIRA?

Tell your doctor about all of your health conditions, including if you:

  • Have an infection, are being treated for infection, or have symptoms of an infection
  • Get a lot of infections or infections that keep coming back
  • Have diabetes
  • Have TB or have been in close contact with someone with TB, or were born in, lived in, or traveled where there is more risk for getting TB
  • Live or have lived in an area (such as the Ohio and Mississippi River valleys) where there is an increased risk for getting certain kinds of fungal infections, such as histoplasmosis, coccidioidomycosis, or blastomycosis
  • Have or have had hepatitis B
  • Are scheduled for major surgery
  • Have or have had cancer
  • Have numbness or tingling or a nervous system disease such as multiple sclerosis or Guillain-Barré syndrome
  • Have or had heart failure
  • Have recently received or are scheduled to receive a vaccine. HUMIRA patients may receive vaccines, except for live vaccines
  • Are allergic to rubber, latex, or any HUMIRA ingredients
  • Are pregnant, planning to become pregnant, breastfeeding, or planning to breastfeed

Also tell your doctor about all the medicines you take. You should not take HUMIRA with ORENCIA® (abatacept), KINERET® (anakinra), REMICADE® (infliximab), ENBREL® (etanercept), CIMZIA® (certolizumab pegol), or SIMPONI® (golimumab). Tell your doctor if you have ever used RITUXAN® (rituximab), IMURAN® (azathioprine), or PURINETHOL® (mercaptopurine, 6-MP).


What should I watch for AFTER starting HUMIRA?

HUMIRA can cause serious side effects, including:

  • Serious infections. These include TB and infections caused by viruses, fungi, or bacteria. Symptoms related to TB include a cough, low-grade fever, weight loss, or loss of body fat and muscle.
  • Hepatitis B infection in carriers of the virus. Symptoms include muscle aches, feeling very tired, dark urine, skin or eyes that look yellow, little or no appetite, vomiting, clay-colored bowel movements, fever, chills, stomach discomfort, and skin rash.
  • Allergic reactions. Symptoms of a serious allergic reaction include hives, trouble breathing, and swelling of your face, eyes, lips, or mouth.
  • Nervous system problems. Signs and symptoms include numbness or tingling, problems with your vision, weakness in your arms or legs, and dizziness.
  • Blood problems. Symptoms include a fever that does not go away, bruising or bleeding very easily, or looking very pale.
  • Heart failure (new or worsening). Symptoms include shortness of breath, swelling of your ankles or feet, and sudden weight gain.
  • Immune reactions including a lupus-like syndrome. Symptoms include chest discomfort or pain that does not go away, shortness of breath, joint pain, or rash on your cheeks or arms that gets worse in the sun.
  • Liver problems. Symptoms include feeling very tired, skin or eyes that look yellow, poor appetite or vomiting, and pain on the right side of your stomach (abdomen).
  • Psoriasis (new or worsening). Symptoms include red scaly patches or raised bumps that are filled with pus.

Call your doctor or get medical care right away if you develop any of the above symptoms.


Common side effects of HUMIRA include injection site reactions (redness, rash, swelling, itching, or bruising), upper respiratory infections (sinus infections), headaches, rash, and nausea. These are not all of the possible side effects with HUMIRA. Tell your doctor if you have any side effect that bothers you or that does not go away.


Remember, tell your doctor right away if you have an infection or symptoms of an infection, including:

  • Fever, sweats, or chills
  • Muscle aches
  • Cough
  • Shortness of breath
  • Blood in phlegm
  • Weight loss
  • Warm, red, or painful skin or sores on your body
  • Diarrhea or stomach pain
  • Burning when you urinate
  • Urinating more often than normal
  • Feeling very tired

HUMIRA is given by injection under the skin.


This is the most important information to know about HUMIRA. For more information, talk to your health care provider.

 

Uses

 

HUMIRA is a prescription medicine used:

  • To reduce the signs and symptoms of:
    • Moderate to severe rheumatoid arthritis (RA) in adults. HUMIRA can be used alone, with methotrexate, or with certain other medicines. HUMIRA may prevent further damage to your bones and joints and may help your ability to perform daily activities.
    • Moderate to severe polyarticular juvenile idiopathic arthritis (JIA) in children 4 years of age and older. HUMIRA can be used alone, with methotrexate, or with certain other medicines.
    • Psoriatic arthritis (PsA) in adults. HUMIRA can be used alone or with certain other medicines. HUMIRA may prevent further damage to your bones and joints and may help your ability to perform daily activities.
    • Ankylosing spondylitis (AS) in adults.
    • Moderate to severe Crohn's disease (CD) and to achieve and maintain clinical remission in adults who have not responded well to conventional treatments. HUMIRA is also for these adults who have lost response to or are unable to tolerate infliximab.
  • In adults, to help get moderate to severe ulcerative colitis (UC) under control (induce remission) and keep it under control (sustain remission) when certain other medicines have not worked well enough. It is not known if HUMIRA is effective in people who stopped responding to or could not tolerate anti-TNF medicines.
  • To treat moderate to severe chronic plaque psoriasis (Ps) in adults who are ready for systemic therapy or phototherapy, and are under the care of a doctor who will decide if other systemic therapies are less appropriate.

64H-982716


Please see the Full Prescribing Information, including the Medication Guide, for HUMIRA.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

If you cannot afford your medication, contact: www.pparx.org or call the toll-free phone number (1-888-4PPA-NOW) for assistance.

Safety Considerations1

Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections. HUMIRA may increase the chance of getting lymphoma, including a rare kind, or other cancers. HUMIRA can cause serious side effects including hepatitis B infection in carriers of the virus, allergic reactions, nervous system problems, blood problems, heart failure, certain immune reactions including a lupus-like syndrome, liver problems, and new or worsening psoriasis.

Use1

HUMIRA is a prescription medicine used to reduce the signs and symptoms of ankylosing spondylitis in adults.

Related Information

Mechanical vs Inflammatory Back Pain

Is your back pain the result of an injury (mechanical) or is it caused by a medical
condition (inflammatory)? Answer these 5 questions and talk to your doctor.

Have your symptoms appeared gradually over time?
Has the pain lasted more than 3 months?
Do you wake up with a stiff back?
Do you feel better after exercising?
Have you celebrated your 40th birthday yet?

Based on your answers, your back pain may be inflammatory.
There are several causes of inflammatory back pain. For some people,
it’s caused by Ankylosing Spondylitis. Talk to your doctor to determine
if you should see a rheumatologist – a specialist qualified in the
diagnosis and management of inflammatory conditions like AS.

Based on your answers, your back pain may not be inflammatory.
That makes it less likely you have a disease like Ankylosing Spondylitis.
It’s still important to talk to your doctor to understand what is causing
your back pain. Your doctor may recommend that you see a specialist
to diagnose and manage your symptoms.

Mechanical vs Inflammatory Back Pain
Take the quiz. Talk to your doctor.

Take the quiz.
Talk to your
doctor.

Find a Rheumatologist
Find a rheumatologist near you

Find a rheumatologist near you.