Hi PW,
As you already said, RA is supposedly not found in the low back. However, many people on this board do indeed have lumbar spine trouble that seems connected. I have severe lumbar spine trouble, requiring four surgeries by age 35 (the first was an emergency surgery at age 22, for a rare condition called cauda equina syndrome.) I was diagnosed with RA six years after my spine problems began. I don't know exactly what the connection is, but I believe there is one. It just doesn't make sense to me that this awful disease would skip messing up my disks, when it seems hell-bent on ruining connective tissue elsewhere.
One other thought- do you know about ankylosing spondylitis? It's another autoimmune disease that definitely does affect the lumbar spine.
Caren

I was going to mention ankylosing spondylitis, too. My first rheumy diagnosed me with sero negative RA, then the second rheumy saw an MRI of my spine and diagnosed me with the AS. But I've had many years of back pain and problems.

I would think RA could go for any joint, at least that's what I understand from my reading, even though it might not be as common with the back. I'd sure get it checked out. Best of luck to you!

I was recently diagnosed with lumbar spine RA as it is visible on X-rays. But I've also had Ra for 39 years.

Ra affects "synovial joints"....meaning joints that have a covering with the fluid producing "synovial membrane". And the only joints in the spine that have that synovial membrane are the facet joints on the very back of the vertebrae. The disks are not involved or the body of the vertebrae themselves. Facet arthritis is on the back, away from the spinal cord and spinal nerves. Arthritis in those joints is a deep aching pain, much like osteoarthritis in other joints and when Ra sets in, it feels hot and the pain is worse.

But 80% of all adults have some kind of arthritis in the spine that comes from sports injuries or things we do that we shouldn't(lifting really heavy stuff when out of shape). I had OA in my spine before I was 20 thanks to high school sports and gym teachers who thought they knew what was safe and what wasn't...and they were wrong. Did you know you can bruise your spinal cord just doing a back bend...and it can lead to life long paralysis? It can, yet we were made to do them in high school. Don't blame RA, blame you gym teachers.

As Fibrolizzy mentions, there is an entire group of inflammatory arthritic diseases that includes severe arthritis of the sarco-iliac joints of the pelvis and the lumbar spine. Ankylosing spondylitis is one, psoraitic arthritis is another as is reactive arthritis(used to be called Reiter's Disease. They are distinguished from Ra by the complete absence of positive blood work.

So if you have been diagnosed with Ra by blood work, then you don't have one of those but chances are, your back pain is from osteoarthritis or an old injury you didn't know you have until now. Let me add that old injuries or OA can be helped with PT or even surgery but RA can't be fixed so hope it's not RA.

Let your rheumy know the next time you are in and if still hurting, ask about getting a lumbar MRI. Only MRI's will show nerve involvement and ruptured disks. Then you take it from there.

I've had 4 major spine surgeries and with more coming so I've been through the wringer...even manage to break my neck 3 months after a surgery. I can tell that PT is the best thing ever and that most back pain comes from sore muscles in spasm. When the bones aren't doing their job, the muscles have to take over and they get sore and weak and HURT like hell. Learn from a good PT how to care for your back and it will help you more than anything else.

Good luck................Jen (14 herniated disks, 6 fused vertebrae and now, severe RA)

All my facet joints are arthritic, especially in the thoracic spine. This started in my early 20's, the doctors now blame it on age, but I would always tell them it has been hurting for years! My thoracic and SIJ are starting to fuse. My Rheumy said it is from PsA and not AS, my spinal surgeon said the same thing, correcting me when I called it AS. I guess AS is usually much more predictable, starting at the base of the spine and progressing upward, PsA can start anywhere in the spine. Exersises have helped my thoracic, I do light weights everyday to strengthen the muscles around the spine. I agree that a lot of pain comes from the my muscles, that have been spasming for 35+ years...

I go back to see the spine specialist Tuesday, regarding my Bertolloti's syndrome, which is an extra lumbar vertebrae and herniated disc L4/L5, getting kind of crowded down there!

Wow! I'm coming out of this thread feeling thankful. Thankful that my back has been fairly strong and pain free for most of my life. Sounds like a few of you have had more than your share of spine and disc problems. I couldn't imagine having multiple back surgeries like some of you have had. I did hurt my upper back back in my 20's. Idiot boss send me to do a two man job by myself at the place I was working at the time. Let's just say double door fridge on a dolly up about 15 stairs thru the door and into the kitchen. It was tough even for a young healthy man and I paid the price for it. Luckily all they said I done was tore some muscle. Took 2 to 3 months to fully recover from that. Now I'm at 41 I think a lot of things like this and old sports injuries like mentioned above really start to catch up with us.

As far as AS goes, I really haven't done a lot of research on but I have read a lot over the last couple years here on the board. It seems to come up pretty often here in the Ra board. I would Google it for more info but if I did it would probably cause me more stress. Sometime I get carried away with conditions and diagnose myself. Lol. I'm just gonna ride it out for a few more days and see if it gets better or not. I'm gonna be sure to mention this to my rheumy at my next visit and get his take. It's definitely not getting any worse thus far and it's more stiffness than pain. I get a little pain with the stiffness when I try to fully extend out or when bending down pretty low. As far as just sitting or laying im pretty comfortable and not hurting. I did have a positive diagnosis with ra in July of 14. My ra factor and anti ccp both agreed I was positive.

Thank you all for your contributions, I now officially feel like a whine bag. We all have atleast one thing in common and it's nice to have some folks to lean on and run things through. :)

What everyone else said and in the mean time, if it's keeping you from sleeping well or otherwise interfering with your life, ask for muscle relaxers. I don't have a dx for my lumbar pain yet, but my back hasn't felt this good in at least a decade. My pain mgmt. specialist did say that it's entirely possible for the tendons and muscles in the lumbar region to be painful from tension secondary to RA pain, which makes a lot of sense ...

Thanks for the tip Etain11. Some type of muscle relaxant would probably do some good as it does feel like I got some tension going on down there. I'll hit my dr up in a couple days if it doesn't improve soon.

The most common cause of back pain is the muscles. As arthritis of any kind sets in, it throws the alignment of the spine out of kilter and so it is left to the muscles to try to hold all those bones in alignment. So muscle relaxers can be a huge help as can PT to strengthen those back muscles so they can hold the spine properly and without that much strain. A weak back is a painful back.

As for Ankylosing Spondylitis and Psoriatic Arthritis, both are in the group of sero-negative spondyloarthropathies where they all feature arthritis similar in appearance to OA, of the sacro-iliac joints and spine. And Jonsparky, you are correct in that AS tends to begin at the bottom and work up whereas PsA can begin anywhere. But both diseases, along with others in the group, all feature a very specific type of arthritis "bars" that join the vertebrae together....called syndesmophytes. This causes the spine to develop a poker-like appearance and causes the victims to be bent over and cannot straighten up. This is why it is so important to diagnose and treat.

But thanks to those bars of bone across the vertebrae, it can differentiated from Ra and other disorders just by x-rays....provided it has advanced that far. PsA also has psoriasis whereas AS has eye and other organ involvement as a distinguishing factor.

(I should add that I was thought to have Reiter's Syndrome for about 10 years and sought help from the #1 doc in the country on Reiter's at the Dartmounth/Hichcock Medical Center in New Hampshire...now works at a huge pharmaceutical company in NJ and is one of the researchers behind our biologics.) Learned a lot.

So AS and PsA and Reiter's(now called Reactive Arthritis or ReA as Dr. Reiter has a very notorious background) are considered inflammatory arthritis but not the same category as RA. RA involves the inflammation of fluid producing synovial membranes and they don't. The arthritis of AS, PsA and ReA looks like OA when seen in X-rays of the joints except for the spine and SI joints. RA looks very different from OA. But both can affect organs. However, RA is considered potentially fatal and AS. PsA and ReA can cripple but don't kill.

God...I learned way more than I needed to!

hugs..............Jen

Jen, you are so informed on so many subjects, I love reading your responses! But how do you remember all of this? I can't even remember what I just read. But I love reading all the good info on here.
PW, good luck on your back. Let us know how it goes.
Wendy

Born with a photographic memory. Sounds wonderful but in my case, it has also made me remember every single episode of child abuse I ever went through. How I wish I could forget.

hugs...........Jen

Another thing mt spinal surgeon mentioned, when the ankylosing happens, this is the growing of the bars and filling erosion, that material is very weak, and can break off, creating another hazard of the shards damaging the spinal cord. I have started to get some curvature of the upper spine kyphosis, i see a chiroprator and try to keep the spinal joints moving, also Thai massage. The doctor said
"you don't want to get the surgery for that, lots of rods"...