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Rheumatoid arthritis and back pain
Last reviewed: 23.04.2024
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Rheumatoid arthritis is a chronic autoimmune disease that causes damage mediated by cytokines, chemokines and metalloproteases. In the peripheral joints (such as wrist, metacarpophalan, sebaceous), symmetrical inflammation occurs, often leading to progressive destruction of the articular structures, often combined with systemic symptoms. The diagnosis is based on specific clinical, laboratory and radiological criteria. The treatment uses pharmaceuticals, physical methods, and sometimes-surgery. Drug therapy includes a combination of NSAIDs that reduce the symptoms and antirheumatic drugs that can modify the course of a disease that has a slow-progressive course.
Criteria for the diagnosis of rheumatoid arthritis (based on the criteria of the American Rheumatology Association, now the American College of Rheumatology) are that a patient with rheumatoid arthritis should have any of the following four criteria: morning stiffness> 1 hour; arthritis> 3 joints; arthritis of the joints of the upper limb (ray-wrist, metakarpophalangeal or proximal interphalangeal); symmetrical arthritis; rheumatoid nodules; rheumatoid factor of serum (positive <5% in healthy control subjects); X-ray changes in brushes, which should include typical for rheumatoid arthritis erosion or clear decalcification of the bone. The signs marked with an asterisk must be present for at least 6 weeks
Most patients with rheumatoid arthritis are affected by the cervical spine (atlanto-axial subluxation, weakness of the transverse ligament of the atlas, erosion of the C2 tooth, instability and subaxial subluxation of SZ-C7), the lumbar region is rarely involved, the sacroiliac joint can be affected.
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