The Risks of Untreated Chronic Back Pain

By

Amy Bernstein

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One of the hallmark symptoms of ankylosing spondylitis (AS) is pain and stiffness in the lower back. Because AS is a chronic condition that often develops before age 30, people with AS can live many years with low back pain. This chronic pain can have a profound effect on daily life if it goes untreated.


Impact on Daily Living

People dealing with long-term pain may have trouble concentrating or find themselves unable to perform daily activities or work duties. Low back pain is second only to the common cold in causes of lost work time.

Emotional Effects

Continuous pain can lead to depression and sleep troubles. And these factors together contribute to a vicious cycle.

The combination of chronic pain and depression leads to greater disability. Greater disability leads to more depression, which leads to greater pain. In addition, too little sleep exacerbates pain, and greater pain makes it harder to sleep. Lack of sleep also contributes to depression.

Changes in the Brain

Some recent studies using brain imaging have found structural changes in the brains of people with chronic low back pain. There is also emerging evidence that chronic pain leads to changes in nerves in the spinal cord. These discoveries may help explain why about 20% of people with low back pain continue to experience pain even after the underlying condition is treated.

Your Doctor Can Help

It is important to treat low back pain associated with AS before it leads to long-term problems. Talk with your doctor if you have AS or are concerned that AS might be the cause of your low back pain.

Key Takeaways

  • A hallmark symptom of ankylosing spondylitis (AS) is chronic pain and stiffness in the lower back.

  • People dealing with long-term pain may have trouble concentrating or be unable to perform daily activities.

  • Continuous pain can lead to depression, and these factors together contribute to a vicious cycle. The combination of chronic pain and depression leads to greater disability. Greater disability leads to more depression, which leads to greater pain.

  • If you have AS, talk with your doctor about low back pain before it leads to long-term problems.

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Medical Reviewers: Robert Williams, MD Last Review Date: Sep 8, 2015

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Medical References

  1. Kim SH, Sun JM, Yoon KB, et al. Risk Factors Associated with Clinical Insomnia in Chronic Low Back Pain: A Retrospective Analysis in a University Hospital in Korea. Korean Journal of Pain. 2015;28(2):137-43.
  2. Arthritis, Osteoporosis, and Chronic Back Conditions. Office of Disease Prevention and Health Promotion. http://www.healthypeople.gov/2020/topics-objectives/topic/Arthritis-Osteoporosis-and-Chronic-Back-Co...
  3. What is Ankylosing Spondylitis? National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Ankylosing_Spondylitis/ankylosing_spondylitis_ff.asp
  4. Low Back Pain Fact Sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm
  5. Chronic Pain and Depression. American Chiropractic Association. https://www.acatoday.org/content_css.cfm?CID=2187

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