Prevalence of Inflammatory Back Pain (IBP) In Patients with Backache Visiting Rheumatology OPD at Khyber Teaching Hospital, Peshawar: Inflammatory Back Pain in Patients with Backache

Amjad Ali; . Najibullah; Alam Zeb; . Imranullah; Inamullah Khan

doi:10.54393/pjhs.v5i06.1635

Authors

Amjad Ali Department of Rheumatology, Medical Teaching Institution, Khyber Teaching Hospital, Peshawar, Pakistan
. Najibullah Department of Rheumatology, Medical Teaching Institution, Khyber Teaching Hospital, Peshawar, Pakistan
Alam Zeb Department of Rheumatology, Khyber Teaching Hospital, Peshawar, Pakistan
. Imranullah Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan
Inamullah Khan Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i06.1635

Keywords:

Inflammatory Back Pain, Epidemiology, SpondyloArthritis, Rheumatology

Abstract

Back pain is a prevalent and often paralyzing condition that impacts people of all ages and backgrounds. When it comes to back pain, it is crucial to differentiate between different kinds in order to accurately diagnose and effectively treat the problem. Objective: To ascertain the frequency of Inflammatory Back Pain (IBP) in patients presenting with low back pain. Methods: This descriptive study was conducted in rheumatology department of Khyber Teaching Hospital, Peshawar, during the period 1^st September 2023 till 31^st March 2024. Male and female patients with back ache (VAS >4) were enrolled and evaluated for the presence of inflammatory back pain using ASAS criteria. Results: The study included 138 patients, 60 (43.48%) male and 78 (56.52%) female. Mean age was 51.7 ± 5.8 years. Majority of the patients belonged to the age group 46 to 60 years 45 (32.60%). The ASAS criteria for IBP was satisfied by 54 (39.1%) patients. Statistically significant association was observed between IBP and family history of IBP. Conclusions: Significant proportion of patients with back pain were found having pain with inflammatory etiology. Male patients aging 46 to 60 years with family history of IBP were more likely having IBP

References

Tong F, Lv Q, Li A, Fang L, Luo Z, Feng J et al. An epidemiological study of the prevalence rate of inflammatory back pain and axial spondyloarthritis in a university in the south of China. Clinical Rheumatology. 2018 Nov; 37: 3087-91. doi: 10.1007/s10067-018-4175-2. DOI: https://doi.org/10.1007/s10067-018-4175-2

Yap KS, Justine YY, Li S, Gladman DD, Chandran V. Back pain in psoriatic arthritis: defining prevalence, characteristics and performance of inflammatory back pain criteria in psoriatic arthritis. Annals of the Rheumatic Diseases. 2018 Nov; 77(11): 1573-7. doi: 10.1136/annrheumdis-2018-213334. DOI: https://doi.org/10.1136/annrheumdis-2018-213334

Yesmin S, Abdal SJ, Rahman A, Islam MN, Ahammad AM, Ahmed S et al. Inflammatory back pain and associated disease conditions among patients with chronic low back pain in Bangladesh. International Journal of Rheumatic Diseases. 2018 May; 21(5): 937-42. doi: 10.1111/1756-185X.13263. DOI: https://doi.org/10.1111/1756-185X.13263

Wang R, Crowson CS, Wright K, Ward MM. Clinical evolution in patients with new‐onset inflammatory back pain: a population‐based cohort study. Arthritis & Rheumatology. 2018 Jul; 70(7): 1049-55. doi: 10.1002/art.40460. DOI: https://doi.org/10.1002/art.40460

Elshahawy E, Mortada M, Elnaggar SA, Ehab N. Overlap of Pain Character in Patients with Inflammatory Back Pain versus Chronic Mechanical Back Pain. The Egyptian Journal of Hospital Medicine. 2022 Oct; 89(1): 5375-8. doi: 10.21608/ejhm.2022.263572. DOI: https://doi.org/10.21608/ejhm.2022.263572

Grinnell-Merrick LL, Lydon EJ, Mixon AM, Saalfeld W. Evaluating inflammatory versus mechanical back pain in individuals with psoriatic arthritis: a review of the literature. Rheumatology and Therapy. 2020 Dec; 7: 667-84. doi: 10.1007/s40744-020-00234-3. DOI: https://doi.org/10.1007/s40744-020-00234-3

Saad MA, Abdul-Sattar AB, AbdElal IT, Barka A. Assessment of Ankylosing Spondylitis as Chronic Inflammatory Disease. NeuroQuantology. 2022 Sep-Oct; 20(16): 2391.

Adizie T, Elamanchi S, Prabu A, Pace AV, Laxminarayan R, Barkham N et al. Knowledge of features of inflammatory back pain in primary care in the West Midlands: a cross-sectional survey in the United Kingdom. Rheumatology International. 2018 Oct; 38: 1859-63. doi: 10.1007/s00296-018-4058-5. DOI: https://doi.org/10.1007/s00296-018-4058-5

Aljohani R, Barradah N, Kashkari A. Awareness and knowledge of the common features of inflammatory back pain among primary care physicians in the western region of Saudi Arabia. Medicine. 2022 Oct; 101(43): e31626. doi: 10.1097/MD.0000000000031626. DOI: https://doi.org/10.1097/MD.0000000000031626

Peláez-Ballestas I, Navarro-Zarza JE, Julian B, Lopez A, Flores-Camacho R, Casasola-Vargas JC et al. A community-based study on the prevalence of spondyloarthritis and inflammatory back pain in Mexicans. Journal of Clinical Rheumatology. 2013 Mar; 19(2): 57-61. doi: 10.1097/RHU.0b013e3182862e65. DOI: https://doi.org/10.1097/RHU.0b013e3182862e65

de Oliveira JL, da Silva GF, Nogueira IA, Azevedo AQ, Baraliakos X, Rocha FA et al. Prevalence of Inflammatory Back Pain in a low-income Population. Journal of Clinical Rheumatology. 2022 Apr; 28(3): 170-3. doi: 10.1097/RHU.0000000000001829. DOI: https://doi.org/10.1097/RHU.0000000000001829

Saeed MA, Ahmed H, Faiq M, Aslam Z, Elaine Anwer Khan S, Batool S et al. Prevalence of inflammatory back pain and radiographic axial spondyloarthritis in a semi‐urban community of Lahore, Pakistan. International Journal of Rheumatic Diseases. 2021 Feb; 24(2): 207-15. doi: 10.1111/1756-185X.14030. DOI: https://doi.org/10.1111/1756-185X.14030

Rudwaleit M and Sieper J. Referral strategies for early diagnosis of axial spondyloarthritis. Nature Reviews Rheumatology. 2012 May; 8(5): 262-8. doi: 10.1038/nrrheum.2012.39. DOI: https://doi.org/10.1038/nrrheum.2012.39

Bittar M, Khan MA, Magrey M. Axial spondyloarthritis and diagnostic challenges: over-diagnosis, misdiagnosis, and under-diagnosis. Current Rheumatology Reports. 2023 Mar; 25(3): 47-55. doi: 10.1007/s11926-022-01096-0. DOI: https://doi.org/10.1007/s11926-022-01096-0

Sieper J, Van Der Heijde DM, Landewe R, Brandt J, Burgos-Vagas R, Collantes-Estevez E et al. New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS). Annals of the Rheumatic Diseases. 2009 Jun; 68(6): 784-8. doi: 10.1136/ard.2008.101501. DOI: https://doi.org/10.1136/ard.2008.101501

Poddubnyy D, Callhoff J, Spiller I, Listing J, Braun J, Sieper J et al. Diagnostic accuracy of inflammatory back pain for axial spondyloarthritis in rheumatological care. RMD Open. 2018 Dec; 4(2): e000825. doi: 10.1136/rmdopen-2018-000825. DOI: https://doi.org/10.1136/rmdopen-2018-000825

Rusman T, John ML, Van Der Weijden MA, Boden BJ, van der Bijl CM, Bruijnen ST et al. Presence of active MRI lesions in patients suspected of non-radiographic axial spondyloarthritis with high disease activity and chance at conversion after a 6-month follow-up period. Clinical Rheumatology. 2020 May; 39: 1521-9. doi: 10.1007/s10067-019-04885-8. DOI: https://doi.org/10.1007/s10067-019-04885-8

Burgos-Vargas R, Wei JC, Rahman MU, Akkoc N, Haq SA, Hammoudeh M et al. The prevalence and clinical characteristics of nonradiographic axial spondyloarthritis among patients with inflammatory back pain in rheumatology practices: a multinational, multicenter study. Arthritis Research & Therapy. 2016 Dec; 18: 1-1. doi: 10.1186/s13075-016-1027-9. DOI: https://doi.org/10.1186/s13075-016-1027-9

Onen F, Solmaz D, Cetin P, Sari I, Balci A, Birlik M et al. Prevalence of inflammatory back pain and axial spondyloarthritis among university employees in Izmir, Turkey. The Journal of Rheumatology. 2015 Sep; 42(9): 1647-51. doi: 10.3899/jrheum.141600. DOI: https://doi.org/10.3899/jrheum.141600

Kenar G, Yarkan-Tuğsal H, Çetin-Özmen P, Solmaz D, Can G, Önen F et al. A lower frequency of inflammatory back pain in male patients with ankylosing spondylitis compared with female patients. Rheumatology International. 2024 Mar; 44(3): 477-82. doi: 10.1007/s00296-023-05449-5. DOI: https://doi.org/10.1007/s00296-023-05449-5

Harth M and Nielson WR. Pain and affective distress in arthritis: relationship to immunity and inflammation. Expert Review of Clinical Immunology. 2019 May; 15(5):541-52. doi: 10.1080/1744666X.2019.1573675. DOI: https://doi.org/10.1080/1744666X.2019.1573675