[Low back pain in rheumatoid arthritis]

Z Rheumatol. 2017 Dec;76(10):869-875. doi: 10.1007/s00393-017-0363-8.
[Article in German]

Abstract

Low back pain (LBP) in patients with rheumatoid arthritis (RA) has so far been of little concern in clinical investigations. The main focus of scientific publications on spinal problems in RA was the cervical spine. In a recent study, we could demonstrate that LBP in RA patients leads to a significantly higher degree of disability and depression as well as to a reduction in quality of life compared to RA patients without LBP. If there is a specific reason for the additional symptom of LBP, such as spinal stenosis or segmental instability, surgical treatment may be indicated to improve disability and quality of life. For a successful outcome of spinal surgery it is important to address the specific aspects of RA patients, such as poor bone quality and the immunosuppressive effect of antirheumatic drug treatment. Whenever possible, minimally invasive surgical techniques should be used and the immunosuppressive medication should be stopped before surgery.

Keywords: Function; Lumbar spinal canal stenosis; Lumbar spine; Quality of life; Surgical procedures.

Publication types

  • Review

MeSH terms

  • Arthritis, Rheumatoid / diagnosis*
  • Arthritis, Rheumatoid / surgery
  • Cervical Vertebrae / surgery
  • Decompression, Surgical
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Infant, Newborn
  • Joint Instability / diagnosis
  • Joint Instability / surgery
  • Low Back Pain / etiology*
  • Low Back Pain / surgery
  • Lumbar Vertebrae* / surgery
  • Minimally Invasive Surgical Procedures
  • Quality of Life
  • Scoliosis / diagnosis
  • Scoliosis / surgery
  • Spinal Fusion
  • Spinal Stenosis / diagnosis
  • Spinal Stenosis / surgery

Substances

  • Immunosuppressive Agents