If your back is bothering you, it’s important to check in with your doctor to get to the root cause.
Ankylosing spondylitis is one condition that’s often confused with psoriatic arthritis. “Both psoriatic arthritis and ankylosing spondylitis are in the family of ‘spondyloarthritis’ and are highly related,” says Davis. Ankylosing spondylitis is another type of inflammatory arthritis. It causes the vertebrae in the spine to fuse, resulting in back pain.
People with ankylosing spondylitis are more likely to lose spinal mobility than people with axial psoriatic arthritis, but the latter may lose range of motion. Most people with axial psoriatic arthritis also have pain in the peripheral joints — hands, feet, ankles — but it’s possible to experience back pain only.
Ultimately, imaging of your back will help your doctor determine whether you have axial psoriatic arthritis or ankylosing spondylitis. “Although there is overlap, there are some subtle differences in the appearances of X-ray changes in both the sacroiliac joints and the spine,” Davis explains.
Another common cause of discomfort is mechanical back pain, which is linked to an injury. If you have obesity, the pain may be caused by added weight on your spine. Unlike spondylitis, which is usually better when you move and worse with rest, mechanical back pain is worse when you move and better with rest, according to both Davis and Bhatt. Mechanical back pain also tends to cause brief back stiffness when you wake up, whereas spondylitis causes lingering morning stiffness, Davis adds.
That said, it’s easy to mistake symptoms of one condition for the other. “What appears to be mechanical pain could be inflammatory pain, and what appears to be inflammatory pain could be mechanical pain,” says Bhatt.
People who have psoriatic arthritis may also have back pain linked to a number of other causes, says Davis, including:
- Osteoarthritis of the spine, also known as degenerative joint disease of the spine
- Spinal stenosis, or the narrowing of spaces in your spine that triggers nerve pain
- Fibromyalgia, or widespread musculoskeletal pain that’s thought to happen when the brain processes pain differently than normal
- Central sensitization, a condition where the central nervous system amplifies the sensation of pain
“It’s a very complex topic, so it’s best to ask a doctor,” Bhatt emphasizes. “There are certain tests your doctor can run to confirm the right diagnosis.”
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