As a hotel chef often on his feet for ten hours a day, and a keen rugby player, Gareth Dwyer, a constant pain in his buttocks, put his work and lifestyle on hold.
‘I played rugby as a prop – pushing against the entire weight of the opposing team – so I thought the pain was just wear and tear,’ says Gareth, 42, says.
‘When I was walking, however, I was humping like a turtle and the pain could spread to my hips – the only way I found relief was to put my hands behind my back and press my palms together Like Prince Charles does, for which my wife took the mickey out of me.’
As a hotel chef often on his feet for ten hours a day, and a keen rugby player, Gareth Dwyer, a constant pain in his buttocks, put his work and lifestyle
Back pain had affected him since his late 20s, and at times was severe enough to wake him in the early hours, but they resolved.
It wasn’t until the age of 35, when he fell down a few steps and broke his spine, that Gareth learned that pain in his buttocks was a sign of a form of inflammatory arthritis. Their X-rays and MRI scans showed that the bones in the joints, which connect the lower spine to the pelvis, became fused and inflamed.
Gareth, who lives in Capel Curig, Snowdonia, along with his wife Naomi, 42, a civil servant, and son Dion, three, also had a positive blood test for the HLA-B27 gene, which helps people with inflammatory arthritis. Predicts development. This confirmed that Gareth had axial spondyloarthritis (or axial spa), a form of arthritis that affects the spine and sacroiliac joints.
An estimated 220,000 people in the UK are believed to have axial spas. It can run in families, and potential triggers for people with a genetic predisposition include infection, stress, and trauma.
Conditions that fall under the umbrella include non-radiographic axillary spasms (where these joints become inflamed, but this is not visible on an X-ray).
In some cases it can progress to radiographic axial SPA (also known as ankylosing spondylitis), where inflammation causes excess bone to grow, leading to fusion of the vertebrae in the spine.
As well as affecting the ability to perform everyday tasks, including bending, it can affect breathing if the ribcage is affected and the lungs do not expand sufficiently. Inflammation also causes pain and fatigue, and walking can be difficult.
Not all people with axial SPA develop spinal fusion — risk factors include smoking and testing positive for the HLA-B27 gene — but treating symptoms early can help prevent progression.
Another warning sign is back pain lasting more than three months that begins before the age of 40 — back pain that begins after 40 is more likely to be caused by wear and tear — including back pain. lower back pain that wakes you up in the early hours
Gareth’s delayed diagnosis meant that his symptoms had already advanced to radiographic axial SPA. ‘My posture was affected because of weakness in my sacroiliac joints, as they could not support my spine,’ he says.
Hip pain, which lasts for more than three months, is one of the common symptoms of axial spa, says Dr. Raj Sengupta, consultant rheumatologist at the Royal National Hospital for Rheumatic Diseases in Bath.
‘The main joints with axial SPA are the sacroiliac joints, which are at the top of the buttocks, and swelling is one of the key features in these joints,’ says Sengupta. Axial Spondyloarthritis Society (NASS) charity.
‘Butt pain originates from the joints and can alternate from one side to the other – this is a classic sign of axial spa – or just stay on one or both sides.
“The problem with buttock pain is that it is often confused with sciatica, a common condition caused by irritation of one of the two sciatic nerves that exit the spine,” he explains.
Sciatica causes pain and tingling in the buttock and extends down the leg to the foot, but with axial spa, if you have buttock pain, it won’t spread down the leg and all the way past the knee.
‘Some people are told they have sciatica when they actually have inflammation of the sacroiliac joints due to axial spa.’
Dr. Sengupta says this is one reason it takes eight-and-a-half years to receive a diagnosis on average.
“As a rheumatologist it is heartbreaking to see patients in a clinic who have experienced back pain for years and have been put off for sports injuries or work,” he says. it is said. ‘I will see five of these patients in a week.
‘The pain often first occurs when someone is in their 20s, when they are building relationships and careers, and they continue to struggle with symptoms. This can lead to mental health problems, as well as more damage to their spinal cord.
Another warning sign is back pain lasting more than three months that begins before age 40 — back pain that begins after 40 is more likely to be caused by wear and tear — including back pain. Lower back pain that wakes you up in the early hours.
One theory for this is that levels of cytokines, compounds that cause inflammation, peak at night. Another warning sign is morning joint stiffness that does not subside after half an hour, but improves with movement and does not rest.
Now the charity NASS has launched a campaign to encourage anyone under the age of 40 with this type of persistent back pain to check whether it’s an axial spa.
‘It’s a race against time with axial SPA,’ says NASS chief executive Dr Dale Webb, explaining that the risk of serious and irreversible damage increases when one goes without treatment.
‘The good news is that, with the right treatment and care, people can live very well with Axial Spa.’
Axial spas are usually treated with biologic drugs that shut down inflammation, says Dr. Sengupta.
‘These have been around for more than 20 years and were approved for the treatment of axonal sp. [in the…