Background/Purpose: We hypothesize that the real prevalence of spondylarthritis (SpA) is much higher than reported in the literature. In this study, we aimed to investigate the presence of SpA in individuals who needed to purchase an orthopedic mattress because of their chronic back pain, and to emphasize the importance of determining the main underlying reason for these complaints.

Methods: Two hundred adults aged< 45 years who had purchased an orthopedic mattress because of chronic back pain were called by phone and asked 3 screening questions in order to identify whether their back pain was inflammatory. The questions were about the presence of (1) non-traumatic pain, swelling and stiffness in any joints, (2) lower back pain or back stiffness on awakening which lasted over a period of at least 3 months and which improved with exercise, (3) heel pain more powerful in the morning which lasted over a period of at least 3 months and which improved with activity. Of 200 individuals, 105 gave positive answers to one or more of the screening questions and 80 individuals [42 women (52.5%), mean age 36.3 ± 6.3] who agreed to clinical evaluation were included in the study. In all evaluated individuals, comparative sacroiliac radiography was taken for the screening of sacroiliitis and lateral radiographies of both feet were taken for the screening of enthesitis. Peripheral blood samples were taken for ESR and serum CRP levels. Patients with suspected sacroiliitis upon direct radiography were examined with sacroiliac MRI. In order to diagnose SpA, the European Spondyloarthritides Study Group (ESSG) criteria were applied.

Results: Among 80 subjects, 65 (81.3%) were diagnosed with SpA, and among these 65 patients, we diagnosed 48 (73.9%) with undifferentiated SpA, 14 (21.5%) with ankylosing spondylitis and 3 (4.6%) with psoriatic arthritis. Thirty seven of 80 subjects (46.3%) were found to have sacroiliitis at different stages and 42 (52.5%) had enthesitis (epin calcanei and/or Achilles enthesopathy) by radiography. ESR and CRP levels were similar in individuals with or without SpA.

Conclusion: We diagnosed SpA in a remarkable percentage of the individuals who were in the need of an orthopedic mattress due to a complaint of chronic back pain. For this reason, we suggest that evaluation of those individuals for SpA will be helpful for early diagnosis, treatment and improvement in the quality of life of the patients. We also think that is important to create awareness about SpA in the general population so that patients will seek out medical diagnosis and treatment instead of transient and inadequate remedies like a new mattress for their back pain.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/prevalence-of-spondylarthritis-in-individuals-needing-to-purchase-an-orthopedic-mattress-because-of-chronic-back-pain/