Assessment of the frequency and impact on disability of low back pain in the Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a systemic inflammatory disease and low back pain (LBP) is a well characterized common disorder and both cause disability. The aim of this study was to: assess the frequency of LBP in RA and to investigate radiological and clinical aspects, as well as impact of LBP on quality of life, depression, fatigue and disability in patients with RA. Additionally, to compare age and sex matched patients with LBP and RA was also proposed.One hundred ten patients who met ACR criteria for the classification of RA and 112 patients with LBP at least 3 months of duration were included in to the study. All patients examined for musculoskeletal and neurological findings and underwent lomber X-ray and MR imaging. Disease activity was assessed using visual analogue scale of pain (VAS), DAS28, ESR, CRP; quality of life and disability using Health Assessment Questionnaire, RA Quality of Life, Arthritis Impact Measurement Scale-2, SF-36, VAS (0-100 mm) and depression, anxiety and fatigue with appropriate measures.Seventy one (64.5%) patients with RA had LBP. VAS-overall pain and intensity of LBP was not different between sub-groups. Low back pain coexisting with RA worsened quality of life and disability in these patients.Low back pain accompanying RA is more common than expected and reduces quality of life and increases depression, anxiety and fatigue in patients with RA. Therefore involvement of the spine, as well as peripheral joints, should be kept in mind, should be carefully scrutinized and managed before serious disability may develop.Key words: Rheumatoid arthritis, low back pain, magnetic resonance, fatigue and quality of life.