Psoriatic arthritis (PsA) can cause inflammation of the spine, resulting in pain and stiffness in the back and pelvic area.  This is known as ‘axial arthritis’ or ‘spondylitis’. This type of back pain is different to back pain caused by straining your back, for example, by lifting a heavy object or sleeping on an uncomfortable mattress.

What are the symptoms?

Some of the more common signs include:

• Back pain that lasts more than three months
• Back pain that wakes you up in the middle of the night
• Back pain that gets better with exercise and worse when you are not moving
• Back stiffness that lasts for more than 30 mins after getting up in the morning
• Pain and stiffness in your hips, buttocks, back and/or neck.

Axial arthritis can cause damage to the joints of the spine. It is important to talk to your GP, rheumatologist or dermatologist if you have these symptoms, as your treatment plan may need to change. 

What will happen to me?

There is no cure for PsA-related inflammatory back pain, but there are many treatments available to help prevent joint damage and manage the symptoms. Your healthcare team can guide you to the right treatment to help prevent joint damage, manage pain and help you maintain your daily activities.

What can I do?

See a rheumatologist. A rheumatologist can diagnose PsA-related axial arthritis and make sure you get the right treatment. 

Learn about your condition and play an active role in your treatment. Not all information you read or hear about is trustworthy so always talk to your healthcare team about treatments you are thinking about trying. Self-management courses can help you develop skills to be actively involved in your healthcare. Contact your local arthritis office for details of these courses.

Stay active.  Regular exercise and physical therapy are important to retain flexibility in the spine. A physiotherapist or exercise physiologist can suggest a specific program of exercises suitable for you. It is important to undertake your recommended program regularly. If you experience early morning stiffness, gentle stretching exercises under a warm shower may help. In addition to your regular tailored exercise program for your joints, it is important to do at least 30 minutes of moderate exercise on most days of the week. This is important for your general fitness and also important for the health of your heart and lungs (aerobic fitness).

Live a healthy life. Eat a healthy diet, stop smoking, and reduce stress to help your oval health and wellbeing.  If you are carrying extra kilos, losing weight with the help of a dietitian may help. Strategies to help reduce stress and anxiety may also be beneficial.

Learn ways to manage pain.  Understanding pain and learning techniques that may help you cope with pain are an important part of managing your PsA-related back pain.

Acknowledge your feelings and seek support. It is natural to feel worried, frustrated, sad and sometimes angry when you have pain. Be aware of these feelings and get help if they start affecting your daily life. A psychologist can help you manage anxiety, fears or worry.

Talk to healthcare team if you are unsure about the things you can do to help manage your back pain.