Thinking about what causes you pain is not an enjoyable activity, but it can be beneficial. Writing down the symptoms you experience can help you track patterns and help manage inflammatory back pain. Continue reading to learn how to properly track your symptoms.
If you’ve been diagnosed with inflammatory back pain (IBP), you know the symptoms: stiffness, particularly upon waking in the morning; pain; and decreased range of motion of the spine. But what you may not know is that these symptoms are also associated with a number of inflammatory arthritis conditions, including ankylosing spondylitis (AS), psoriatic arthritis, enteropathic arthropathy, juvenile idiopathic arthritis, and reactive arthritis.
To find out if you simply have IBP or one of these other conditions, which are collectively known as spondyloarthropathies, you and your doctor may need to track your symptoms over an extended period to see if or how they progress or evolve. That’s why Mohamad Bittar, MD, a rheumatologist and assistant professor of medicine the University of Tennessee Health Science Center in Memphis, recommends that people with IBP keep a symptom diary.
“It’s extremely important to be able to differentiate between inflammatory back pain and these other spondyloarthropathies, as the treatment and the prognosis are significantly different,” Dr. Bittar says.
“So it’s very helpful for your doctor to review the diary with you to determine whether your symptoms are consistent” with these other conditions, he adds.
Is It Definitely Inflammatory Back Pain?
Like other spondyloarthropathies, IBP, which is also called spondyloarthritis, is actually a form of inflammatory arthritis. This means the pain and discomfort you feel with IBP results from the cells of your immune system attacking one another in error, a process that causes inflammation. With IBP, pain is typically localized to the lower back and buttocks. It usually strikes people before age 40, and discomfort usually persists for three or more months. People with IBP usually report morning stiffness that improves with mobility or exercise.
As you track your symptoms in your diary, your doctor should be able to determine if they match IBP or if your pain is being caused by something else, Bittar says.
Is Your IBP Progressing to Another Inflammatory Condition?
Another reason keeping a symptom diary is important when you have inflammatory back pain is that IBP can progress to AS or another spondyloarthropathy, which can lead to other health complications. It’s been estimated that 40 percent of people with IBP will develop AS.
“Recording what doctors call extra-articular symptoms is important,” Bittar notes. “Because inflammatory back pain can progress to AS, it’s important to report symptoms like skin rashes or psoriasis-like symptoms; chronic diarrhea, blood in your stools, or abdominal pain; and eye inflammation symptoms like redness, pain, and blurry vision.
“Spondyloarthropathies like AS,” Bittar continues, “are actually a spectrum of conditions that can affect different organs, including the joints, eyes, skin, and bowels, among others, with serious long-term implications. For example, eye inflammation can lead to vision changes and blindness if not properly diagnosed and treated. That’s why it’s important to know about extra-articular manifestations of inflammatory back pain, and be on the lookout for them.” A diary can help you do that, he adds.
What Should You Track in Your IBP Symptom Diary?
Any time your back pain strikes, note it in your journal. Include these notes:
- Pain duration and intensity
- How and when the pain resolves
- Any joint stiffness
- What you were doing at the time your pain or stiffness started
- The date and time of day you noticed your symptoms
“Effective treatment should decrease the level of pain significantly, improve morning stiffness or even take it away, and improve general functionality,” Bittar says. “I wouldn’t expect you to continue to wake up in the middle of the night because of back pain, for example, once on treatment. So it would be helpful to record things like: Is the pain still happening every day or a few days a week? What’s the duration of morning stiffness?” In terms of symptom intensity, he adds, you want to help your doctor understand the severity of your pain or stiffness. A simple 0 to 10 scale, with 0 being no pain or stiffness and 10 being severe pain or stiffness, works well.
How Much Detail Should You Include?
In general, you should also include any extra information that can help explain the symptoms you experience in more detail. For example, was the pain on the left or right side of your back? Was it sharp or dull? Your exercise habits are also worth noting. Describe the type of exercises you’re doing and when you do them (what time of day and how often), and indicate whether your physical activity relieves your symptoms at all.
Ultimately, there’s no one right way to keep a symptom diary, but the general rule is the more information you track, the better. Review your journal both by yourself and with your doctor or physical therapist. It can be a useful way to remember what helps and what doesn’t in the management of your inflammatory back pain.