Painkillers are ‘hiding’ serious back condition in Scots patients

● Anti-inflammatory drugs could mask arthritic problems in thousands

0 Painkillers can hamper diagnosis of axial spondyloarthritis Thousandsofscottishpatients with an inflammatory arthritic back condition may be misdiagnosed because the pain killers they take hide the problem from doctors.

A new University of Aberdeen study, funded by Arthritis Research UK, aims to see how big a role patients’ medication plays in slowing down diagnosis of axial spondyloarthritis.

It is estimated over 7,000 people in Scotland live daily with inflammatory back pain.

Most manage pain with antiinflammatory drugs such as Ibuprofen or stronger variants whilst they wait to have the condition formally diagnosed by a rheumatologist.

Axial spondyloarthritis is an inflammatory condition affecting the spine and joints in the pelvis and in extreme cases can lead to parts of the spine fusing together. It is diagnosed using MRI scans after which it cannot be cured but can be managed with special anti-inflammatory medication. Researchers behind the study suspect that some people who undergo an MRI scan receive a negative diagnosis for axial spondyloarthritis because the Ibuprofen-like drugs they are taking sufficiently reduce the inflammation and “hide” the symptoms.

Early diagnosis is key to preventing the condition from getting worse but typically it can take between eight to 11 years to be properly identified. This study will give an indication as to what proportion of axial spondyloarthritis are mis-diagnosed as a result of the antiinflammatory drugs.

Two hundred and fifty patients with the condition will be recruited to the study from around 20 different centres. They will stop taking their regular anti-inflammatory drugs like Ibuprofenp for a week and then given an MRI scan. They will then start taking the drugs again for six weeks before receiving a second MRI scan. Researchers will then compare the proportion of people who scanned positive for axial spondyloarthritis with those who scanned negative for the condition once they are back on them.

Lead researcher, Dr Gareth Jones, a musculoskeletal pain and spondyloarthritis expert, said: “The fact it can take up to 11 years to get a formal diagnosis of axial spondyloarthritis is obviously a concern. There are good drugs to help people manage the condition but they are only available to people who get a correct diagnosis.”