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Rheumatoid arthritis and back pain
Medical expert of the article
Last reviewed: 08.07.2025
Rheumatoid arthritis is a chronic autoimmune disease that causes damage mediated by cytokines, chemokines and metalloproteases. In the peripheral joints (such as the wrist, metacarpophalan, sebaceous) there is symmetrical inflammation, often leading to progressive destruction of the joint structures, often combined with systemic symptoms. The diagnosis is based on specific clinical, laboratory and radiological criteria. In the treatment, pharmaceuticals, physical methods, and sometimes surgery are used. Drug therapy includes a combination of NSAIDs, which reduce symptoms, and antirheumatic drugs, which modify the course of the disease, which has a slowly progressive course.
The diagnostic criteria for rheumatoid arthritis (based on the criteria of the American Rheumatology Association, now the American College of Rheumatology) are that a patient with rheumatoid arthritis must have any 4 of the following: morning stiffness > 1 hour; arthritis in > 3 joints; arthritis of the upper extremity (wrist, metacarpophalangeal, or proximal interphalangeal joints); symmetric arthritis; rheumatoid nodules; serum rheumatoid factor (positive in < 5% of healthy controls); radiographic changes of the hands, which must include erosions typical of rheumatoid arthritis or clear decalcification of bone. Features marked with an asterisk must be present for at least 6 weeks
In most patients with rheumatoid arthritis, the cervical spine is affected (atlantoaxial subluxation, laxity of the transverse ligament of the atlas, erosions of the C2 tooth, instability and subaxial subluxation of C3-C7), the lumbar spine is rarely involved, the sacroiliac joint may be affected.
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