Most of the mechanical spinal problems seen in practice on a day to day basis are related to movement and postural factors. It is rare to hear of patients completely pain free during the day, then suffering from diffuse aching pain at night. Further to this, nocturnal pain is also a well recognised red flag for underlying pathology. It is good to hear that you have had the relevant tests to exclude any obvious sinister cause.
Key features of inflammatory arthritis are:
- morning stiffness (>30mins) and pain that improves on gentle joint movement
- Raised erythrocyte sedimentation rate (ESR) and C-reactive Protein (CRP), which both suggest high levels of inflammatory substrate in the blood. These can be measured via blood tests.
Non inflammatory arthritisis such as osteoarthritis can still produce morning stiffness, but tends to last <30mins as a general rule.
Do you have any discomfort at any tendon insertions, such as your achilles? This may point to more of an autoimmune type inflammation.
As a hunch, it may be worth have a HLA-B27 check done. This is a gene that a proportion of people who have it suffer from autoimmune type inflammatory conditions. The gene is responsible for the immune system identifiying self from foe.
If this is positive, in conjunction with your symptom distribution and characteristics of the pain, ankylosing spondylitis (AS) also needs to be considered.
A trip to the chiropractor would be waranted to do a more thorough spinal examination as there are many unanswered questions here. Further to that, your chiropractor may send you to your GP for some further blood tests, specifically, ESR, CRP, rheumatoid factor, ANA and HLA-B27.
Chiropractors do more than adjust the spine. They are also trained in nutritional medicine and can offer particular help with inflammatory arthridities.
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