Back Pain
Expert diagnosis and personalized treatment at Arthritis Care of Los Angeles.
What is Back Pain?
Back pain is extremely common and can have many causes. A rheumatologist specializes in diagnosing and treating back pain that is caused by inflammatory conditions such as ankylosing spondylitis, psoriatic arthritis, or other forms of inflammatory spine disease (spondyloarthritis). Inflammatory back pain is different from common mechanical back pain — it typically starts before age 45, develops gradually, improves with movement, and is worse after prolonged rest. Identifying whether back pain has an inflammatory cause is important because these conditions respond to specific treatments that can prevent permanent spine damage.
Common Symptoms
- Back pain that started gradually before age 45
- Morning stiffness in the back lasting more than 30 minutes
- Pain that improves with exercise and movement
- Pain that worsens with rest or inactivity
- Night pain that improves after getting up
- Alternating buttock pain
- Stiffness and reduced flexibility in the spine
- Pain that has lasted more than three months
Experiencing these symptoms? Get expert care today.
How is Back Pain Diagnosed?
Evaluation includes detailed history (distinguishing inflammatory from mechanical patterns), physical examination of spinal mobility, blood tests (HLA-B27, ESR, CRP), and imaging (X-rays of the pelvis and spine, MRI of the sacroiliac joints). MRI can detect inflammation years before changes appear on X-rays. Dr. Forouzesh is experienced at identifying inflammatory back pain early, when treatment is most effective.
Treatment Options
NSAIDs
First-line treatment for inflammatory back pain. NSAIDs can be very effective at reducing inflammation and pain in the spine.
Biologic Therapies
TNF inhibitors and IL-17 inhibitors for patients who do not respond adequately to NSAIDs. These can halt disease progression and prevent spinal fusion.
Physical Therapy
Essential for maintaining spinal flexibility, strengthening core muscles, and preventing postural changes.
Exercise Programs
Regular movement is a cornerstone of treatment. Swimming, walking, and stretching programs designed for spinal conditions.
JAK Inhibitors
Newer oral medications for inflammatory back pain in patients who need alternatives to biologic therapies.
Key Statistics
80%
Of adults experience back pain at some point
Source: NIH/NINDS
5-7%
Of chronic back pain is inflammatory in nature
Source: American College of Rheumatology
7 Years
Average delay diagnosing inflammatory back pain
Source: Spondylitis Association of America
Frequently Asked Questions
Ready to Get Expert Care?
Schedule your appointment with Dr. Solomon Forouzesh, MD, FACP, FACR — a board-certified rheumatologist with 50++ years of expertise in arthritis and autoimmune diseases.