6 Types of Arthritis That Can Cause Back Pain

Don’t write off persistent aching just because you’re young.

By Sarah Klein, CPTMedically reviewed by Mathew Devine, DO

March 5, 2024

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Back pain might feel like one of those inescapable things that can happen when you get older—or just while living your life in general. Who hasn’t attributed the occasional pang or jab to sleeping in a weird position, slouching at a desk for eight hours, or lurching to grab something off the floor in a slightly wonky way?

But not all aching stems from strains, sprains, or spasms (as those examples above can sometimes lead to); it can also be related to some type of arthritis in your spine. And while the term “arthritis” might lead you to believe it’s something that only affects people who are a certain age—say, folks over 50—it’s worth chatting with a doc if you’ve been dealing with the aching for a while or you have other symptoms alongside it (regardless of how old you are), experts say. Here are six types of arthritis that can cause back issues—and what you’ll likely notice if you have one.

1. Osteoarthritis

Wear and tear from aging, overuse, or an injury can cause our joint tissues to break down, which can lead to pain and stiffness—a.k.a. osteoarthritis (OA). While you might be more familiar with the hand or knee varieties, OA—which is the most common type of arthritis—can affect your lower back, specifically the discs of tissue between vertebrae. Some people are more likely to deal with it than others, including if you’re over 50, past menopause, or have had an injury or surgery in the past.

What you’ll probably notice: OA is a mechanical, or structural, type of arthritis, Nilanjana Bose, MD, a rheumatologist at Lonestar Rheumatology in Houston, Texas, tells SELF, which means there’s an actual physical injury to the lower back.¹ This is opposed to inflammatory arthritis, which is caused by an overactive immune system and has some slightly different symptoms (which we’ll talk about in a minute). This means you might feel stiffness or swelling when you move your back in a certain way (say, lifting a big box) or after you’ve been still for a while (like right when you wake up).

2. Spinal stenosis

Spinal stenosis, another common mechanical arthritis, tends to go hand-in-hand with OA. As the cartilage between vertebrae wears down, your body does its best to repair the problem by creating tiny bony growths near the damaged area. Unfortunately, instead of helping the situation, this can put a lot of pressure on your spine and the surrounding nerves, leading to sharp pain and stiffness, Dr. Bose says. If you’re in a group more likely to develop OA, your chances of having spinal stenosis might go up too.

What you’ll probably notice: While achiness from this condition can happen anywhere on your back, if those growths are higher up your spine, you might feel some tingling in your shoulder or arm. If they’re lower down, your legs might become numb or slightly achy. You could even get a burning sensation through your butt that worsens when standing or walking—but gets better when leaning slightly forward.

3. Axial spondyloarthritis

There are two different kinds of this type of arthritis: radiographic axial spondyloarthritis (also called ankylosing spondylitis or AS) and nonradiographic axSpA. Both are inflammatory and can hurt your spine. No one really knows why each one develops (frustrating, right?!), but some experts believe that genes or exposure to viruses or bacteria might be to blame. This one is pretty rare overall: It only pops up in somewhere between 9 and 30 out of 10,000 people. If someone does have it, they might start having symptoms in their 20s and 30s.

What you’ll probably notice: Throbbing from axSpA tends to center on your lower back, and it might be worse during the night or when you first wake up because you’ve been lying still in bed for so long, Elizabeth Schulman, MD, attending physician at the Hospital for Special Surgery and an assistant professor at Weill Cornell Medical College in New York City, tells SELF. Important to note: Some primary care docs can mistakenly believe people with nonradiographic axSpA have mechanical back pain. That’s because there’s often no visible damage to your spine with the condition when viewed on an X-ray, Dr. Schulman says, and you have to spot it through an MRI. A lot of the time it takes a rheumatologist trained in treating axSpA to recognize (and accurately test for) it, Dr. Schulman explains. Paige Cerulli, 37, was doing sit-ups when she first experienced AS pain. “My physician assumed I was making up excuses to get out of gym class,” Cerulli tells SELF. Doctors remained stumped until one rheumatologist finally spotted the spinal issue more than 15 years later: “[He was] the first doctor to really listen to me when I described how severe the pain was and how it was impacting my life.

4. Psoriatic arthritis

If you have psoriasis, there’s a roughly 30% chance you’ll also develop psoriatic arthritis (PsA)—and then have a 20% chance of having spinal issues that stem from it, Dr. Schulman says.² Because PsA is an inflammatory condition, your immune system kicks into high gear, and your body might mistakenly attack healthy cells and tissues all over your body—and that includes your back. Though you can get PsA at any point, symptoms usually tend to show up after age 30. Having a relative with the condition can also up your risk.

What you’ll probably notice: Because this condition occurs due to inflammatory changes in the spine, it “can mimic ankylosing spondylitis,” Dr. Bose says.³ Typically, you’ll feel some discomfort in your lower back and the structures that connect it to the pelvis, a.k.a. your sacroiliac joints. This means you might have throbbing in your hips or butt that can also work its way up, Dr. Schulman says.

5. Enteropathic arthritis

About one in five people with inflammatory bowel disease (IBD), like Crohn's disease or ulcerative colitis, develop this form of arthritis, which can lead to issues with their spine. “Many times they’re young—like 20s and 30s—and active, so they might chalk up their back pain to working out or sitting at a desk,” Dr. Schulman says.⁴ Doctors don’t really understand why it happens, but changes to the bacteria living in your gut might trigger an immune system response that leads to inflammation that can result in joint pain.

What you’ll probably notice: The most obvious enteropathic arthritis symptoms will probably be digestion-related—think: diarrhea, blood in your poop, having the urge to go fairly often. You will also likely have some swelling, tenderness, and stiffness along your spine, Dr. Schulman says. Increasingly, gastros are screening people with IBD and back pain for this condition, she says.⁵

6. Reactive arthritis

If you develop a bacterial infection in your gut, urinary tract, or genitals, your immune system will try to fight those invaders. In some cases, however, your body might overreact to fight the infection and attack some otherwise healthy areas, like the joints in your spine. This can leave you with tenderness and swelling in your lower back and pelvis, Dr. Schulman says. Up to 4% of people who get chlamydia and 15% of people who get gastro bugs, like salmonella, will develop reactive arthritis.

Most folks fully recover within a few months after their infection, though it can take up to a year in some cases, and a doc will prescribe anti-inflammatory pain meds or steroids to help, Dr. Schulman says. “The hope is it doesn’t progress to persistent arthritis.” (Although long-term issues can, unfortunately, occur 15 to 50% of the time.)

What you’ll probably notice: With most reactive arthritis cases, you might get some aching about 10 days after your infection clears up, along with any residual symptoms from whatever issue you had—say, lingering fatigue from food poisoning.⁶ You might feel stiffness in your lower back or butt, especially in the morning or at night.

When to see a doctor

All this might sound scarier than a nagging ache from sleeping funny, but don’t worry too much yet: Most back pain—about 80%—is considered acute, meaning it only lasts one to seven days. If you’re still in this window, make an appointment with a primary care doctor, Dr. Bose says. They’ll do an initial evaluation to see if there’s an obvious cause, like a muscle strain. Depending on your symptoms, you might need an X-ray or an MRI and/or be referred to physical therapy, she says. If your primary doc suspects another issue, like one of these arthritis types, is at play, they’ll send you to a rheumatologist or orthopedist, Dr. Schulman says.

Anytime you spiral down the “what do I have/I’ve gone and diagnosed myself with something awful” rabbit hole, you’re bound to strike a nerve (no pun intended)—but try your best not to freak out just yet. That’s because (a) fretting can actually make your pain worse, and (b) a trained pro can help solve whatever’s happening. Importantly, when issues are flagged right away, your outcome will generally look pretty good. “It’s definitely something that can be managed if caught early,” Dr. Bose says.

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