“Crohn’s disease is primarily a chronic inflammatory condition of the gastrointestinal (GI) tract. However, it is well known that the inflammation in Crohn’s disease can spread beyond the gut, affecting other systems in the body, including joint pain and back pain, especially in cases of prolonged or severe inflammation,” says Dr Kiran Shinde, Consultant Gastroenterologist, Sahyadri Super Speciality Hospital, Hadapsar, Pune, India.
Axial arthritis and ankylosing spondylitis in Crohn's disease
“Up to 25 percent of Crohn’s patients have joint pain due to a related condition called ankylosing spondylitis,” says Dr. Shinde. “This type of arthritis affects the spine and sacroiliac joints, where the lower spine and pelvis meet, leading to symptoms of back pain.” This condition is more common in people with IBD like Crohn’s and can cause chronic pain, stiffness, and reduced mobility in the lower back and pelvis.
The role of immune disorders
The immune disorder that characterizes Crohn's disease affects many tissues in the body, including those in the spine. This immune response can lead to inflammation in the joints, muscles, and soft tissues surrounding the spine, contributing to back pain.
Vitamin and mineral deficiencies
People with Crohn's disease often have problems absorbing nutrients, especially vitamin D, calcium, and B vitamins. Vitamin D deficiency can weaken bones and cause musculoskeletal pain. In addition, calcium deficiency can lead to bone density problems, increasing the risk of fractures and chronic pain.
Factors related to treatment
Some medications used to control Crohn's disease, especially steroids, can contribute to bone loss over time, leading to osteoporosis or osteopenia, which increases the risk of back pain.
Postural and lifestyle factors
Living with Crohn’s disease can also indirectly affect posture, physical activity levels, and stress, all of which can contribute to back pain. Chronic pain and fatigue can lead to a sedentary lifestyle, weakening the core muscles, leading to poor posture and increased back pain over time.
Diagnosis and management of back pain in Crohn's disease patients
“Back pain in Crohn’s disease patients can be caused by arthritis, side effects of medications, or changes in the musculoskeletal system caused by Crohn’s disease,” Dr. Shinde emphasizes. “If you have Crohn’s disease and experience symptoms of back pain, consulting a specialist can help determine the cause and appropriate treatment.”
