"Mechanical pain"

Posted , 4 users are following.

Hi everyone,

I've been reading your posts and found them very helpful. It's thanks to the power of Google that I started suspecting AS might be exactly what I have. However! Like some people here, that's not what the rheumatologist thought today. I should be ecstatic that he believes I have mechanical pain but I'm not convinced!

I'm a 41-YO woman and my symptoms are:

-Middle and lower back pain, wakes me up at 4am and doesn't go away until I get up and start moving. Started 4-5Y ago now and again, last 6 months frequent, weeks at a time, doesn't matter where I sleep ( changed bed, mattress, added memory foam...no difference)

-Index finger light pain for 2Y, hurts touching the area lightly, like neuropathic pain. Normal x-ray (GP though ?periosteal lifting)

-Achilles/peroneal pain in certain positions 1 1/2Y

-I have bumps on some fingernails

-I had unexplained optic neuritis in 2012

My inflammatory markers are negative

HLAB27 negative

He examined me thoroughly and concluded I just have mechanical pain.

This is my MRI report:

There is cervical spondylosis at C5/6 there is a broad based

posterior disc osteophyte bar this results in bilateral

foraminal narrowing and impingement of both exiting C6 nerve


At C6/7 there is a further posterior disc osteophyte bar

resulting in bilateral foraminal narrowing. There is

impingement of both exiting C7 nerve roots.


No other significant disc lesion



Normal alignment. There are posterior disc protrusions at

T7/8 and T8/9. No associated compression.



Normal alignment. There is loss of disc height and hydration

at L4/5 and L5/S1.

At l4/5 there is a non compressive disc bulge.


At L5/S1 there is broad based disc bulge with bilateral

facet hypertrophy . This results in left lateral recess and

foraminal narrowing. The disc is in contact with both the

exiting L5 and descending left S1 nerve roots but no

definite compression.



Cervical spondylosis

Lumbar degenerative disease

Do you expert people agree with my consultant?

I was certain he would confirm my suspicions. I was certain I had AS. The pain I have is still tolerable as on/off but... not AS?!

Thank you in advance


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13 Replies

  • Posted

    Hi juliapal,

    I have AS and am HLAB27 negative.  My recommendation is a second opinion. Another rheumatologist can test for inflammatory markers, etc.  I’m not a doctor, but I know there are other conditions that cause similar symptoms. 

    Also, you can visit the NASS website and try some of the non-medical treatments and find out if it improves your symptoms (swimming, diet, physio, etc.)

    Good luck!

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    • Posted

      Thank you Kathleen. My inflammatory markers were negative but then again that might reflect the absence of a flare-up I suppose?

      I shall give swimming a go, you're right. I'm a gym bunny and a runner but I don't know what I should/shouldn't do in terms of exercising as of course I have no diagnosis so didn't ask the rheumatologist.

      I will request a second opinion. Thank you!

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  • Posted

    I agree with CtKathleen - look for a second opinion.

    I too am negative for that gene, but my symptoms are textbook AS. My joints do not show any damage but the pain is constant. My doctor prescribed me recently a second round of cortisol which I will not take. I took it once for an ungodly episode I had last year and it wreaked havoc on my hormones.

    I change my diet, I exercise... I don't take NSAIDs. 

    Most recent "curiosity" is a spontaneous hematoma near my right hip. It feels as if I seriously hurt myself, which I didn't, but the pain is strong and there is even a bruise slowly coming up to the surface .

    My pain changes regions. My lower back have been fine most of the time in these past months, but hips, femurs and knees are pretty active, especially on the right side. Other joint sometimes join in...

    So, if you can see another specialist.

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    • Posted

      I used to bruise somewhat easily but NEVER without a reason.

      My rheumatologist ordered all the tests (blood, X-ray...) and concluded that despite the lack of any damage on the joints it was AS. My main symptoms during the first (and the worst) episode were sacroiliac pain and horrible muscle spasms that led to a postural distortion, that was fortunately resolved. 

      I had had even two years before some joint pain but never like this.

      The internal medicine specialist I saw after confirmed the diagnosis. 

      I feel rusty and after prolonged sitting I have difficulties moving normally. Same goes when I wake up.


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  • Posted

    Get a second opinion. Was this before or after the MRI?
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    • Posted

      Does he know about the other symptoms you mentioned? Has he given you another diagnosis other than mechanical pain? It's not necessarily AS but your doctor's explanation doesn't sound very satisfactory to me. 

      Do you have another appointment? Perhaps seek recommendations for more open-minded rheumatologists in your area and see if you can get an appointment with one of them. 

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    • Posted

      Thank you for your reply.

      I was nervous at the appointment, sweating all over and felt rushed. I didn't list every single thing, no.

      He discharged me saying he recommends physiotherapy for my "mechanical" aches. I do tonnes of sports including yoga and pilates, core, strength, cardio and running but yeah I'll try.

      I have already made a GP appointment for a second opinion referral. We shall see!

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    • Posted

      Great, good luck. Obviously I hope it isn't anything more serious and that physio sorts it out, but I had similar symptoms and normal blood tests and it was a real struggle to get my rheumatologist to believe my pain was inflammatory. I have probable psoriatic arthritis (and a new rheumatologist!).

      Report / Delete Reply

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