Could Your Symptoms Indicate Ankylosing Spondylitis? - Internal Medicine

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Based on the symptoms you've described, there is a possibility that they could be indicative of Ankylosing Spondylitis (AS), a type of inflammatory arthritis that primarily affects the spine and can lead to severe, chronic pain and discomfort. AS is characterized by inflammation of the spinal joints, which can result in pain and stiffness in the back and neck, particularly in the morning or after periods of inactivity. The symptoms you mentioned, such as neck and back pain, night sweats, and fluctuating body temperature, align with some of the common manifestations of AS.

The onset of your symptoms in April, particularly the neck and shoulder pain followed by significant lower back pain, is noteworthy. The fact that these symptoms improved and then recurred in June could suggest a pattern of inflammatory activity, which is typical in AS. Additionally, the presence of night sweats and mild fever (even if it is within a normal range) can sometimes accompany inflammatory conditions.

Your blood tests showing normal white blood cell counts, negative rheumatoid factor, and low CRP levels are reassuring, as they suggest that there is no acute infection or significant systemic inflammation at the time of testing. However, it is important to note that AS can sometimes present with normal inflammatory markers, especially in the early stages.

Given your symptoms and the potential for AS, it would be prudent to consult with a rheumatologist, who specializes in autoimmune and inflammatory diseases. They may recommend further testing, such as imaging studies (like an MRI of the sacroiliac joints) or genetic testing for the HLA-B27 antigen, which is often associated with AS.
In terms of severity, AS can vary widely among individuals. Some may experience mild symptoms that are manageable with over-the-counter pain relief and physical therapy, while others may have more severe symptoms that require stronger medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) or biologic therapies.
As for your upcoming trip to Europe in July, if you are diagnosed with AS, it would be wise to consider the following:
1. Medication Management: Ensure you have enough medication for your trip, including any NSAIDs or prescribed treatments. Carry a copy of your prescriptions in case you need to refill them abroad.

2. Physical Activity: Plan for regular movement and stretching, especially if you will be sitting for long periods during travel. Consider bringing a travel pillow for neck support.

3. Hydration and Nutrition: Stay hydrated and maintain a balanced diet, as inflammation can be exacerbated by dehydration and poor nutrition.

4. Rest: Ensure you get adequate rest, as fatigue can worsen symptoms.

5. Emergency Plan: Know where to seek medical help in case of a flare-up while traveling.

If your symptoms do not align with AS, they could potentially indicate other conditions such as reactive arthritis, fibromyalgia, or even a viral infection that may have resolved but left lingering symptoms. It's crucial to continue seeking medical advice until you receive a definitive diagnosis.
In conclusion, while your symptoms may suggest Ankylosing Spondylitis, further evaluation by a specialist is necessary to confirm the diagnosis and determine the best course of action. Your health and well-being are paramount, and addressing these concerns with a healthcare professional will provide you with the clarity and treatment you need.