Why Spondyloarthritis is Harder to Diagnose in Women (Video)

Back pain is one of the most common reasons patients seek care—but not all back pain is the same. In this segment, I explain why inflammatory back pain associated with spondyloarthritis and ankylosing spondylitis is frequently overlooked, especially in women. From a rheumatology perspective, I break down how symptoms are often mislabeled as routine back pain, chronic back pain, or non-inflammatory arthritis, delaying appropriate evaluation and care.

In this video with MD Newsline, I walk through how axial spondylitis diagnosis and axial spondyloarthritis diagnosis rely on recognizing key clinical patterns that differ from mechanical vs inflammatory back pain. While inflammatory vs mechanical back pain typically improves with movement and responds to anti-inflammatory therapy, many women present atypically due to central sensitization of pain. This form of chronic pain and nervous system involvement can obscure classic symptoms, contributing to delayed diagnosis in women and widening known sex differences in spondyloarthritis.

What You’ll Learn In This Video:

• How inflammatory back pain differs from mechanical causes of back pain

• Why ankylosing spondylitis and axial spondyloarthritis are often missed in women

• The role of central sensitization of pain in altering symptom presentation

• How mechanical vs inflammatory back pain affects diagnostic decision-making

• Why recognizing sex differences in spondyloarthritis is critical for clinicians

• The importance of early diagnosis of inflammatory arthritis for long-term outcomes

Many women with axial spondyloarthritis don’t match textbook descriptions. Improving awareness of atypical presentations and nervous system involvement is essential to reducing missed diagnoses and ensuring timely, effective treatment.