Office Worker’s Buttock and Back Pain Turns Out to Be a Serious Disease

A health news report tells the story of a 38-year-old female office worker (identified as N.T.H) who experienced persistent pain in her right buttock and lower back, along with discomfort in her neck and ribs for about six months. At first, she assumed it was simply due to sitting too long at work, a common belief for many people with sedentary jobs. However, further medical examination revealed a much more serious underlying condition. 

Initial Symptoms and Early Misdiagnosis

For several months, Ms. H. suffered from:

• Constant, dull pain in her right buttock and lower spine,

• Pain in her neck and both sides of her ribs,

• Occasional pain at night,

• A sensation of stiffness in the spine each morning that lasted about 5–10 minutes.
  The pain did not improve with movement, and she did not experience numbness in the arms or legs or swelling in other joints, which are often seen in typical musculoskeletal injuries.

Worried by these unusual symptoms, she visited several clinics where doctors initially diagnosed her with:

• Cervical spine degeneration,

• Lumbar spine degeneration,

• Referred pain possibly related to intercostal nerves.

She was prescribed medication based on these initial diagnoses and experienced slight improvement. However, after two weeks of treatment, new symptoms appeared, such as upper abdominal pain, heartburn, and acid reflux, prompting her to seek further medical advice. 

Specialist Evaluation and True Diagnosis

Ms. H. then underwent more detailed testing by a specialist in musculoskeletal disorders. The results showed:

• Elevated inflammation markers in her blood,

• MRI evidence of inflammation in the right sacroiliac joint,

• Gastric inflammation visible in endoscopy, with negative testing for Helicobacter pylori infection.

Based on these findings, the specialist diagnosed her with axial spondyloarthritis (SpA) — a chronic inflammatory condition affecting the spine — at a high level of disease activity, along with vitamin D deficiency.

After appropriate treatment was started, Ms. H. experienced:

• Relief from sacroiliac joint pain within two weeks,

• Continued fatigue in her spine, but overall significant improvement,

• Better control of her digestive symptoms. 

Medical Expert Explanation

According to Dr. Trinh Thi Nga, a specialist in rheumatology and musculoskeletal disorders, axial spondyloarthritis (SpA) is a group of inflammatory diseases with characteristic clinical and genetic features. It is diagnosed based on a combination of:

• Clinical symptoms (such as chronic spine pain and joint inflammation),

• Imaging tests (like MRI showing sacroiliac joint inflammation),

• Elevated inflammatory markers (such as CRP).

Dr. Nga also noted differences between men and women in the disease: women are often diagnosed later, typically about 2 years after men, and may respond less well to certain treatments, likely due to variations in immune-related molecules such as Interleukin-17 (IL-17) and tumor necrosis factor-alpha (TNF-α) in the body. 

Treatment Considerations and Recommendations

Treatment for SpA is usually long-term and often includes anti-inflammatory drugs. However, these medications can increase the risk of gastrointestinal side effects, especially in patients with a history of stomach ulcers or older adults. Therefore, doctors may recommend using NSAIDs (nonsteroidal anti-inflammatory drugs) together with protective medications for the stomach (such as proton pump inhibitors). In some cases, biologic therapies may be used to better control inflammation and disease activity. 

Potential Complications if Left Untreated

If spondyloarthritis is not detected and treated early, it can lead to serious long-term complications, such as:

• Spinal deformity and fusion,

• Inflammation affecting other organs, including the eyes, digestive system, and skin,

• Reduced mobility,

• Lowered quality of life.

The condition is often misinterpreted as ordinary back pain related to posture or sedentary work, particularly in office workers, which can delay appropriate diagnosis. 

Doctor’s Advice for the Public

Doctors advise that anyone experiencing chronic spine pain lasting more than three months, especially in the lower back or buttock area, pain that does not improve with rest, or pain that worsens at night or in the morning, should see a rheumatologist or musculoskeletal specialist promptly. Early detection and treatment can help slow disease progression and prevent joint fusion, preserving function and quality of life.