I was wondering if someone could clarify why the lower back can be painful in the early morning hours before rising. I read something years ago about klebsiella in the gut causing inflammation to the lower back. For me, the pain varies and sometimes is almost non existent. I have been having those symptoms for years. Was wondering if by sleeping more elevated would help symptoms since back pain doesn't happen during the day while in an upright position.
The pains we experience in the mornings are due to increased AS activity while at rest; to wit lymph no longer moves around (it has no heart to continually pump it around) and the IgA congregate near their source (the lymph nodes in proximity to the lower gut) and affect the synovial linings rich in B27. The complementary cascade that causes inflammation is triggered when two adjacent IgA connect on the B27 dense cell, calling in macrophages to carry out the destruction of that cell. While we are moving, there are fewer IgA pairs to connect because these are distributed throughout our lymph due to our movement, especially the gluteus muscles, that pump the lymph around.
The "character of our content" (food we eat) can have considerable effect upon just how much IgA is generated in the first place.
John - Thanks for your response. What's all that mean in simple terms?
For me, mornings were always the worst times for back and hip pain. I think it was mostly just due to inactivity of sleeping because any prolonged times of inactivity would cause problems, such as sitting too long at a desk. After I crawled out of bed, a hot shower would help loosen me up so that I could function. As long as I stayed active, the back and hip pain would not be crippling bad, but I soon as I stopped, the pain would flare up greatly again.
All in all, I would say that the problem could mostly be attributed to body temperature, noting that the causal problem was from AS and its relation to klebsiella. I even noticed that if I a got a fever from some other sickness, my back and hip pain would decrease.
However, I haven't had such bad pain problems once I got the no-starch diet figured out.
This is characteristic of AS. The problem is that when we are sleeping, we are essentially not moving (much). With AS, when we don't move, we become very stiff. Lower back pain in the morning, and I would imagine you feel very stiff and have difficulty moving for a bit, is the result of this. DragonSlayer's very technical and gut-related explanation aside, you are very normal when it comes to AS.
How long before the stiffness passes?
White light and love,
Greg, having AS pain leave when we are ill is a common effect. Many of us here have experienced this. When our immune systems are focussed on an actual illness, it stops attacking us.
Morning stiffness is a direct result of inactivity, as you say. I have experienced this in the heat of the Caribbean waking up under a light sheet and in the -25 of Northern Ontario under a duvet.
Body temperature may be a factor for you, as may kleb. p., but I can assure you that it is not a factor for me. Nor is it a factor for every ASer.
Light and love,
John explained the mechanics... unsure it can be stated in laymen terms. I know from personal experience stiffness was always worse in the morning.
Stretching really helps me, I make sure to do 15 minutes of stretching daily. Also drink lots of water to ensure have to go bathroom several times a day to ensure i get up and walk around.
Simply that MOVEMENT is good and INACTIVITY is bad. When we move around, the probability of cellular death that causes inflammation decreases because movement distributes lymph and therefore dilutes the local concentrations of IgA-Kp; the agent provocateur in AS. Imagine food coloring added to a glass of water that is very visible where it is introduced into the water, but once stirred in is not so obvious. The IgA is produced in the lymph nodes nearest our larger joints because that is where ground zero--the colon--is located.
Dead on John about the lymph and gut immunity activity! In 2015 I noticed that a strong jog for about 25 minutes covering 4.7 km a few times a week made a huge difference. I hypothesized that it had much to do with getting the bad out and the good in. A happy side effect of the regular jogging was waking in the morning feeling normal. I supposed that it had a lot to do with good, vascular flow. Then by 2017-2018 I was feeling like physical drainage from tissues was not working, particularly through the small lymph vessels throughout the body. Because in 2013 I had exposure to a sick kitten through scratches for a week from rough playing I imagined that a bartonella infection that I picked up was entrenching itself in the epithelial walls of my lymph vessels. Bartoneall favours vessel walls because they are close to oxygen; an aerobic bacteria.
My feet, hands and head all have burning nephropathy now and so walking on all fours is difficult to tolerate. The flesh is easily damaged now and so I seldom jog. Just doing calisthenics makes the engaged tissues very unhappy too. I guess my point is that keeping every detoxification mechanism maximized helps reduce inflammation and pain. Exercise is a good remedy.
I still haven't been diagnosed with an SpA. It will come soon but too late. My symptoms brought me to retirement in 2017 and I wasn't even 50 years old yet. There have been many past environmental exposures -- mold, bartonella, sea water, EBV, measles,... -- but I still am convinced that NSAIDs did the most damage!