Prevalence of chronic axial pain, inflammatory back pain, and spondyloarthritis in diagnosed psoriasis.

objectiveTo provide prevalence estimates for inflammatory back pain (IBP) and spondyloarthritis (SpA) in those subjects with psoriasis using 2009-2010 National Health and Nutrition Examination Survey (NHANES) data.

methodsIn the NHANES 2009-2010 sample set, 6,684 persons ages 20-69 years were screened for participation, and 5,103 answered questions regarding onset of back pain, location of pain, and functional limitations. Data set assembly and statistical analysis were performed using SASTM and SUDAAN software. SEs were estimated by Taylor series linearization. The equality of the prevalence estimates for selected variables was tested (univariately) at an alpha level of 0.05 using 2-sided Student's t-test with appropriate degrees of freedom.

resultsA total of 148 persons had self-reported medically diagnosed psoriasis. The psoriasis group versus the nonpsoriasis group had a significantly higher prevalence of axial pain using the 3-month duration criterion (31.1% versus 18.9%; P = 0.04) and alternating buttock pain (7.2% versus 2.4%; P = 0.03) and more frequently met IBP criteria from Berlin criteria 7b and 8a (P = 0.04 and 0.02, respectively). The prevalence of SpA was significantly higher in the psoriasis group versus the nonpsoriasis group when using Amor or European Spondyloarthritis Study Group criteria (14.3% versus 1.5%; P < 0.001). Sudden onset of axial pain was significantly higher in the psoriasis group (23.3% versus 13.0%; P = 0.01).

conclusionThere is a higher prevalence of lower axial pain, IBP, SpA, and alternating buttock pain associated with a prior diagnosis of psoriasis. These data may influence the way psoriasis patients are approached in primary care and specialty clinics.