Back pain can be tricky to pinpoint. When your back hurts, you might wonder if you strained it while mowing the lawn, if you need better lumbar support in your car, or if you are experiencing a new symptom of systemic lupus erythematosus (SLE) — also known as lupus.

Back pain can have many potential causes, and getting an accurate diagnosis is essential to treating it. Aside from an injury, one potential cause of back pain in people with lupus is degenerative disc disease (DDD). If you’re experiencing back pain with lupus, it’s important to schedule an appointment with your healthcare provider to determine the root cause.

What Is Degenerative Disc Disease?

The spine is made up of bones called vertebrae, and between them, there are discs. These discs act as cushions for the vertebrae, allowing you to move comfortably. As you age, these discs gradually wear down. This wear and tear can cause the bones of the spine to rub together. When the spinal discs become worn and can’t provide enough padding to the vertebrae, this is called degenerative disc disease.

Degenerative disc disease can cause pain in the lower back. It can also cause numbness or tingling that radiates down the legs and buttocks or, if the discs in the neck are affected, to the arms to the fingertips. Wear and tear of the shock-absorbing discs in your spinal column is a normal part of aging. In fact, the majority of people over 40 have some degeneration of their spinal discs. However, not everyone with DDD experiences symptoms.

Causes of DDD include:

• Aging
• Injuries
• Genetics
• Obesity
• Activities that frequently stress the spine, such as jobs with repetitive twisting, lifting, and bending

The spinal disc wear of degenerative disc disease can also lead to other conditions. Potential complications of DDD include:

• Spinal stenosis — The narrowing of the space around the spinal cord
• Spondylolisthesis — When a vertebra moves out of its normal alignment in the spine (this can be either anterolisthesis, when the vertebra moves forward, or posterolisthesis, where it moves back)
• Herniated disc — When the outer part of a spinal disc tears or leaks
• Scoliosis — Abnormal curving of the spine

Health experts have also linked some autoimmune diseases, including lupus and rheumatoid arthritis, to DDD.

Lupus and the Spine

Lupus is a disease where the immune system mistakenly attacks healthy tissues and organs. It can affect any part of the body. When lupus affects the spine, the immune response attacks normal proteins, leading to joint and nerve destruction, bone loss, inflammation, and swelling. As damage occurs, your spinal discs are less able to absorb shock, which can lead to the pain associated with DDD.

Transverse myelitis is a rare nervous system disorder that causes spinal cord inflammation. It affects approximately 1 percent of people with lupus. Although myelitis does not cause DDD, it can cause similar symptoms, like pain, tingling, numbness, and loss of sensation. However, it usually causes additional symptoms like loss of bladder and bowel control, which can help doctors differentiate it from DDD.

Lupus, along with aging, genetics, some types of arthritis, and other immune system abnormalities, can all cause similar back pain symptoms. Because these conditions can overlap or share similar symptoms, your healthcare provider may attribute your back issues to one or more causes. If you have concerns about your diagnosis, it’s always a good idea to seek a second opinion.

What MyLupusTeam Members Say

Members of MyLupusTeam often share how challenging it can be to get a clear diagnosis for back pain when lupus is involved. One member expressed frustration with conflicting information from their care team: “A rheumatologist told me these diseases are unrelated. A spinal surgeon told me he thinks lupus caused my spinal issues. A neurosurgeon told me there’s no way to know. Different answers from everyone!”

Other MyLupusTeam members have shared their experiences with lupus and other diagnoses:

• “I have lupus nephritis, fibromyalgia, and Sjögren’s disease. I also have degenerative disc disease.”
• “I have lupus, Sjögren’s disease, antiphospholipid syndrome, degenerative disc disease, anemia, and Cushing syndrome.”
• “I have lupus, spinal stenosis, degenerative disc disease, Raynaud’s disease, Sjögren’s disease, Ehlers-Danlos syndrome, and celiac disease.”
• “I have lupus, spinal osteoarthritis, and facet joint disease. I have had two spinal surgeries for herniated cervical discs and bone spurs.”

Lupus Medications and the Spine

If you take medications for lupus, these can have additional effects on your bones, particularly your spine. For example, prednisone, a corticosteroid commonly used to treat lupus, increases the risk of developing osteoporosis. Osteoporosis is a condition that weakens the bones, which can lead to painful fractures of the vertebrae.

If your doctor prescribes prednisone or another steroid to address your symptoms of lupus, it’s important to discuss strategies for keeping your bones strong. Some healthcare providers recommend taking a calcium or hormone supplement or increasing vitamin D intake. In patients who need greater doses of steroids for a longer time, healthcare providers may recommend taking bisphosphonates, drugs used to treat osteoporosis.

Talk to Your Doctor

If you’re living with back pain or any discomfort related to your spine, it’s important to talk to a healthcare professional. Your spinal cord carries messages between your brain and body, enabling you to move and function. The spinal column is made of three parts: the cervical, thoracic, and lumbar regions, all of which are critical to supporting your body. If you experience any back pain, joint pain, or any other pain or discomfort in these areas, you should seek medical advice from a healthcare professional.

To pinpoint the source of your pain, your doctor might recommend various tests, including blood tests, X-rays, or magnetic resonance imaging (MRI). Depending on the results, treatment options could include corticosteroids to reduce inflammation, nonsteroidal anti-inflammatory drugs (NSAIDs) to manage pain, or immunosuppressive drugs to ease your symptoms and reduce inflammation. Your doctor might also recommend physical therapy to strengthen your muscles and increase your range of motion. If your symptoms persist, schedule a follow-up to discuss other options.

Talk With Others Who Understand

MyLupusTeam is the online social network for people with lupus and their loved ones. On MyLupusTeam, more than 234,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Are you living with lupus and degenerative disc disease? Share your experience in the comments below, or start a conversation by posting on your Activities page.