I am 39 years old, female, active, and in excellent health overall. i have had a troublesome back since my 20's (occasionally would go "out" with significant pain, and about a week to be walking upright again) i was an athlete, and hard on my body with moving things, etc, because i was always physically strong and able to do so. over last couple years, have had significant increase in "flare-ups" of my back, though it rarely goes out any more, just pain and stiffness and unable to lift or do sudden twisting or stepping. i must have 6 perfectly-positioned pillows to sleep (side only... if on back, i can't get up, and stomach has been impossible for several years now) morning pain is almost intolerable. teeth are wearing down from night-time clenching. went to dr. 2 years ago. x-rays showed spondylolysthetic changes in my L5/S1 vertebrae. (the vertebrae is slightly twisted and tilted down, and showing arthritic wear, with no spurs.) ANA blood test showed a result of 1240. (i was told normal was 1:20?). ANA was repeated 18 mos later, and showed same result. Dr indicates it is a result of aging, but i have genetic history of very active, very long-lived parents and grandparents, and i myself am very active and healthy other than this. i am not one to want to take meds unless necessary, but also don't want to make this problem worse by not treating it. i appear young, active and healthy to others, unless they see me trying to get up from sitting for extended periods (during flare-ups, it does not have to be extended period) and my most comfortable position when sitting, is to round my back over, leaning elbows on my legs or desk. Any arching of my back is painful. people always ask if my back is bothering me, even when it seems okay to me, so i think i am just used to it by now and do not notice that I am bent forward. should i be taking a medication, or seeing a specialist? i will occasionally take ibuprofen when at it’s worst.   what should i ask of my doctor? i get the feeling he thinks i am complaining of small aches and pains associated with aging, but this is definately not the case. can you give me any direction?