Spondyloarthritis is an umbrella term for several inflammatory diseases that primarily affect the spine and other joints.
Spondyloarthritis is an umbrella term for inflammatory diseases that can affect the back, pelvis, neck and some larger joints, as well as internal organs, like the intestines and eyes. The most common of these diseases is ankylosing spondylitis. Others include:
- Psoriatic arthritis.
- Reactive arthritis.
- Enteropathic arthritis (associated with the inflammatory bowel disease)
- Undifferentiated spondyloarthritis.
Also called spondyloarthropathy or spondylitis, these conditions usually develop between ages 17 and 45. But it may occur at younger ages.
No one knows what causes spondyloarthritis. Researchers believe that genes play a big role. For example, some people with a gene called HLA-B27 are at greater risk of developing ankylosing spondylitis (AS). Gender may also be a risk factor for AS as men are more likely to develop this condition than women.
For many people, the first and predominant symptom of spondyloarthritis is pain in the lower back and hips, especially in the morning and after periods of inactivity. But pain and swelling can also occur in shoulders, hips, knees, ankles and hands. It can range from mild to severe.
Inflammation may also cause:
- Redness and pain in the eyes (uveitis or iritis).
- Pain and swelling along the tendons of the finger or toes (dactylitis) or where tendons and ligaments meet the bone (enthesitis), which commonly occurs at the back or bottom of the heel.
- The skin rash of psoriasis, an inflammatory skin disease.
- Pain, bloating and other stomach symptoms of Chrohn’s disease, ulcerative colitis or inflammatory bowel disease.
Joint symptoms, and accompanying fatigue, may come and go. If untreated, inflammatory back symptoms can cause bones in the spine to fuse. This makes the spine less flexible and can result in a hunched-forward posture.
X-rays of the sacroiliac joints, a pair of joints in the pelvis, often show changes called sacroiliitis in people with spondyloarthritis. If these changes do not show up on X-ray but symptoms suggest spondyloarthritis, the doctor may take a magnetic resonance image (MRI) that can show these changes before an X-ray can. A blood test for the HLA-B27 gene can also help confirm a suspected diagnosis of spondyloarthritis, although not everyone with the gene will develop arthritis.
There is no cure for spondylitis, but treatments can ease symptoms and potentially slow disease progression.
When joint swelling is not widespread, injections of a corticosteroid medication directly into the joint or membrane surrounding the affected area can provide quick relief.
Doctors may prescribe disease-modifying antirheumatic drugs (DMARDs) to relieve symptoms and prevent joint damage. These include traditional DMARDS, such as methotrexate and sulfasalazine or biologics such as TNF and IL-inhibitors.
Topical treatments that include vitamins A and D can help to treat skin symptoms.
Antibiotics may be helpful for reactive arthritis.
Spondyloarthritis has physical and emotional effects. This includes making healthy lifestyle choices such as exercising regularly, not smoking, protecting skin and choosing healthy, anti-inflammatory nutrition. Complementary therapies, such as massage, acupuncture, hot/cold therapy, guided imagery and visualization can help to ease pain and reduce stress. Maintaining good posture also helps to reduce back and neck pain and preserve mobility. Counseling, participating in support groups or an online community offered by the Arthritis Foundation may also be helpful.
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