Spondyloarthritis is an umbrella term that describes different types of arthritis. These types mainly affect the spine, but they can also cause symptoms in other parts of the body.
There has been some debate about whether spondyloarthritis is an autoimmune condition or an autoinflammatory condition. However, recent research suggests that spondyloarthritis is indeed an autoimmune condition.
This article will explore spondyloarthritis in detail. Specifically, it will examine the different types, symptoms, and treatment options associated with the condition.
There are several subtypes of spondyloarthritis. Each can involve a different part of the body.
The following sections will look at some of these types in more detail.
Ankylosing spondylitis is the most common form of spondyloarthritis. It involves ligaments, tendons, and joint capsules attaching to bones in the spine and peripheral joints.
It can cause the bones in the spine to fuse together, leading to stiffness and immobility.
This type of spondyloarthritis primarily involves the joints in the spine and pelvis.
Like axial spondyloarthritis, the non-radiographic form also affects the spine and causes lower back pain.
However, the effects of non-radiographic spondyloarthritis are not visible on X-rays. They are only visible on more sensitive imaging tests, such as MRI scans.
Peripheral spondyloarthritis describes a number of spondyloarthritis subsets.
Spondyloarthritis tends to be more common in males, whereas rheumatoid arthritis is more common in females.
Rheumatoid arthritis symptoms typically start appearing when a person is around 40–50 years of age. The symptoms of spondyloarthritis usually occur earlier than this.
The early symptoms of rheumatoid arthritis usually affect the hands and feet. The early symptoms of spondyloarthritis usually start with back pain.
People often develop spondyloarthritis in their teenage years or 20s. Those with the following characteristics may be more likely to experience spondyloarthritis:
- being male
- having a family history of spondyloarthritis
- being one or being a descendant of the following northern populations:
- Siberian Eskimos
- Scandinavian Lapps
It is important to note that spondyloarthritis is notoriously difficult to diagnose in females. This could mean that it is more common in females than some statistics may show.
Lower back or hip pain is a common early symptom. However, symptoms can vary depending on the type of spondyloarthritis a person has.
Inflammation elsewhere in the body is a symptom of spondyloarthritis. It can especially affect the:
Spondyloarthritis-related inflammation can cause:
- irritation and redness in the eyes
- eye pain, light sensitivity, and blurry vision
- pain in the tendons of the fingers and toes
- gastrointestinal symptoms
Another symptom of spondyloarthritis and the swelling it causes is psoriatic rashes. These may appear differently depending on a person’s skin color.
These symptoms may be particularly painful first thing in the morning or after periods of rest.
Untreated spondyloarthritis could lead to a person developing the following conditions:
- heart inflammation
- intestinal inflammation
A person who is experiencing symptoms of spondyloarthritis should contact a doctor to treat the condition. This may help prevent these complications.
If a person has had chronic lower back pain since before the age of 40 years, they may have spondyloarthritis. People often assume that they simply have back pain due to poor posture or other mechanical issues.
Because the pain can come and go, some people may assume that the pain is not important. However, not seeking treatment for spondyloarthritis can lead to complications later on.
A person who suspects that they have spondyloarthritis should contact a doctor. They should provide the doctor with details about their pain onset and whether or not they have other inflammatory symptoms that might suggest the presence of spondyloarthritis.
A doctor will diagnose spondyloarthritis by taking a person’s medical history and performing a physical exam.
Imaging can help confirm a diagnosis. The doctor may request an MRI scan if an X-ray does not show damage but a person has symptoms that suggest the presence of spondyloarthritis.
A blood test is also available for the HLA-B27 gene, which is a gene associated with the condition. However, testing positive for the gene does not necessarily mean that a person has spondyloarthritis.
The doctor may also choose to carry out a complete blood count, to diagnose anemia, or a metabolic panel, to analyze a person’s kidney and liver function.
Sometimes, medical professionals can mistake spondyloarthritis for other similar conditions, which can delay diagnosis and treatment. This is especially the case among females.
There is currently no cure for this condition. However, treatment can help relieve the symptoms and slow the progress of the condition.
Some treatment options include:
- over-the-counter nonsteroidal anti-inflammatory drugs
- corticosteroid injections to specific joints
- disease-modifying antirheumatic drugs, including Janus kinase inhibitors
- topical gels and creams for joint pain and skin-related side effects
- surgery (when the joints have severe damage)
- biologic drugs, including TNF alpha-blockers and IL-17 blockers
Biologics are very effective but expensive. These drugs can also increase a person’s risk of infection.
Also, physical therapy can help restore range of motion in the affected joints.
One 2020 study involved putting 100 people with axial spondyloarthritis, non-radiographic axial spondyloarthritis, or psoriatic arthritis with axial involvement on physical therapy treatment programs.
The therapy significantly improved the pain that the condition caused, including among those with secondary conditions such as fibromyalgia.
Occupational therapy can also help a person improve or maintain their ability to perform day-to-day activities. An occupational therapist can provide recommendations and assistive devices to help prevent further injury.
Living with spondyloarthritis can make performing certain everyday tasks more difficult, but it is possible to manage the symptoms. Also, the condition does not usually affect a person’s life expectancy significantly.
Symptoms such as pain and fatigue may come and go, and treatments can help a person live with this condition.
Some behavioral changes can also make living with spondyloarthritis easier. These changes include:
- exercising, for joint and heart health
- quitting smoking
- eating an anti-inflammatory diet
- improving sleep hygiene
There are also spondyloarthritis support groups available for people who may need additional support.
Not seeking treatment for spondyloarthritis can lead to complications. Joints can fuse, for example, which may cause severe stiffness or immobility.
The symptoms of spondyloarthritis can come and go. However, even if a person does not constantly experience symptoms, they should still contact a doctor.
Not seeking treatment can lead to more complications of the condition. For example, it could become increasingly painful.
With the right treatment, people with spondyloarthritis can live an active life. Although there is no way to cure the condition, it is possible to manage the symptoms and prevent disease progression.
Making certain behavioral changes and trying medical treatments can make the pain and inflammation of spondyloarthritis more manageable.