An inflammatory disease known as spondyloarthritis affects the joints, particularly the spine, and the areas where ligaments and tendons attach to bones. Pain, stiffness, swelling, and damage to bones and joints may result from these diseases. Other organs can also be affected, including the eyes, skin, gut, and heart.
There are six main types of spondyloarthritis, each with different features and symptoms. They are:
Ankylosing spondylitis (AS) is one of the most common and severe types of spondyloarthritis. AS can cause chronic back pain, stiffness, and reduced mobility. It mainly affects the spine, causing inflammation and fusion of the vertebrae. It can also affect the hips, shoulders, ribs, and other joints. Aortic valve disease and uveitis (inflammation of the inner eye) can also be caused by AS.
An infection of the urinary or gastrointestinal tract triggers reactive arthritis. Reactive arthritis can cause inflammation of the joints, tendons, and eyes. It can also cause skin rashes, mouth ulcers, and genital sores. Reactive arthritis usually goes away in a few months, but it can also return or become chronic in some cases.
As a result of psoriasis, a chronic skin condition characterized by red, scaly patches, spondyloarthritis is often associated with it. It can affect any joint, but it often affects fingers, toes, the spine, and the sacroiliac joints (between the spine and the pelvis). Aside from causing joint pain, swelling, stiffness, and deformity, it can also affect the nails, causing pitting and separation from the nail bed.
Inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, cause this type of spondyloarthritis to develop. It causes inflammation of the joints, especially the spine and the sacroiliac joints. In addition to abdominal pain, diarrhea, and bleeding from the gut, enteropathic arthritis can flare up or improve with bowel disease activity.
Inflammation of the joints, tendons, eyes, and skin can accompany juvenile spondyloarthritis, which affects children and adolescents under 16. It can also cause fever, weight loss, and fatigue in children. Different subtypes of juvenile spondyloarthritis can be distinguished based on the number and location of the affected joints and the presence or absence of other symptoms.
Undifferentiated spondyloarthritis: This type of spondyloarthritis does not fit into any of the above categories, but it features features of spondyloarthritis, including inflammation of the spine, sacroiliac joints, and entheses. As well as affecting the eyes, skin, and gut, it can also affect other joints and organs.
There is no definitive cause of spondyloarthritis, but it is believed that genetic and environmental factors contribute to it. People with AS are more likely to have a gene called HLA-B27, which is found in about 90% of them, as well as in other types of spondyloarthritis in varying proportions. There is, however, no guarantee that you will develop spondyloarthritis if you have the HLA-B27 gene, since only a small percentage of people with this gene develop it. It is unknown whether other genes play a role in the development of spondyloarthritis.
Infections, such as those caused by bacteria or viruses, and physical trauma, such as injuries or surgeries, are examples of environmental factors that can trigger or worsen spondyloarthritis. Immune systems can be activated by these factors, causing inflammation and damage to joints and other tissues.
The symptoms of spondyloarthritis vary depending on the type, severity, and duration of the disease. However, some common symptoms include:
A common symptom of spondyloarthritis is pain. Pain may affect any joint, but it tends to affect the lower back, buttocks, hips, and heels. It can be dull, sharp, or throbbing, and it may be worse in the morning or after prolonged rest. Aside from radiating pain to the chest, neck, or legs, the pain can also affect other parts of the body.
Another common symptom of spondyloarthritis is stiffness. It can affect any joint, but it often affects the spine, making it hard to bend or twist. It is usually worse in the morning or after prolonged rest, and it improves with movement or exercise. In addition to limiting the range of motion of the affected joints, stiffness can make it difficult to perform daily tasks.
Swelling is a sign of inflammation in the joints or entheses. Often, it affects the fingers, toes, knees, and ankles, but it can affect any joint. Swelling can be red, warm, or tender to the touch, and it can affect the movement of the affected joints. As a result of swelling, the affected joints can also change shape or size, resulting in disability or deformity.
In spondyloarthritis, fatigue is a feeling of tiredness that is not relieved by rest or sleep. It can adversely affect spondyloarthritis patients, making them feel weak, sluggish, or depressed. Chronic inflammation, pain, stiffness, and anemia (low red blood cell count) can all contribute to fatigue. People with spondyloarthritis may also experience fatigue due to their medications, lifestyle, or stress levels.
Other symptoms: Depending on the type and extent of spondyloarthritis, other symptoms may occur, such as:
Eye problems, such as uveitis (inflammation of the inner eye), conjunctivitis (inflammation of the outer eye), or iritis (inflammation of the iris). These can cause eye pain, redness, sensitivity to light, or blurred vision.
Skin problems, such as psoriasis (red, scaly patches on the skin), erythema nodosum (red, tender lumps on the legs), or pyoderma gangrenosum (painful ulcers on the skin). These can cause itching, burning, or bleeding of the skin.
Gut problems, such as inflammatory bowel disease (Crohn’s disease or ulcerative colitis), which can cause abdominal pain, diarrhea, bleeding, or weight loss.
Heart problems, such as aortic valve disease, which can cause chest pain, shortness of breath, or fainting.
Lung problems, such as fibrosis (scarring of the lung tissue), which can cause coughing, wheezing, or difficulty breathing.
Osteoporosis (loss of bone density), which can increase the risk of fractures or spinal deformity.
The diagnosis of spondyloarthritis can be challenging, as there is no single test that can confirm or rule out the disease. The diagnosis is based on a combination of factors, such as:
The medical history involves asking questions about symptoms, duration, severity, pattern, and family history of spondyloarthritis.
The physical examination involves checking the joints, spine, skin, eyes, and other organs for signs of inflammation, damage, or deformity.
The presence of certain genes, such as HLA-B27, that are associated with spondyloarthritis, can be measured with blood tests, such as the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).
Tests for imaging: These can reveal changes in bones, joints, or entheses, such as erosion, fusion, or inflammation. The most common imaging test is X-rays, which can show the damage to the spine or sacroiliac joints, and magnetic resonance imaging (MRI), which can show the inflammation of the spine, sacroiliac joints, or entheses.
Tests such as urine tests, stool tests, joint fluid analysis, or skin biopsy can help rule out other conditions that cause similar symptoms, such as infections, gout, or rheumatoid arthritis.
Spondyloarthritis is treated by reducing inflammation, pain, stiffness, and swelling, as well as by preventing or slowing the degeneration and damage of bones and joints. It also aims to improve the function and quality of life of people with spondyloarthritis. Treatment options include:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can reduce the pain and stiffness of spondyloarthritis by controlling the inflammation and pain. Besides corticosteroids, other medications include corticosteroids, which can be injected into affected joints or entheses to reduce inflammation and swelling, or taken orally to treat severe flare-ups of the disease. A disease-modifying antirheumatic drug (DMARD) such as methotrexate or sulfasalazine can also slow down the progression of the disease and prevent joint damage. The newest medications are biologic agents, such as tumor necrosis factor (TNF) inhibitors or interleukin (IL) inhibitors, which can block the action of certain proteins that cause inflammation and damage in spondyloarthritis. People with spondyloarthritis can benefit from these medications, which are usually given by injection or infusion and can reduce symptoms and improve function.
In addition to exercises, stretches, massage, heat, cold, or electrical stimulation, physical therapy can also help to improve mobility, strength, and flexibility of the spine and joints. In addition to teaching people with spondyloarthritis how to maintain a good posture, avoid injury, and cope with pain and stiffness, physical therapy can also help them cope with pain.
Occupational therapy can help to improve the ability to perform daily activities, such as dressing, bathing, cooking, and working. People with spondyloarthritis can use occupational therapy to manage their stress, fatigue, and emotions by modifying the home or work environment, using assistive devices, or learning new skills or techniques.
It is usually reserved for severe cases of spondyloarthritis, when medications and therapies do not work to control the symptoms. It is possible to repair or replace damaged joints, such as the hips and knees, or to correct deformities or fuse the spine through surgery. People with spondyloarthritis can find relief from pain, improved function, and a restored appearance with surgery.
It is possible to improve the overall health and well-being of people with spondyloarthritis through lifestyle changes such as quitting smoking, losing weight, eating a balanced diet, getting enough sleep, and managing stress. It is also possible to reduce or avoid triggers or factors that can worsen the disease, such as infections, trauma, or excessive joint use.
There is no known way to prevent spondyloarthritis, as the cause of the disease is not fully understood. However, there are some steps that can help to reduce the risk or delay the onset of the disease, such as:
Testing for the HLA-B27 gene, if you have a family history of spondyloarthritis or related conditions, may help identify whether you are at a higher risk for the disease, monitor your symptoms, and seek early treatment.
The vaccines can help to protect your immune system and prevent inflammation and damage caused by infections that can trigger or worsen spondyloarthritis, such as hepatitis B, influenza, or tetanus.
Having regular check-ups and screenings for conditions associated with spondyloarthritis, such as psoriasis, inflammatory bowel disease, and eye problems. You can prevent complications or co-morbidities that can negatively affect your quality of life by diagnosing and treating these conditions early.
Getting involved in support groups or organizations for people with spondyloarthritis or related conditions. By doing so, you will be able to get information, advice, and emotional support from people who understand your circumstances and challenges, and you will also be able to raise awareness of the disease and its impact on society.
It can affect the joints, spine, and other organs as a chronic and progressive disease. Besides causing pain, stiffness, swelling, and damage to the bones and joints, it can also affect a person's quality of life and function. A person with spondyloarthritis can manage their symptoms, slow down or prevent damage, and lead a fulfilling and productive life with proper diagnosis, treatment, and care.
An individual's quality of life can be significantly affected by spondyloarthritis, which is a group of inflammatory rheumatic diseases affecting the spine and joints. To effectively manage and prevent complications, it is essential to understand the causes, symptoms, diagnosis, treatment, and prevention methods of spondyloarthritis.
The exact cause of spondyloarthritis is unknown, but genetics, environment, and the immune system may all play a role.
Spondyloarthritis tends to run in families, indicating a genetic predisposition.
There is a strong association between the HLA-B27 gene and spondyloarthritis, although not everyone with this gene develops the disease.
Genetically susceptible individuals may be triggered to develop spondyloarthritis by certain environmental factors, such as infections or trauma.
Spondyloarthritis is thought to be primarily caused by immune system dysfunction, which leads to inappropriate inflammation.
According to the specific subtype of spondyloarthritis, symptoms may include:
It is common to experience back pain and stiffness in the morning or after periods of inactivity.
Joint pain and swelling, especially in the hips, knees, and ankles.
An overall feeling of fatigue and malaise.
Joints and spine are limited in their range of motion.
Inflammation of tendons or ligaments attaching to bones, causing pain and swelling.
Redness, pain, and sensitivity to light are symptoms of uveitis, an inflammation of the eye.
Spondyloarthritis is typically diagnosed through a combination of medical history review, physical examination, and diagnostic tests.
A healthcare provider will ask about symptoms and perform a physical examination to assess joint mobility, flexibility, and signs of inflammation.
X-rays, MRIs, and CT scans are used to visualize changes in the spine and joints, such as inflammation, erosion, or fusion.
There is no specific blood test for spondyloarthritis, however certain markers of inflammation, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), may be elevated in affected individuals.
Ankylosing spondylitis is strongly associated with the HLA-B27 gene, which can be tested for.
Symptoms of spondyloarthritis can be relieved, inflammation reduced, joint damage prevented, and function improved through treatment options such as:
Treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and biologic agents.
Spondyloarthritis can be reduced with physical therapy and exercise programs that improve flexibility, strength, and posture.
A healthy weight, good posture, and avoiding activities that exacerbate symptoms can help manage spondyloarthritis.
In severe cases, or when other treatments are ineffective, surgery may be considered to repair or replace damaged joints, especially those in the spine and hips.
Spondyloarthritis can be prevented by minimizing the risk factors associated with the condition. While some risk factors cannot be modified, preventive measures can include:
Inflammation can be reduced by eating a balanced diet, exercising regularly, and avoiding smoking.
A prompt medical diagnosis and treatment of spondyloarthritis can help prevent complications and improve outcomes.
Some individuals may benefit from stress management techniques, such as relaxation exercises and mindfulness practices.
