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Spondyloarthritis: Types, Causes, Symptoms and Treatment

Overview 

Spondyloarthritis (or spondyloarthropathy) is a group of inflammatory rheumatic conditions that cause arthritis. Spondyloarthritis differs from other types of arthritis as it involves the sites where ligaments and tendons attach to bones called ‘entheses’. 

This blog gives a comprehensive understanding of spondyloarthritis, its types, symptoms, and the treatment options for this condition. 

What is spondyloarthritis? 

Spondyloarthritis is the term to describe a group of inflammatory diseases that cause joint inflammation or arthritis

Spondyloarthritis differs from other kinds of arthritis because it also leads to inflammation in areas known as entheses, where the ligaments and tendons connect to the bones. Ligaments are the tissues that connect the bones, and Tendons are the tissues that connect the bones to the muscles.  

The condition can also lead to inflammation in the eyes and gastrointestinal tract. It affects people in their teens and 20s, particularly young men. People with a family history of have a higher risk of developing the condition.   

What are the types of spondyloarthritis? 

The different types of spondyloarthritis are as follows: 

Ankylosing spondylitis

Ankylosing spondylitis is the most common form of spondyloarthritis. It results in the inflammation of the spinal joints, which can cause chronic pain and disability if left untreated. In severe cases, the inflammation can lead to the formation of new bone on the spine, resulting in immobility. Ankylosing spondylitis may also lead to pain and stiffness in other body parts and affect large joints, including the shoulders, knees, hips, and heels.  

Reactive Arthritis

The most common infections include a sexually transmitted or bacterial infection in the intestines that can trigger reactive arthritis. Reactive arthritis typically affects the knees, ankles, and feet. The inflammation can also affect the eyes, skin, and the urethra (the tube that carries urine out of the body).   

Psoriatic Arthritis

Psoriatic arthritis is a type of arthritis that combines the swollen, sore joints of arthritis with psoriasis, a skin disease that typically causes itchy, scaly, discolored patches to appear on the skin and scalp. Many people develop psoriasis years before being diagnosed with psoriatic arthritis.  

Enteropathic Arthritis

Enteropathic arthritis is inflammatory arthritis that is related to many inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis

Another way to classify spondyloarthritis is as follows :

  1. Axial Spondyloarthritis that mainly affects the pelvic and spine joints
  2. Peripheral Spondyloarthritis that mostly affecting the arms and legs

What are the symptoms of spondyloarthritis? 

The different types of spondyloarthritis can cause the following symptoms: 

  • Back pain 
  • Tiredness 
  • Pain or swelling in the joints, including the hips, hands, wrists, elbows, shoulders, swelling in the knee, ankles, and feet 
  • Swelling in the tendons of the toes or the fingers  

Other problems can happen in patients with spondyloarthritis. These can include:

  1. Osteoporosis
  2. Psoriasis
  3. Inflammation of the heart’s aortic valve 
  4. Inflammation of part of the eye, known uveitis, occurs in about 40% of those with spondyloarthritis. 
  5. Intestinal inflammation

When should you contact the doctor? 

When you suffer from recurring lower back pain before age 40, you may have spondyloarthritis. Contact the doctor if you suspect you have spondyloarthritis. During the consultation, you must discuss the onset of your pain in detail and whether or not you have other inflammatory symptoms that may indicate the presence of spondyloarthritis. 

 

What are the causes of spondyloarthritis? 

People who suffer from spondyloarthritis may tend to inherit it. Scientists linked about 30 genes to the condition, mainly the HLA-B27 gene. 

What are the risk factors for spondyloarthritis? 

It is always hard to understand the various causes of developing spondyloarthritis. However, the risk for the condition can be higher if the patient: 

  1. Has a family history of spondyloarthritis 
  2. Tests positive for the HLA-B27 gene 
  3. Has a chronic bacterial infection in their gut 
  4. Is suffering from another inflammatory condition, such as psoriasis or inflammatory bowel disease 

What are the complications of spondyloarthritis? 

If left untreated, spondyloarthritis can lead to the development of osteoporosis, heart inflammation, intestinal inflammation, and uveitis.  

How is spondyloarthritis treated? 

Doctors cannot cure spondyloarthritis. However, the following things can help:  

  1. Nonsteroidal anti-inflammatory drugs (NSAIDs) – Various NSAIDs assist people in managing the symptoms. These medications include ibuprofen, meloxicam, indomethacin, and naproxen.  
  2. Corticosteroid medication – corticosteroid injections to specific joints or the membrane around the tendon can work rapidly . This is the best option for people if their joint swelling is in a particular region.  
  3. Antibiotics – if people experience reactive arthritis that begins with a bacterial infection, antibiotics may help to a certain degree.  
  4. Disease-modifying antirheumatic drugs (DMARDs) – The doctor can prescribe DMARDs to help with the symptoms and limit joint damage. These medications, such as methotrexate and sulfasalazine work well on arthritis patients.   
  5. Immunotherapy – mononuclear antibodies stimulate the body’s immune system to help fight the disease.   
  6. Tumour necrosis alpha (TNF-alpha) blockers – are the newer class of drugs known as biologics. TNF alpha-blocker drugs can treat arthritis in both the spine and joints. However, these treatments are very costly and may lead to severe infections. 
  7. Surgery – chronic inflammation can damage the cartilage in the hips, resulting in pain and problems with movement. In such cases, people can need a hip replacement (a surgical procedure to address hip pain). In severe cases, they may require spinal surgery. 

What are the behavioural changes that people can make? 

Doctors recommend that patients with spondyloarthritis make specific behavioural changes that help living with the condition more manageable. These changes include the following: 

  1. Getting regular exercise for good joint and heart health 
  2. Quitting smoking 
  3. Practicing good posture 
  4. Consuming an anti-inflammatory diet 
  5. Improving sleep 

Conclusion 

Spondyloarthritis is a progressive condition whose trajectory is hard to predict. If this condition is left untreated, it can lead to more complications. There is no way to cure the condition, but people can manage their symptoms and prevent the disease from progressing.  

Frequently Asked Questions 

How is spondyloarthritis diagnosed? 

There are different ways to diagnose spondyloarthritis, such as X-rays of the sacroiliac joints in the pelvis, MRI (magnetic resonance imaging), and a blood test to check for the HLA-B27 gene. 

Does eliminating gluten from the diet improve spondyloarthritis? 

Some people feel that removing gluten from their diet helps them reduce the spondyloarthritis symptoms. If they believe gluten aggravates their symptoms, they must speak with the doctor about getting tested for celiac disease or trying a gluten-free diet. 

What are the foods that people must include in their diet? 

People must include a variety of fruits and vegetables, whole grains, fibre, lean protein, fatty fish, and anti-inflammatory spices to aid them in reducing inflammation in the body.

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