What is Spondyloarthritis?

Spondyloarthritis refers to a set of inflammatory disorders that mainly afflict the spine, joints, and ligaments. Sometimes, arthritis develops in other parts of the body such as in the intestines, urinary tract, heart, and skin. The range of symptoms for the different types of these disorders include back and joint pain, scaly skin, weight loss, and eye irritation. The conditions can cause stiffness and make movement difficult. A treatment course generally involves anti-inflammatory medication and an exercise regimen, with surgery as an option in cases of acute problems.

This group of diseases is also termed seronegative spondylarthropathies. Seronegative indicates that a blood test is negative for the rheumatoid factor, an antibody found in those with rheumatoid arthritis. The set of disorders includes ankylosing spondylitis, reactive arthritis, psoriatic arthritis, enteropathic arthritis, and undifferentiated spondyloarthritis. When children develop the condition, it is referred to as juvenile spondyloarthropathy.

There are various reasons that a person might develop one of these disorders. Often, there is a family history of the condition, and people with the genetic marker HLA-B27 are more likely to develop the disease. Reactive arthritis can be set off by an intestinal or urinary tract infection.

Spondyloarthritis is usually chronic and progressive in nature. The condition often occurs in young adults between 20 and 30 years old. The symptoms can manifest a little differently depending on the form of the disease.

Ankylosing spondylitis is characterized by inflammation of the joints of the spinal column, and the part where the spine meets the pelvis. It often causes pain and stiffness in the lower back. The discomfort could later extend to middle back, neck, hips, and heels. Typically, back pain tends to be worse in the mornings.

Those with psoriatic arthritis develop raised patches of reddened skin, and pitted and cracked nails. The disease can advance to one or more joints in the body resulting in pain, swelling, and stiffness. Some might also suffer from conjunctivitis.

Symptoms of reactive arthritis include a burning sensation when passing urine, and inflammation of the eyes and mucous membranes. Those afflicted usually experience pain and swelling of the joints. Enteropathic arthritis involves inflammation of the intestine, although it can inflame joints of the limbs, cause abdominal pain, and cause diarrhea.

Usually, spondyloarthritis is diagnosed and treated by a rheumatologist. Diagnosis is made following a physical check-up, a review of the symptoms, and a check of the patient's health history. The physician might call for additional tests, such as X-rays of the joints and spine, an MRI, and a blood test. The rheumatologist can also assess potential complications that could develop with the disease.

There are different treatment options that typically can help manage the pain and specific symptoms of the condition. Nonsteroidal anti-inflammatory drugs (NSAIDs) are most commonly recommended in the initial stages. Corticosteroids might be used for short periods. For psoriatic arthritis, a medical professional might recommend a medicated cream for the skin. Eye drops could be suggested for patients with symptoms of eye inflammation.

A doctor might prescribe a different class of medications in some cases. These include disease-modifying anti-rheumatic drugs (DMARDS) such as sulfasalazine. A relatively new approach is treating spondylarthropathies with tumor necrosis factor inhibitors, or TNF blockers for short. These inhibit the action of TNF-alpha, proteins that can cause inflammation in patients.

Surgery usually is recommended only if serious problems develop. It can be performed for joint replacement, for example, or it might be suggested if the curvature of the spine is severely affected by the condition.

Besides medication, there are some simple remedies that can help ease some of the discomfort. One measure is the local application of heat to alleviate joint stiffness. Cold packs can be used on areas that show swelling.

An exercise program is often an essential component of treatment. A physiotherapist can prescribe exercises that can assist in retaining flexibility and mobility of the joints. Regular exercise routines can strengthen the back, improve posture, and generally help people function better.