When Erica came home from college one weekend, her right knee and shoulder felt so stiff, she had trouble walking. She blamed it on a rigorous week of training for a gymnastics meet. However, a specialist diagnosed her problem as spondyloarthritis.
What Is Spondyloarthritis?
It’s an umbrella term that includes a spectrum of rheumatic diseases affecting a person’s joints, tendons, ligaments and spine. According to ygoy, this disorder strikes individuals between 16 and 30 years old. The majority of patients are men. Only one type of spondyloarthritis – psoriatic – affects both sexes equally.
The Spondylitis Association of America indicates that spondyloarthritis includes six separate disorders: ankylosing spondylitis, undifferentiated spondyloarthropathy, juvenile spondyloarthropathy, psoriatic arthritis, reactive arthritis and enteropathic arthritis.
Researchers haven’t uncovered any exact causes of spondyloarthritis, according to the American College of Rheumatology. However, they believe that heredity is at least partially to blame since the six conditions tend to occur more frequently in families where a member has one of the disorders. Patients usually share a common genetic marker known as HLA-B27.
Certain infections such as chlamydia and bacteria that cause intestinal dysentery have been known to set off one of the types of spondyloarthritis. In North America, the condition appears to be most common in the far northern regions of the U.S. and Canada.
Because there are six varieties of spondyloarthritis, patients’ symptoms vary somewhat. However, affected individuals all have a tendency toward inflammatory arthritis of the spine, sacroiliac and other joints. They also suffer from a condition known as enthesopathy, an inflammation that occurs where their ligaments attach to the bone.
Most also lack some of the physical signs or markers of other types of arthritis. An example is lumps found under the skin.
The primary symptoms associated with spondyloarthritis are pain and inflammation; stiffness in different areas like the hip, knee, shoulder, ankle and neck; and lack of flexibility of the spine. Also common are a general lack of flexibility of the joints, pain in the lower back and a break up in vertebrae.
Some individuals develop a breathing problem if the condition affects their rib cage, fever with inflammation of the lungs, indigestion, loss of appetite, fatigue or a combination of these symptoms. In addition to affecting the spine and peripheral joints, this illness sometimes involves the skin, intestines and eyes.
Diagnosis and Treatment
Doctors initially take a thorough history and perform a physical exam when a patient appears with inflammatory back pain or leg arthritis. X-rays of the sacroiliac joints and spine can pinpoint the presence of this disorder. If evidence points to spondyloarthritis, physicians will also order tests to check for the presence of the HLA-B27 gene.
Several types of treatment can help relieve many of the symptoms of this condition:
Exercise. Many forms of physical therapy and recreational exercise for half an hour a day can help reduce pain and stiffness. Specific back exercises can also improve function.
Medications. Treatment often starts with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Disease-modifying anti-rheumatic drugs (DMARDs) like sulfasalazine and methotrexate don’t work for arthritis of the spine or sacroiliac joints but are effective for arthritis of the arms or legs.
Doctors sometimes prescribe corticosteroids by mouth, although these drugs have many potentially serious side effects. Injections of depo-steroid medications into a patient’s joints or tendon sheaths relieve local flares for some individuals.
Reactive arthritis patients sometimes improve after a course of antibiotics like ciproflocin. Tumor necrosis factor (TNF) blockers treat many symptoms of spondyloarthritis. However, they are expensive drugs – brand names Remicade, Enbrel and Humira – and have many potential side effects.
Surgery. Some patients need surgical correction of spinal deformities or procedures like a total hip replacement.
The prognosis for most patients with spondyloarthritis is good despite their discomfort. In most cases, the specialist treating them is a rheumatologist.