Spondyloarthropathy

Spondyloarthropathy is a syndrome of the lower back that leads to various physical discomforts. Read and learn all about the causes, symptoms, diagnosis, treatment and more about this condition.

Spondyloarthropathy Definition

Doctors and medical researchers define Spondyloarthropathy as a progressive inflammatory disorder which damages the spinal column as well as the tendons, ligaments and joints. Basically, it refers to any disease of the joints of the vertebral column.

Picture of Spondyloarthropathy

Picture 1 – Spondyloarthropathy Picture

The condition is also referred to as Ankylosing Spondylitis.

Spondyloarthropathy Symptoms

In the initial stages, the disease is characterized by pain and stiffness in the lower back region. The symptoms are most prominent during the morning. With passing time, the pain spreads to the neck and the torso. Certain patients are also found to suffer from other problems like:

  • Fever
  • Loss of weight
  • Lack of energy

As the disease advances, the mobility of the patients may get limited. This is due to the fusing together of the bones in the vertebral column. A few patients may also suffer from problems in the skin or the eye.

The symptoms gradually appear over a course of several years. They rarely manifest all at once. The severity of the discomforts varies depending on the condition of the patient.

Spondyloarthropathy Types

The condition has been classified into various types, such as:

Ankylosing Spondylitis

It gives rise to pain and stiffness in the lower back region. The pain gradually spreads up and affects the upper back and the chest as well as other areas like the hips and the heels. In more acute cases, the spinal joints affected by the disorder may also fuse together. This can result in greater stiffness. Children affected by this disease may suffer from the symptoms in the heels, toes, hips or knees which may later graduate to the spine.

Enteropathic Arthritis

It affects the intestinal wall and the spine. This form of the disorder gives rise to symptoms that are inconstant in nature and tend to appear, go away and come back again. Arthritis in the spine often arises due to a flare-up of an inflammation in the wall of the intestine. Typically, the arthritic symptoms of this condition tend to impact the joints of various areas of the body such as the elbows, knees, hips and ankles.

Psoriatic Arthritis

This form of the disorder is most commonly related with Psoriasis; a skin condition that is quite common. The arthritic symptoms of this disease usually affect the elbows, hips and knees. These frequently arise long after the first appearance of psoriatic symptoms. The disorder commonly gives rise to inflammatory problems in the toes and fingers. The nails in the fingers and toes may also display signs of pitting or hardening.

Reiter’s Syndrome

It is one of the less common although one of the most serious types of Spondyloarthropathy. Also known as Reactive Arthritis, this condition leads to swelling of the joint between the lower back and pelvis. It is also a cause of inflammation in the joints in the fingers, toes and feet. In majority of patients, the disorder results in severe inflammation of the fingers and possible swelling of the toes. Inflammation of the toes is, however, less common than swelling of the fingers. Patients of this condition may also suffer from other problems like weight loss, skin rashes or fever.

Undifferentiated Spondyloarthropathy

It is a term used to refer to the signs of spondylitis in an individual who does not display enough symptoms of Ankylosing spondylitis (AS) or any associated disorder to be diagnosed for the same. Usually, patients of this disorder are found to have a good prognosis. However, some patients may develop AS or any other related ailment over a period of time. Presently, there is no definite treatment for this condition. However, medications and other curative options are available to manage and reduce pain and other discomforting symptoms.

Spondyloarthropathy Causes

Medical experts are still clueless about the exact cause of this condition. However, ankylosing spondylitis is mainly supposed to arise due to the presence of a specific gene known as HLA-B27. Patients who tend to suffer from any form of Spondyloarthropathy are typically found to carry this gene. Race is also associated with this condition as approximately 8 percent Caucasians are found to possess this particular gene.

The likeliness of appearance of the condition in families is higher than other types of rheumatic disease, such as rheumatoid arthritis or lupus.

Spondyloarthropathy Diagnosis

The condition is diagnosed through

  • Analysis of the medical history of the patient
  • Physical examination
  • Carrying out lab tests, such as blood tests

A number of diagnostic tests are conducted to determine the presence of HLA-B27 and whether the level of serum immunoglobulin A and alkaline phosphate is elevated. The type of tests may differ according to the form of Spondyloarthropathy that a person is suffering from.

Doctors also observe and ask patients about symptoms like morning stiffness and inflammation in joints and tissues. Patients may be also carefully observed to detect symptoms that are unique to particular forms of Spondyloarthropathy, like scaly skin (as in Psoriatic arthritis).

In many patients, X-rays may also be conducted to detect

  • Bamboo spine
  • Bilateral sacroiliac involvement
  • Patchy sclerosis
  • Squaring of vertebral bodies
  • Superficial bone erosions

However, an absence of the rheumatoid factor in the patients’ blood is likely to be the biggest indicator of Spondyloarthropathy.

Image of Spondyloarthropathy

Picture 2 – Spondyloarthropathy Image

The diagnosis of Spondyloarthropathy often changes into the detection of one of its various forms. It often takes several visits to the doctor’s chamber before a successful diagnosis is made. This is particularly true in case of a seronegative diagnosis in which no positive results are found from an analysis of the blood of patients. The diagnosis is typically made on physical changes and symptoms experienced by sufferers.

Spondyloarthropathy Differential Diagnosis

The differential diagnosis of Spondyloarthropathy is based on the clinical symptoms of the disorder. It involves distinguishing the symptoms of the condition from those of rheumatoid arthritis. Doctors should make sure that patients are not suffering from other similar conditions, such as:

  • Septic arthritis
  • Crystal arthritis
  • Metabolic bone disease
  • Chronic inflammatory arthropathies

Spondyloarthropathy Treatment

This is typically a mild condition and may remain undetected for many years. Most individuals with this condition do not face problems while carrying out daily activities. Treatment is usually required in the later stages, characterized by acute pain and stiffness. Treatment aims to relieve the discomforting symptoms and involves use of:

  • Non-steroidal anti-inflammatory drugs (NSAIDs) – These are commonly used to cure pain and swelling associated with the disorder. These are effective in reducing the progression of the disorder and preventing deformities.
  • Medications – These are used to cure specific symptoms like intestinal inflammation, as in Enteropathic Arthritis.

The use of treatment options basically depend on the form of Spondyloarthropathy that a patient suffers from. However, no treatment has been found to be completely effective in correcting the condition. Curative options usually aim at managing and controlling the symptoms of the disorder rather than removing them.

Apart from medical treatment, Stretching and Deep breathing exercises have also been found to be effective in reducing the progression of the symptoms of this discomforting disease. According to some medical studies, maintaining a correct posture has also been found to be the best way to prevent this spinal deformity. In very severe cases, supports and light weight braces are found to help patients in maintaining a better posture. In many cases, however, support of such equipments is not required.

Other than medications, pain management also often includes plenty of rest, regular exercise, and energy conservation techniques.

Spondyloarthropathy Prognosis

Although a non-threatening condition, Spondyloarthropathy does not have a good long term outcome. Once the condition arises, its progression cannot be actually controlled by any treatment. If the condition impacts the hip, a hip replacement surgery can be required. In case of an acute spinal involvement, a spinal wedge Osteotomy may become necessary. Better posture can help prevent worsening of the deformity.

When arising in children, Spondyloarthropathy tends to be a chronic problem that may persist even during the adult years. Most children affected with this disorder are able to lead an active lifestyle. However, episodic development of painful symptoms can be a cause for worry for both children and adults. If you find the symptoms of this disorder arising in any family member, consult a good doctor or therapist to find a way to manage the condition properly.