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Spondyloarthritis is a family of inflammatory rheumatic diseases that causes arthritis.1 The main symptoms are pain and stiffness in the spine (especially the low back). It is relatively common, affecting more people than multiple sclerosis, rheumatoid arthritis or amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease), yet it remains relatively unknown to many patients and physicians.2 One in 100 people have spondyloarthritis, including 2.7 million people in the United States.2
Spondyloarthritis is a progressive disease, and some people may experience new bone formation in the spine or spinal fusion which can lead to problems with mobility. There is no cure for spondyloarthritis, but symptoms such as pain, stiffness, and fatigue can be managed.
Axial spondyloarthritis (axSpA) is a type of spondyloarthritis that mostly affects the spine and sacroiliac joints (a pair of joints in the pelvis).1 There are two progressive stages of the disease:
Not all people living with non-radiographic axSpA will progress to radiographic AS; however, people affected by either stage may have similar levels of pain, stiffness, and fatigue.
Peripheral spondyloarthritis (pSpA) is a type of spondyloarthritis that affects the joints of parts of the body other than the spine, such as the arms and legs.1 There are a number of subtypes,6 including:
What Are Symptoms of Spondyloarthritis?
Common symptoms of spondyloarthritis include:
Half of people with spondyloarthritis have other health issues that can manifest with spondyloarthritis8 including:
Spondyloarthritis Is Often Genetic
Spondyloarthritis has a genetic component. Family members of those with spondyloarthritis are at higher risk, depending partly on whether they inherited the HLA-B27 gene.1 Having the HLA-B27 gene does not always mean someone will develop spondyloarthritis. In the end, the diagnosis relies on a rheumatologist’s judgment based on several factors considered together.
How Is Spondyloarthritis Diagnosed?
Spondyloarthritis often starts in the late teens to mid-20s. It can take between eight and 11 years to get a correct diagnosis.4 Lower back pain is a symptom for most people with spondyloarthritis, but is also extremely common in the general population. Often, back pain is initially managed by non-specialists until it becomes severe or a doctor determines you have inflammatory back pain. Inflammatory back pain is different than mechanical back pain, which is caused by structural changes in the joints, vertebrae, or tissue, or may be caused by an injury. For diagnosis, a rheumatologist may order imaging, including X-ray or MRI of the spine or sacroiliac joints to look for signs of inflammation or spinal fusion.1 (Take our Quiz: Could I Have Spondyloarthritis?)
How Is Spondyloarthritis Managed?
Living with the chronic back pain of axial spondyloarthritis requires care from a specialist called a rheumatologist. A rheumatologist can help create a treatment plan that may include nonsteroidal anti-inflammatory drugs (NSAIDs), disease modifying anti-rheumatic drugs (DMARDs) if peripheral arthritis is present, or biologic treatments in the case of ankylosing spondylitis when treatment with NSAIDs has failed.5
In addition, lifestyle changes, such as good posture, exercise and a nutritious diet may help some people with spondyloarthritis. Smoking in particular has been shown to increase spinal disease progression as well as reduce response to treatment.9 Exercise is particularly important for people with axial spondyloarthritis, including physical therapy and joint-directed exercises.1 Many recommended exercises promote spinal extension and mobility. (Read Spondyloarthritis Exercises for Better Posture.)
About Peripheral Spondyloarthritis10
Common symptoms of pSpA include:
Additionally, people with pSpA may have one or more of the following:
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