Spondyloarthritis
Professor Hasan Tahir - Rheumatology
Created on: 11-13-2012
Updated on: 09-06-2023
Edited by: Aoife Maguire
Spondyloarthritis, also known as spondyloarthrosis or osteoarthritis of the spine, is a degenerative disease affecting the cartilage of the joints in the cervical, lumbar or dorsal area of the spine. The causes of spondyloarthritis can be ageing, trauma, vertebral deformity, infections, obesity, genetics, postural problems and other conditions, such as rheumatism or collagen diseases.
The main symptoms of spondyloarthritis are pain, stiffness and swelling, although dorsal spondyloarthritis can be asymptomatic. In the case of lumbar osteoarthritis, pain is located in the lower part of the back and usually extends to the buttocks, and in some cases towards the legs.
Initial treatment is in the form of medication and physiotherapy. Surgery is reserved for cases in which the patient suffers persistent and uncontrollable pain, even with the use of medication.
Disease prognosis
The prognosis of the disease is unpredictable. Some patients suffer a chronic and progressive form of the disease, while others suffer an irregular course with relapsing episodes. However, there are some patients with signs of osteoarthritis of the spine who display no symptoms at all.
Localised pain or having a pinched nerve (herniated disc) are some of the symptoms of spondyloarthritis.
What are the causes of spondyloarthritis?
Spondyloarthritis can appear naturally due to ageing. With increasing age, the bones and ligaments of the spinal column suffer wear and tear and can lead to:
- Bone spurs
- Intervertebral disc degeneration and weakness
- Disc herniation
- Bulky discs
- Osteoarthritis of the joints
- Rigid ligaments
What are the symptoms of spondyloarthritis?
The most common symptoms of spondyloarthritis are:
- Localised pain in the back
- General neck pain
- Stiffness and swelling
If you suffer from a pinched nerve (herniated disc) you may experience:
- Pain that spreads to the arms or legs
- Numbness and tingling
- Weakness if the nerve is severely pinched
The symptoms of spondyloarthritis depend on the location of the disc wear.
Medical tests for spondyloarthritis
There are different tests when determining the diagnosis of spondyloarthritis. A doctor will begin the consultation by asking some questions and then undergoing a physical examination. This might include:
- Checking the range of motion in the problem area
- Testing your reflexes and muscular strength to see if there is pressure on nerves in the spinal cord
- Observing if the compression of the spinal cord is affecting you when you’re walking
To complete the examination, a doctor may decide to use the following tests:
- Imaging tests
- X-rays
- CT scan
- MRI
- Myelography
- Nerve function tests
- Electromyography (EMG)
- Nerve conduction studies
Can it be prevented?
There is no scientific evidence to suggest that spondyloarthritis can be prevented, however among the risk factors are:
- Age: the older you are, the more likely you are to develop the disease.
- Occupation: jobs that involve repetitive movements or complicated positions can cause strain on the spine. Some experts believe it can be a risk factor.
- Genetics: you test positive for the HLA-B27 gene.
- Family history: if you have a family member with spondyloarthritis, then you have a higher chance of developing it too.
- Previous injuries or infections — frequent bacteria infections, in your gut especially, are believed to increase the risk of spondyloarthritis.
Treatments for spondyloarthritis
Spondyloarthritis is a degenerative process, therefore there is no specific treatment to reverse this disease. However, there are some treatments aimed at relieving pain:
- Self-care
- Physiotherapy
- Adjuvant therapies (chiropractic and acupuncture)
- Minimally invasive procedures using injections or surgery
- Medicines
- Exercises
- Surgery
Which specialist treats spondyloarthritis?
The type of specialist that treats spondyloarthritis is a rheumatologist.