What Is It?
Spondyloarthritis literally means arthritis of spine. It is characterized by inflammation affecting sacroiliac joints of spine. Sacroiliac joints are the joint between spine and pelvic bones.
Who Gets It & Why
• SpA usually affect young persons of age 20-40, male and female are affected equally.
• Exact reason is not known but genetic factor along with other multiple factors play role in the disease causation.
Common Symptoms
- Pain and stiffness back and/or neck
- Early morning stiffness usually more than 30 mins
- Fatigue
- Some patients also have joint pain and swelling affecting large joints usually of knee, ankle and feet.
- Sudden onset of redness, pain, watering and blurring of vision in the eyes
- Skin rash- Psoriasis
- Frequent loos stool mixed with blood and mucus
Back pain is quite common in society. One in two individuals will have low back pian in lifetime. Usually, back pain is self-limiting and subsides within 3 months. While it is usual for the back pain to worsen after activity and gets better with rest, it is reverse for back pain associated with spondyloarthritis. In spondyloarthritis back pain is worse in the early morning hours or after taking prolonged rest and it gets better after routine daily work. Compared to usual low back pain, spondyloarthritis associated back pain starts at a younger age.
How It’s Diagnosed
- Doctor’s clinical evaluation for typical signs and symptoms
- Blood tests –ESR, CRP and HLAB27
- Imaging- X-ray and MRI.
Treatment Option
Treatment depends upon severity of symptoms, predominant manifestations; axial (involving back and neck) or peripheral (knee ankle foot and other joints), involvement of skin eyes and gut. For axial disease treatment involves exercises and NSAIDs. Some patients need advanced therapies in the form of biologics or tofacitinib. Peripheral manifestations can be treated with NSAIDs, sulfasalazine and biologics/tofacitinib. Treatment of other organs like eye and gut requires multidisciplinary management.
Lifestyle:
- Regular exercises of spine and other joints is helpful in reduction of pain and stiffness
- Avoidance of smoking and tobacco use.
- Balanced diet and stress management
Monitoring
- Periodic blood tests and doctor follow-up, occasional repeat X-ray and MRI.
- Never start or stop medicines without medical advice.
Outlook
- With early diagnosis and proper treatment, most people lead normal, active lives. “Bamboo spine”- means complete fusion of spine joints is seen in around 10% of patients. With early diagnosis, treatment and exercises speed of spinal fusion can be retarded.
When to Contact Your Doctor
🚩 Sudden joint swelling, increased pain and stiffness of back or neck, redness of eyes.
🚩 New side effects from medications
