Spondylitis is an umbrella term for chronic arthritis-type conditions that affect the joints in the spine and sacroiliac region. The spine comprises bones known as vertebrae and the material between each vertebrae in the joints is referred to as disks. Over time, the joints and disks can be inflamed or worn out from use.
What is Spondylitis?
Spondylitis is an inflammation of the joints between the vertebrae, similar to arthritis. The joints begin to swell and grow, eventually fusing with time. When the bones start to fuse, this condition is referred to as ankylosing spondylitis. As the bones begin to grow towards each other and fuse, the spine becomes less flexible and mobile.
Spondylitis Types
Traditional Spondylitis Classification System
Traditional classification system for spondylitis classifies it into six types:
Ankylosing Spondylitis (AS)
A type of chronic joint inflammation that majorly affects the spine. The term ankylosis refers to stiffness in the joints that results from injury or disease.
Reactive Arthritis (ReA)
A type of inflammatory arthritis that manifests several days or weeks after a genitourinary or gastrointestinal infection.
Psoriatic Arthritis (PsA)
A chronic inflammatory disease that affects the joints where tendons and ligaments attach to the bone. This condition is associated with psoriasis- an inflammatory skin condition.
Enteropathic Arthritis (EnA)
A type of chronic inflammatory arthritis that is associated with Crohn’s disease and ulcerative colitis, both of which are inflammatory bowel disease.
Juvenile Spondyloarthritis
A type of chronic inflammatory arthritis that starts in people aged 16 and younger and typically affects leg joints.
Undifferentiated Spondyloarthritis (USpA)
This refers to a diagnosis a doctor may give if a person presents a variety of symptoms that cannot be classified as a specific rheumatoid disorder.
New Spondylitis Classification System
The newer classification system for spondylitis categorises it into two main categories, as per which part of the body the condition affects.
Peripheral Spondyloarthritis (pSpA)
Peripheral spondyloarthritis causes inflammation in the joints and tendons outside the sacroiliac joints and spine. It usually affects the following areas:
hands
wrists
elbows
shoulders
knees
ankles
feet
Peripheral Spondyloarthritis includes:
reactive arthritis
enteropathic arthritis
undifferentiated arthritis
Axial Spondyloarthritis (AxSpA)
Axial spondyloarthritis causes pain and inflammation in the pelvis, spine or both. This category encompasses a broad range of spondylitis types in people with or without sacroiliac joint fusion and damage.
Spondylitis Symptoms
The symptoms of spondylitis may include:
Pain in the lower back and stiffness, especially after prolonged periods of rest
Radiating back pain
Pain that starts on one side of the body and spreads to other
Loss of appetite and fever during early stages
Limited breathing capacity and painful breathing- caused due to the curvature of the spine, scarring of the lungs and inflammation.
Additional spondylitis symptoms may include:
Anaemia
Fatigue
Pain that spreads to other joints
Mild inflammation in the eyes
Organ damage- eyes, lungs and heart
Stooped posture due to back pain
Stiff spine
Spondylitis Causes
Spondylitis is caused by an inflammation associated with an overactive immune system. Though it is unclear what exactly causes spondylitis, genetics and environmental factors play a huge role in its development. Environmental factors that can affect the development of spondylitis vary but include:
-Living conditions
-Exposure to toxins or chemicals
Spondylitis Diagnosis
After a thorough medical history and physical examination, a physician may order one or more of the following tests to evaluate the condition:
X-ray: It helps detect abnormalities in the bone along the spine.
ESR (Erythrocyte Sedimentation Rate): Analyses blood to evaluate inflammation.
Genetic testing: This type of test helps determine if the patient is carrying a copy of the gene (HLA-B27) that is found in over 95 percent people with spondylitis.
Spondylitis Treatment
The treatment of spondylitis focuses on reducing stiffness and pain and preventing deformities. Spondylitis medications work by modifying the immune system to slow down the progression of spondylitis. Spondylitis treatment options may include:
Medications
NSAIDs (Non-steroidal anti-inflammatory drugs) help reduce inflammation or swelling and manage mild to moderate pain.
Short-term use of corticosteroids, for example epidural steroid injections directly injected into the affected joint help relieve swelling, pain and improve range of motion.
TNF (Tumour Necrosis Factor) blockers to help reduce swelling, stiffness and pain.
DMARDs (Disease modifying anti-rheumatic drugs help delay the fusing of vertebral bodies of the spine, reduce inflammation and slow the progression of spondylitis.
Short-term use of muscle relaxants and pain relievers for severe pain and muscle spasms.
Exercise and complementary therapies: Exercise, physical therapy, hot and cold therapies, TENS (Transcutaneous Nerve Stimulation) help promote an ideal posture, maintain flexibility and strengthen back muscles.
FAQs
How to manage spondylitis pain?
Spondylitis treatment and pain management may involve DMARDs (Disease Modifying Anti-Rheumatic Drugs) to decrease inflammation and slow down the progression of spondylitis. Short-term use of muscle relaxants and pain relievers also help reduce severe pain and muscle spasms. Surgical procedure to place rods in the spine, replace a joint or remove thickened or hardened bone is another treatment option.
Where does spondylitis hurt?
The most common symptom of spondylitis is stiffness, lower back or hip pain. Over time, the symptoms of spondylitis progress to other areas of the spine and the body.
What foods trigger spondylitis?
Foods that trigger spondylitis may include:
Preservatives
Trans fats
Saturated fats
High sodium content foods
Added sugars
Can walking reduce spondylitis?
Walking is a type of low-impact workout that is highly beneficial for spondylitis. It is also the ideal way to ease the body into exercising.
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