by Kimberly Allen, RN
Spondyloarthropathis are a group of chronic diseases that primarily affect the spine, but can affect other areas of the body as well. There are numerous diseases in this group the most common being ankylosing spondylitis. Others include psoriatic and reactive arthritis as well as links with inflammatory bowel disease and ulcerative colitis. Spondyloarthropathies can develop in children as well as adults. It is more common in males than females as well as being more common in whites than non-whites.
Although there are several diseases in the group of sponsyloarthropathies each with their own symptoms as well as prognosis’s they all have some similarities as well as overlapping symptoms. All generally involve the joints of your lower back and pelvis as well as the areas where the ligaments and tendons attach to the hips, knees, and feet. In many cases spondyloarthropathies resemble rheumatoid arthritis however, they are different diseases. The most significant difference is that even though it is classified as a rheumatic disease people with spondyloarthropathies as a rule have a negative rheumatoid factor. This is called seronegative.
While the exact cause of spondyloarthropathies is not known researchers have found a gene that is common to most people suffering from spondyloarthropathies called the HLA-B27 gene. This is also believed to be one of the main reasons spondyloarthropathies tend to run in families more than other rheumatic diseases like RA and lupus.
Symptoms that are common to all forms of spondyloarthropathies are pain and fatigue. Over 70% of people with some form of spondyloarthropathy complain of daily pain and stiffness, while around 65% also complain of overwhelming fatigue. Many also report the stiffness and pain improve throughout the day after moving about and exercising. In addition to the common symptoms each type also has symptoms specific to that type. In ankylosing spondylitis the back pain usually starts in the lower back and the progresses to the upper back. If the ankylosing spondylitis is severe the joints of the spine that are affected tend to fuse together causing increased pain and stiffness in your back. ankylosing spondylitis in children tends to start in the lower extremities, ie the hips and knees as well as the heels or great toes before progressing to the spine. Reactive arthritis, also known as Reiter’s syndrome cause pain inflammation and swelling in the sacroiliac joint, which is the joint between your spine and pelvis. It also tends to affect the small joints like those in your fingers and toes as well as your feet. This type of spondyloarthropathy can also cause a fever and skin rash as well as weight loss and inflammation. Children with this type tend to manifest symptoms in their lower extremities first. Psoriatic arthritis is a form of spondyloarthropathy that is associated with psoriasis. People with this type almost always develop psoriasis first, frequently several years before symptoms of psoriatic arthritis develop. People with psoriatic arthritis develop pain and stiffness in their large joints like the hips and knees as well as the sacroiliac joints. They also develop swelling of their fingers and toes causing “sausage digits” Enteropathic arthritis is associated with diseases like inflammatory bowel and chron’s disease. In this type there is inflammation of the intestinal wall. In this type the symptoms tend to come and go, however, the symptoms tend to flare when the abdominal pain flares. The joints affected in this type are also the large joints. Children with this type tend to develop the symptoms of arthritis before the inflammation of the intestinal wall.
Most people with spondyloarthropathies have such mild symptoms that they tend to go undiagnosed for years. For those with more severe cases the treatment is generally focused on the relief of joint pain and stiffness as well as preventing deformity and improving function. The type of treatment depends on the type of spondyloarthropathy that you have. The most common medications used are NSAID’s. In some types your doctor may recommend DMARD’s while in others like enteropathic arthritis medications that are for intestinal inflammation are used.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.