Spondylitis
Spondylitis, commonly referred to as ankylosing spondylitis, is a chronic form of arthritis primarily affecting the spine and characterized by inflammation of the joints and ligaments. The exact cause of this condition remains unknown, though it may have a genetic component, particularly involving the HLA-B27 gene. Symptoms typically manifest in early adulthood and include persistent pain and stiffness in the lower back, buttocks, and hips, especially after periods of inactivity. This pain often alleviates with movement. In addition to spinal discomfort, spondylitis can lead to complications such as eye inflammation, heart issues, and mobility challenges. Diagnosis is not straightforward, as no definitive test exists; instead, healthcare providers rely on clinical assessments and imaging studies to identify joint inflammation. Treatment generally focuses on physical therapy, exercise, pain relief medications like NSAIDs, and the use of assistive devices to manage symptoms and maintain mobility. Awareness and early intervention are crucial for managing the progression of this condition effectively.
Subject Terms
Spondylitis
ALSO KNOWN AS: Ankylosing spondylitis
ANATOMY OR SYSTEM AFFECTED: Joints, spine
DEFINITION: A form of arthritis that affects the spine.
CAUSES: Unknown; possibly genetic
SYMPTOMS: Pain in lower back, buttocks, and hips in morning or after inactivity; difficulty bending spine; bent posture; difficulty walking; pain in heels and soles; fever; appetite loss and weight loss; fatigue and decreased energy; eye swelling, redness, and pain; sensitivity to light; difficulty with chest expansion for deep breathing; heart failure; heart block
DURATION: Chronic
TREATMENTS: Exercise and physical therapy; medications (pain relievers, NSAIDs); assistive devices (canes, walkers)
Causes and Symptoms
Spondylitis, also known as ankylosing spondylitis, is a form of arthritis that is chronic and affects the spine. It is a specific disease within a family of diseases called spondyloarthropathies. Examples include psoriatic arthritis, Reiter’s syndrome, and associated with inflammatory bowel disease (IBD). Spondylitis has unique features differentiating it from the other spondyloarthropathies and its own prognosis. The cause of spondylitis is unknown, but the condition may be genetic. Most people with this condition or other spondyloarthropathies are born with a particular gene, HLA-B27. However, having the gene does not mean that a person will develop spondylitis.
Symptoms include mild to severe back and buttock pain that is often worse in the early morning hours. This pain usually decreases with activity. The condition may begin in the teens or twenties and appears gradually over time. Continued of the ligaments and joints of the can cause the spine to fuse together, leading to deformity and disability. The inflammation of ankylosing spondylitis can affect other parts of the body, most commonly other joints and the eyes, but sometimes the and heart valves. Other complications include arthritis of the hip joints and the joints between the and sternum, bone spurs and inflammation in the feet, inflammation of the eyes, scarring of the lungs, inflammation of the prostate, and inflammation of the and aortic valve. Severe disease may lead to poor posture and deformities.
It is reported that men are more likely than women to develop spondylitis; however, females may develop milder cases that sometimes go undiagnosed. Most symptoms of spondylitis appear in early adulthood, prior to age forty, although young males may have symptoms in early adolescence, or even in childhood.
The hallmark signs and symptoms are stiffness and pain in the lower back, buttocks, and hips upon waking in the morning or after a period of inactivity; back pain relieved by movement and exercise; difficulty bending the spine; pain in the hips and difficulty walking; pain in the heels and soles of the feet; bent posture; straightening of the normal curvature of the spine; fever; loss of appetite and weight loss; and decreased energy; eye swelling, redness, and pain; to light; difficulty with chest expansion for deep breathing; heart failure; and heart block.
No definitive test can diagnose ankylosing spondylitis. Most doctors expect to see X-ray evidence of inflammation of the joint between the sacrum and the ilium, as well as any one of the following: inflammatory back pain, reduced mobility of the spine, and reduced ability to expand the chest. Blood tests results that can suggest spondylitis include an elevated sedimentation rate and anemia. The of from the joint will confirm inflammation.
Treatment and Therapy
Treatment includes exercise and physical therapy to help reduce stiffness and to maintain good posture and mobility. Medications for pain and inflammation, such as nonsteroidal (NSAIDs), are prescribed. Treatment of iritis involves regular eye examinations. Assistive devices, such as a cane or walker, are used to help reduce joint stress and inflammation. Surgery is rarely performed. Patients should choose chairs that help them avoid slumped or stooped postures. Other treatments include hip replacement surgery, treatment for iritis with steroid and dilating drops, and a for severe heart block.
Bibliography:
Alan, Rick. "Ankylosing Spondylitis." Health Library, November 26, 2012.
"Ankylosing Spondylitis." Mayo Clinic, 21 Dec. 2023, www.mayoclinic.org/diseases-conditions/ankylosing-spondylitis/symptoms-causes/syc-20354808. Accessed 8 Apr. 2024.
"Ankylosing Spondylitis." National Institute of Arthritis and Musculoskeletal and Skin Diseases, May 2023, www.niams.nih.gov/health-topics/ankylosing-spondylitis. Accessed 8 Apr. 2024.
Klippel, John H., Paul A. Dieppe, Fred F. Ferri. Primary Care Rheumatology. Philadelphia: W. B. Saunders, 2002.
Koopman, William J., and Larry W. Moreland, eds. Arthritis and Allied Conditions: A Textbook of Rheumatology. 15th ed. Philadelphia: Lippincott Williams & Wilkins, 2005.
Royen, Barend J. van, and Ben A. C. Dijkmans, eds. Ankylosing Spondylitis: Diagnosis and Management. New York: Taylor & Francis, 2006.
Van der Linden, S., and D. van der Heijde. “Ankylosing Spondylitis: Clinical Features.” Rheumatic Disease Clinics of North America 24, no. 4 (1998): 663–76.
Weisman, Michael H., Désirée van der Heijde, and John D. Reveille, eds. Ankylosing Spondylitis and the Spondyloarthropathies. St. Louis, Mo.: Mosby/Elsevier, 2006.