Axial spondyloarthritis (axSpA)

Spondyloarthritis, or spondyloarthropathy, is an inflammatory arthritis affecting the spine. Spondyloarthritis often inflames the entheses, the sites where ligaments and tendons enter bone. Many patients progress to a degree of spinal fusion, or ankylosing spondylitis (AS).

Last Updated: September 27, 2023

Spondyloarthritis more often affects males in their teens or 20s. It may run in families. Ankylosing spondylitis (AS) is associated with the HLA-B27 gene. Alaskan or Siberian Eskimos and Samis have higher frequency of HLA-B27 and more likely to have AS. Up to 30 genes may cause types of spondyloarthritis.

  • Early spondyloarthritis may present as inflammation that causes pain and stiffness, often in the spine.
  • Low back pain is the most common symptom.
  • Later signs may be bone destruction that deforms the spine and lowers function in the hips or shoulders.
  • Patients may have pain, fatigue or stiffness that is continuous or comes and goes.

Spondyloarthritis patients should get physical therapy and do joint-directed exercises to promote spinal extension and mobility. First-line medications for symptom relief are nonsteroidal anti-inflammatory drugs (NSAIDs). Biologic medications including TNF-alpha and IL-17 blockers may treat spinal or peripheral symptoms.

People with spondyloarthritis should exercise frequently to maintain joint and heart health. People with spondyloarthritis who smoke should quit or get help to do so. Smoking aggravates spondyloarthritis and may speed up the rate of spinal fusion. Patient support groups for people with spondyloarthritis may be helpful and informative

Reference: Spondyloarthritis-Fact-Sheet.pdf (rheumatology.org)

Last Updated: September 27, 2023
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