Spondyloarthritis

What is Spondyloarthritis?

There are more than 100 types of arthritis. Spondyloarthritis is common name for group of arthritis. Ankylosing spondylitis, Psoriatic Arthritis, Reactive Arthritis, IBD related arthritis is included under Spondyloarthritis group.

Who gets Spondyloarthritis?

Spondyloarthritis can occur at any age, mostly between 20 to 40 years of age. It is common among males. Approximately 50 lakh people suffer from spondyloarthritis in India.

What causes spondyloarthritis?

The cause for spondyloarthritis is unclear.

Is this disease is hereditary?

Yes. This disease can be hereditary. Sometimes it is seen in different severity among family members.

What are the symptoms of Spondyloarthritis?

• The disease affects spine joints in most of the patients initially. Back, neck or chest pain and stiffness is reported many patients. Intensity of pain and stiffness varies from time to times and also from patient to patient.
• Gradually it may proceed to stiffness of whole spine and forward bending. It can cause difficulty in bending, twisting and turning. This arthritis can also affect joints of arm and legs. It can also affect eye, intestine or skin.

How Spondyloarthritis is diagnosed?

Diagnosis is made by symptoms and physical examination by a trained doctor. Rheumatologist may consider blood investigations, x-ray, MRI, CT scan etc to confirm the diagnosis as needed.

Is there any blood investigation to confirm diagnosis of spondyloarthritis?

No. Diagnosis is based on correlation between symptoms, physical examination and investigations.

Which blood investigations are needed for spondyloarthritis?

• Before starting treatment investigations are done to see that blood counts, liver and kidney are normal.
• HLA B27 testing can help in confirming diagnosis.

What is HLA B27?

HLA B27 is a gene. It is positive in 5 to 6 % of normal population. HLA B27 positive person is more likely to get spondyloarthritis.

Which type of exercise is helpful in Spondyloarthritis?\

Back and spine related exercises are important for Spondyloarthritis. Regular exercise can help in reducing dose of drugs and also help in reducing damage to joints.

What care should be taken by patient of Spondyloarthritis?

Patient is advised to use not too soft or too hard mattress. Sleeping in prone position is advised. Patients are advised to do movements or walk intermittently while working in same position for long time.

Which are the treatment options for spondyloarthritis?

This disease is treated by two types of medicines:

1. Anti inflammatory medicines:

2. Disease Modifying Anti Rheumatic Drugs (DMARDS)

• Anti Inflammatory Medicines: Diclofenac, Aceclofenac, Naproxen, lndomethacin, Etoricoxib etc are some of examples of these types of medicines. These drugs reduce pain and swelling.
• Analgesic: Paracetamol and Tramadol are analgesic drugs. These drugs help in reducing pain.
• Steroid: These drugs do not help much in these diseases. Whenever single joint is involved then steroid injection can be taken.
• DMARD: These are important drugs to control the disease. These drugs take 6 to 8 weeks to show their effectiveness. They are helpful in improving long term outcome. Methotrexate, Sulphasalazine, Etanercept, lnfliximab, Adalimumab are some examples.

Which local therapy helps in spondyloarthritis?

Ice Application helps in reducing inflammation of swollen joint. Joint which is not having inflammation or swelling can be helped by local heat application. Wax bath, diathermy, ultrasound etc are other local pain relieving options used by physiotherapists.

When surgery is advised?

Knee, hip, shoulder and elbow joint replacement is possible. Spine surgery is advised to those patients who suffer from nerve compression.