What is spondyloarthritis?

Spondyloarthritis is the term for a group of inflammatory diseases that cause joint inflammation, or arthritis. Most inflammatory diseases are thought to be hereditary. So far, there isn’t any scientific evidence to suggest that the disease can be prevented.

Spondyloarthritis can be classified as either axial or peripheral. The axial form affects mostly the pelvic joints and spine. The peripheral form affects the limbs. The condition may also cause inflammation in the eyes, gastrointestinal tract, and areas where ligaments and tendons attach to your bones.

The most common type of spondyloarthritis is ankylosing spondylitis (AS). This type mainly impacts the joints of the spine. It may also affect other large joints in the body.

Other types of spondyloarthritis are:

Spondyloarthritis symptoms

The main symptoms of spondyloarthritis are pain, stiffness, and swelling. Bone damage may also occur. Where you feel symptoms in the body depends on the type of spondyloarthritis you have.

AS pain often starts in the buttocks and lower back. It may spread to the chest and neck. Tendons and ligaments may also be involved. In rare cases, AS will impact the heart and lungs.

Enteropathic arthritis may cause pain in the spine, arms, and leg joints. It may also cause bloody diarrhea and abdominal pain due to inflammatory bowel disease.

Juvenile arthritis often causes pain in the pelvis, hips, ankles, and knees. The condition may also cause fatigue.

Psoriatic arthritis can impact the spine. When this happens, it’s known as psoriatic spondyloarthritis. It may also cause pain in the neck.

Reactive arthritis may cause inflammation in the urinary tract, the joints, and the eyes. It can lead to inflammation of the spinal joints.

Undifferentiated arthritis often causes symptoms similar to AS. This includes pain in the lower back, buttocks, and heels.

What causes spondyloarthritis?

The exact cause of spondyloarthritis isn’t clear, although genetics play a part. The main gene involved in all types of spondyloarthritis is HLA-B27.

Although the HLA-B27 gene doesn’t cause the condition, it can increase your risk of developing it. Research is ongoing to determine how other genes may cause spondyloarthritis.

Some research suggests a link between an imbalance of your microbiome and the development of spondyloarthritis or other inflammatory diseases. More research is needed to understand the relationship between gut bacteria and systemic inflammation.

Reactive arthritis is the only type of spondyloarthritis known to be triggered by a bacterial infection. It most commonly results after chlamydia or a food-borne infection.

Who’s at risk for spondyloarthritis?

It’s not always clear why someone gets spondyloarthritis. Your risk for the condition may be higher if you:

  • have a family member with spondyloarthritis
  • are of Alaskan, Siberian Eskimo, or Scandinavian Lapps descent
  • test positive for the HLA-B27 gene
  • have frequent bacterial infections in your gut
  • have another inflammatory condition, such as psoriasis or inflammatory bowel disease

Diagnosing spondyloarthritis

Early diagnosis is important to help manage symptoms and reduce your risk of complications or disability. Your doctor may suspect you have spondyloarthritis based on your symptoms, medical history, and a medical exam.

The condition may be confirmed with:

  • X-rays of the sacroiliac joints in the pelvis
  • magnetic resonance imaging
  • a blood test to check for the HLA-B27 gene

Spondyloarthritis treatment options

There’s no cure for spondyloarthritis. Treatment focuses on reducing pain, improving or maintaining mobility, and reducing your risk of complications.

Although it may seem counterintuitive, regular movement is critical to manage discomfort associated with the condition.

Treatment plans are individualized, but most will include:

  • physical therapy
  • low-impact exercise
  • non-steroidal anti-inflammatory drugs
  • corticosteroid injections
  • antirheumatic drugs
  • TNF alpha-blocker drugs

Antibiotics are used to treat an active bacterial infection present with reactive arthritis. Severe cases of spondyloarthritis may require surgery to treat bone destruction or cartilage damage.

Smoking is a known cause of inflammation in the body. If you smoke, it’s important to stop. Your doctor can help you find a smoking cessation program that’s right for you.

Learn more: Anti-inflammatory drugs for arthritis »

Does what you eat help spondyloarthritis?

There’s no specific diet for spondyloarthritis. Still, eating healthy is vital to your overall health and to help prevent weight gain. Excess weight puts extra pressure on your joints.

Some foods and ingredients may cause inflammation and should be limited. These include:

  • sugars
  • fried foods
  • saturated fats and transfats
  • refined carbohydrates
  • monosodium glutamate
  • aspartame
  • alcohol

To help battle inflammation in your body, strive to eat a diet rich in:

  • a colorful variety of fruits and vegetables
  • whole grains
  • fiber
  • lean protein
  • fatty fish

Spondyloarthritis may cause bone thinning and osteoporosis, so it’s important to get enough calcium in your diet as well. The National Ankylosing Spondylitis Society recommends getting 700 milligrams of calcium daily.

Dairy products are a good source of calcium. Research indicates that dairy may cause inflammation in people allergic to lactose. If you’re lactose-sensitive, opt for plant-based sources of calcium instead, such as:

  • green leafy vegetables
  • legumes
  • dried figs

You can also get calcium from fortified orange juice. Spinach is high in calcium, but it’s also high in oxalates. Oxalates bind to calcium and prevent its absorption.

Learn more: Foods that reduce inflammation »

Will going gluten-free help with spondyloarthritis?

Some people claim that going gluten-free reduces their spondyloarthritis symptoms. Although it’s irrefutable that gluten should be avoided if you have celiac disease, gluten sensitivity in people without celiac disease is controversial.

In some cases, people may think gluten is making them feel bad after eating, when the culprit is actually wheat or another allergen. If you feel gluten makes your symptoms worse, talk to your doctor about getting tested for celiac disease and trying a gluten-free diet.

Check out: Turmeric and other anti-inflammatory spices »

What’s the outlook?

Spondyloarthritis is a progressive condition. Its course is difficult to predict. Even so, the outlook for most people is good if they take steps to manage their symptoms and stay as healthy as possible.

Regular exercise and physical therapy go a long way to support mobility and reduce stiffness and pain. Over-the-counter and prescription medications to reduce inflammation are also often beneficial.

Like many other chronic conditions, spondyloarthritis symptoms may come and go. Symptoms may also vary from day to day. Complications, such as heart problems and lung scarring due to long-term inflammation, are rare.

Spondyloarthritis is serious. But with the right coping strategies and a consistent treatment plan, most people with the condition live full lives.