Summary about Disease
Spondylitis refers to inflammation of the vertebrae (bones of the spine). While the term can generally refer to any inflammation of the spine, it is often used to describe a group of inflammatory rheumatic diseases that cause arthritis. The most common type is ankylosing spondylitis (AS), which primarily affects the spine and sacroiliac joints. Other types include non-radiographic axial spondyloarthritis, psoriatic arthritis, reactive arthritis, and enteropathic arthritis (associated with inflammatory bowel disease). Spondylitis can lead to pain, stiffness, and, in severe cases, fusion of the vertebrae.
Symptoms
Pain and stiffness: Typically in the lower back, buttocks, hips, neck, and shoulders. Pain is often worse in the morning or after periods of inactivity.
Fatigue: A common and often debilitating symptom.
Uveitis: Inflammation of the eye, causing pain, redness, and blurred vision.
Enthesitis: Inflammation of the entheses (points where tendons and ligaments attach to bone), leading to pain and tenderness, particularly in the heels, ribs, and chest.
Limited range of motion: Difficulty bending, twisting, or moving the spine.
Postural changes: In advanced cases, a stooped or hunched-over posture.
Causes
The exact cause of spondylitis is unknown, but it is believed to be a combination of genetic and environmental factors.
Genetics: The HLA-B27 gene is strongly associated with ankylosing spondylitis, but not everyone with the gene develops the condition. Other genes also play a role.
Immune system: Spondylitis is an autoimmune condition, where the body's immune system mistakenly attacks healthy tissues.
Environmental triggers: Infections or other environmental factors may trigger the disease in genetically susceptible individuals.
Medicine Used
Nonsteroidal anti-inflammatory drugs (NSAIDs): Such as ibuprofen and naproxen, to reduce pain and inflammation.
Disease-modifying antirheumatic drugs (DMARDs): Such as sulfasalazine and methotrexate, to slow the progression of the disease.
Biologics: Such as TNF inhibitors (e.g., etanercept, infliximab, adalimumab) and IL-17 inhibitors (e.g., secukinumab, ixekizumab), to target specific parts of the immune system.
Corticosteroids: Such as prednisone, to reduce inflammation (used for short-term relief).
Pain relievers: Such as tramadol or opioids, for severe pain.
Is Communicable
Spondylitis is not communicable. It is not contagious and cannot be spread from person to person.
Precautions
Regular exercise: To maintain flexibility, strength, and range of motion.
Good posture: To minimize stress on the spine.
Physical therapy: To learn exercises and techniques to manage pain and improve function.
Smoking cessation: Smoking can worsen spondylitis.
Healthy diet: To support overall health and reduce inflammation.
Regular medical checkups: To monitor the disease and adjust treatment as needed.
How long does an outbreak last?
The duration of an "outbreak" (flare-up) of spondylitis symptoms varies greatly from person to person. Flare-ups can last for days, weeks, or even months. There is no set time frame, and symptoms can fluctuate over time. With effective management, the goal is to reduce the frequency and severity of flare-ups.
How is it diagnosed?
Medical history and physical examination: The doctor will ask about symptoms, family history, and perform a physical exam to assess range of motion and tenderness.
Imaging tests:
X-rays: To look for changes in the spine and sacroiliac joints.
MRI: To detect early signs of inflammation that may not be visible on X-rays.
Blood tests:
HLA-B27 test: To check for the presence of the HLA-B27 gene.
Inflammatory markers: Such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), to measure inflammation levels.
Timeline of Symptoms
The timeline of symptoms can vary significantly.
Early stages: Gradual onset of lower back pain and stiffness, often worse in the morning.
Progression: Pain may spread to the hips, buttocks, neck, and shoulders. Fatigue and enthesitis may develop.
Advanced stages: Fusion of vertebrae (ankylosis), leading to limited range of motion and postural changes. Uveitis and other complications may occur.
Important Considerations
Early diagnosis and treatment: are crucial to slow the progression of the disease and prevent long-term complications.
Individualized treatment plans: Treatment should be tailored to the specific symptoms and needs of each person.
Multidisciplinary approach: Management often involves a rheumatologist, physical therapist, ophthalmologist, and other healthcare professionals.
Living with spondylitis: Requires ongoing self-management, including exercise, good posture, and stress management.
Support groups: Can provide emotional support and information.