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ONSEN® BLOG / About health

Spondyloarthropathy – symptoms, causes, treatment

25 kwietnia 2024
Spondyloarthropathy, AS, back pain, joint inflammation
Contents
Causes of spondyloarthritis
Symptoms of spondyloarthritis
Diagnosing spondyloarthritis
Treatment methods for spondyloarthritis
Rehabilitation in spondyloarthritis
Prevention of spondyloarthritis
Sleep in spondyloarthritis
Spondyloarthropathies are a group of rheumatic diseases with identical clinical features. These are ailments that mainly affect the spine joints and can also affect other structures. They are classified as inflammatory diseases and, consequently, can lead to progressive stiffness and back pain, negatively impacting the patient's health.

Among the most well-known spondyloarthropathies is ankylosing spondylitis, which is inflammation of the spine joints. There are also inflammatory bowel diseases, which seemingly have nothing to do with joints. It can also be psoriatic arthritis or reactive arthritis, which can occur after bacterial infections. Therefore, it is important to be vigilant for spondyloarthropathy symptoms to initiate prompt treatment.
Ankylosing spondylitis, arthritis, rheumatic diseases, Bechterew

Causes of spondyloarthritis

Medicine does not fully understand the causes of spondyloarthropathy, but it is commonly believed to result from a complex interaction of genetic, immunological, and environmental factors that affect a small portion of the population. One of the key predisposing factors for its development is the presence of the HLA-B27 antigen, a protein found on the surface of cells. It plays an important role in presenting antigens to the immune system. Approximately 90% of patients with ankylosing spondylitis carry this antigen.

Environmental factors, including bacterial and viral infections, may contribute to the development of spondyloarthropathy in cases of reactive arthritis, which often occurs as a result of fairly common gastrointestinal infections, and sometimes also urogenital infections. It is suspected that these microbes may trigger an immune response that then sustains and attacks the body's tissues.

In some patients, a dysfunction of the immune response may be a factor in the development of spondyloarthropathy, where the immune system begins to attack the body's tissues. This leads to inflammatory conditions in the joints and other tissues. This disruption of the immune response may be caused by abnormalities in cytokines, which are regulators of the inflammatory response.
HLA-B27 antigen, spondyloarthropathy, inflammation

Symptoms of spondyloarthritis

Most often, the initial symptoms of spondyloarthropathy are varied and change depending on the type of disease and the characteristics of the patient. The key symptom is back pain and stiffness, especially in the lumbar region, which worsens at night and decreases after physical activity. In addition, patients may experience pain and swelling in peripheral joints, especially in the lower limb joints.

Spondyloarthropathies can lead to inflammation of tendons and their attachments, which manifests as pain and tenderness. They may also affect other organs, causing, for example, eye inflammation, gastrointestinal problems, or skin changes, due to their specific course.

These symptoms affect the quality of life of patients, limiting their ability to work and perform daily activities. Therefore, early diagnosis and treatment are crucial for preventing a more severe health deterioration. It is important to be sensitive to the symptoms of spondyloarthropathy in order to avoid it or increase the effectiveness of treatment.
Spinal stiffness, spinal joint swelling, back pain

Diagnosing spondyloarthritis

In many cases, diagnosing spondyloarthropathy can be a challenging task due to the diversity of symptoms. Matters are not made easier by their shared characteristics with other rheumatic diseases. The diagnostic process typically begins with a detailed medical history and physical examination, during which the doctor gathers information about the patient's medical history. This requires a very detailed analysis of symptoms, and thus specialized knowledge.

A key role is played by imaging tests, primarily magnetic resonance imaging (MRI). This allows for early detection of inflammation in the sacroiliac joints and possibly in other spinal joints. This can even occur before changes are visible on X-rays, which are becoming less common. X-rays are used to assess the extent of disease progression, particularly in cases of progressive degenerative changes and joint fusion, when they are already known and visible.

The diagnostic process is supported by laboratory tests, although there is no specific test for all forms of spondyloarthropathy. Often, tests for C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are performed to assess inflammatory markers. Tests are also conducted for the presence of HLA-B27 antigen, although its presence is not crucial for making a diagnosis.
CRP test, C-reactive protein, viral infection

Treatment methods for spondyloarthritis

It should be remembered that treatment of spondyloarthropathy is complex and requires an individual approach to each patient. The goal of therapy is to reduce pain and prevent disease progression to the extent possible. This is aimed at maintaining the best possible quality of life for patients. Treatment typically involves a combination of pharmacotherapy, rehabilitation, and psychological therapy, making it multidimensional.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are typically used as the first-line treatment to alleviate pain and reduce inflammation. They often provide quick relief of symptoms, but long-term use is not advisable due to side effects such as gastrointestinal or renal problems.

Increasingly, disease-modifying antirheumatic drugs (DMARDs) are being used, such as sulfasalazine. These may be used in milder cases and sometimes in spondyloarthropathies associated with gastrointestinal inflammation. Other cases may require biologic disease-modifying drugs such as TNF inhibitors like tacrolimus or infliximab. There are also more advanced targeted therapies, including interleukin inhibitors such as secukinumab and ixekizumab. These are used when conventional treatment is ineffective.

Treatment also includes rehabilitation with a physiotherapist, which involves exercises aimed at maintaining range of motion and strengthening muscles, leading to overall physical fitness improvement. Physiotherapy can also help reduce stiffness and pain to prevent joint function loss.

Psychological support is also essential because chronic pain and functional limitations can lead to frustration, depression, or anxiety, which is never pleasant. The foundation here is psychological counseling, but optimal would be psychotherapy, which helps patients cope with emotional difficulties related to the disease. Understanding the disease as well as actively participating in treatment significantly improve its outcomes.
Medications for spondyloarthropathy, targeted therapy, spinal inflammation treatment

Rehabilitation in spondyloarthritis

Rehabilitation in the case of spondyloarthropathy plays a crucial role in disease management. Its aim is to reduce pain and improve functioning, which translates into an increase in the quality of life for patients. It focuses on areas such as maintaining or improving range of motion, which is associated with muscle strengthening. Patient education on self-management of health is important in this regard.

The foundation of rehabilitation lies in strengthening exercises, which focus on building muscle strength, which is crucial for maintaining joint and spinal stability at an appropriate level. Strengthening the muscles surrounding the spine helps reduce stress on the joints. This, in turn, significantly alleviates spondyloarthropathy symptoms.

Stretching exercises are also used to increase joint flexibility. This results in reduced stiffness, particularly in the spinal area. Similarly, aerobic exercises such as swimming, walking, or cycling are recommended. These activities also improve cardiovascular fitness and alleviate inflammation.

Hydrotherapy, or exercises in water, is particularly recommended. Warm water helps alleviate pain, and the buoyancy reduces joint stress, allowing exercises to be performed with less effort. It is worth discussing this option with the attending physician as it is safe and straightforward.

In addition to this, manual therapy is used to increase range of motion and reduce muscle tension. Electrotherapy may also be considered, such as TENS currents. These are mainly used for temporary pain relief, as they do not affect the cause of the disease.

Patient education is important in the disease management so that the patient can cope with pain effectively. Effective psychological support is also crucial, as chronic illness and pain can affect the patient's emotional state. Well-conducted psychological counseling can help create effective coping strategies for stress and anxiety, reducing the risk of depressive episodes.
Rehabilitation, physiotherapy, spinal exercises

Prevention of spondyloarthritis

Unfortunately, effective preventing spondyloarthropathy is difficult because its exact causes are not fully known. They involve complex interactions of genetic, immunological, and environmental risk factors that must occur together. However, there are some general recommendations that may help reduce the risk of symptoms or exacerbations in individuals at risk or already affected.

Of course, the key is early diagnosis, which allows for prompt initiation of treatment. This can significantly impact the course of the disease. Individuals with genetic predispositions, such as the presence of the HLA-B27 antigen, should be aware of the first symptoms, such as chronic back pain and stiffness, especially if they occur at a young age.

In prevention, regular exercise is important, which can improve range of motion. Their main task is muscle strengthening, especially those around the spine. They also help maintain appropriate body weight, promoting weight control. Physical activity is important in preventing joint stiffness, which helps control inflammation.

The diet should be rich in nutrients containing antioxidants and omega-3 fatty acids. Flaxseed, fruits, and vegetables are particularly recommended, especially those from organic farming. It is also important to consider adequate hydration, which supports the immune system and reduces inflammation.
Spondyloarthropathy, treatment of spondyloarthropathy, spine diagnosis

Sleep in spondyloarthritis

For individuals suffering from spondyloarthropathy, the quality of sleep can be significantly reduced due to experiencing pain, stiffness, and other symptoms associated with the disease. Managing sleep is an important part of the treatment plan, as good sleep quality can help alleviate pain, which is associated with reducing inflammation and improving overall well-being.

It's important to find a comfortable sleeping position that is comfortable and minimizes pain. Some individuals with spinal joint inflammation should also consider sleeping on their back with a pillow under their knees, which helps reduce tension in the lower back. Similarly, using a knee pillow when sleeping on the side can be helpful.

It's also important to take care of sleep hygiene, which is key to regeneration. This includes equipment such as the Osaka Air mattress, which is particularly recommended for individuals with spondyloarthropathy. It also includes maintaining a cool temperature and limiting noise and light, which helps increase deep sleep. Some patients with spondyloarthropathy may require orthopedic pillows to better support their neck.

However, if sleep problems are chronic and seriously affecting life, consider a polysomnography, which any doctor can refer you to. It may be necessary to conduct other tests to effectively diagnose and treat sleep disorders, such as sleep apnea, which may occur with spondyloarthropathy.

We also encourage you to explore other articles on the best sleep and health blog, as well as the Encyclopedia of Healthy Sleep prepared by the ONSEN® team of specialists. For those who care about spine health, we recommend a set of spine exercises prepared by our physiotherapist.
Orthopedic mattress, mattresses for the spine, sleeping with back pain

FAQ: Spondyloarthritis

What is spondyloarthritis?

Spondyloarthritis, often abbreviated as SpA, is a group of rheumatic diseases characterized by joint inflammation, particularly of the spine joints. These diseases may also involve peripheral joint inflammation and extra-articular manifestations such as eye inflammation, skin psoriasis, or inflammatory bowel conditions.

Is spondyloarthritis an autoimmune disease?

Yes, spondyloarthritis is considered an autoimmune disease. This means that in spondyloarthritis, the body's immune system often attacks its own tissues, causing inflammation. This occurs especially in the spine joints but can also manifest in other areas.

Is spondyloarthritis the same as ankylosing spondylitis (AS)?

Spondyloarthritis includes several different diseases, including ankylosing spondylitis (AS), which is one of the types of axial spondyloarthritis (axSpA). This further divides into radiographic axSpA, where changes are visible in radiological examinations of the sacroiliac joints, and non-radiographic axSpA, where such changes are not visible.

How to sleep with ankylosing spondylitis (AS)?

For individuals suffering from AS, sleep comfort can be significantly improved by using an orthopedic mattress such as the Osaka Air, which provides proper spinal support. It is also important to maintain a straight posture during sleep, use appropriate anatomical pillows, and avoid sleeping positions that may increase pain or stiffness.

How does spondyloarthritis cause organ changes?

Spondyloarthritis is a chronic inflammatory disease that can lead to various organ changes. These include uveitis (eye inflammation), skin psoriasis, inflammatory bowel diseases, and cardiovascular conditions. Organ changes in the course of spondyloarthritis arise from a systemic inflammatory state, therefore requiring multi-specialty evaluation and specific treatment.

Contents
Causes of spondyloarthritis
Symptoms of spondyloarthritis
Diagnosing spondyloarthritis
Treatment methods for spondyloarthritis
Rehabilitation in spondyloarthritis
Prevention of spondyloarthritis
Sleep in spondyloarthritis
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