Spondylitis

What is Spondylitis? 

Spondylitis is a condition where the immune system attacks the joints, causing inflammation, bone fusion, and excess bone formation. It is a long-term condition which can lead to chronic pain and discomfort, and occurs more frequently in men. The most common type of spondylitis is ankylosing spondylitis. 

Ankylosing spondylitis, also known as axial spondyloarthritis, can, over time, cause some of the bones in your spine to fuse. This reduces your spine’s flexibility and can cause you to hunch. If your ribs are affected, it can be difficult to breathe deeply. Inflammation also can occur in other parts of the body — most often, the eyes. Spondylitis tends to first develop in teenagers and young adults.

What are the symptoms of spondylitis?

Symptoms can vary. They usually begin in early adulthood and develop gradually over several months or years. They include:

  • Lower back pain that worsens with rest and improves with exercise
  • Stiffness and lack of mobility in your spine, especially in the morning or after long periods of inactivity
  • Extreme fatigue 
  • Hunched or stooped back
  • Pain and swelling in other parts of your body such as your eyes, heart, or lungs (depending on the type of spondylitis)
  • Difficulty breathing and chest pain (in severe cases)

The areas of your body that are most commonly affected are:

  • The joint between your pelvis and the base of your spine 
  • The spinal bones (vertebrae) in your lower back
  • Where your tendons and ligaments attach to your bones, mainly in the spine, but sometimes along the back of your heel
  • The cartilage between your breastbone and your ribs
  • Your hip and shoulder joints

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What causes Spondylitis?

The exact cause is unknown, but may be a combination of genetic and environmental factors, such as infections.  Factors that are known to contribute to spondylitis are:

  • Poor posture while sitting / standing for a long time
  • Lack of exercise
  • Family history
  • Obesity
  • Excessive smoking and alcohol consumption

How is Spondylitis diagnosed?

Diagnosing spondylitis is difficult as it develops slowly and there is no conclusive test. When you see your GP they will usually discuss your symptoms, what they are and how long you have had them for. They will also check to see whether they are worse after rest. They may ask you to bend in different directions to test your range of motion.

Your GP may then send your for a blood test to see if you have any signs of inflammation. If you have inflammation you may be sent for other tests, such as an X-ray, to rule out other causes, an MRI or an ultrasound. Because accurate diagnosis depends on the development of the condition, it can take a long time to be diagnosed. 

How is Spondylitis treated?

Unfortunately there's no cure for Spondylitis and the damage caused by the condition cannot be reversed. However, there are treatments that can help to relieve the symptoms and slow down progression of the condition. Treatments include the following: 

  • Exercises and stretching routines to reduce pain and increase movement 
  • Heat and cold packs to reduce inflammation, relax muscles and numb pain
  • Physiotherapy to reduce stiffness, improve comfort and increase flexibility
  • Medication to relieve pain and reduce inflammation 
  • Movement modifications: a good posture, awareness of how your body and moves, and avoiding activities that put stress on your spine can also help 
  • Surgery: in rare cases surgery may be considered to repair or replace significantly damaged joints or to correct severe spinal deformities

Does Spondylitis cause other complications? 

In about 40% of patients, Ankylosing Spondylitis can lead to a type of acute eye inflammation known as iritis (or uveitis). It can also lead to inflammation around the heart causing high blood pressure and other cardiovascular conditions, but this is very rare affecting 2%-10% of people with the condition.

There is Spondylitis in my family. How can I avoid it? 

Since the cause of spondylitis is still unknown, there are no certain ways to avoid it. However the following actions may help to reduce the risk or severity of symptoms:

  • Be healthy – exercise regularly and eat a balanced diet
  • Practice good posture and body mechanics, especially when lifting heavy objects
  • Take breaks and do stretching exercises if you are sitting or standing for long periods
  • Avoid smoking