Did you know that there are many types of arthritis and not all arthritis is equivalent?

Spondyloarthritis is a family of arthritis encompassing multiple forms of arthritis including the ones below.

Types of spondyloarthritis:

• Ankylosing spondylitis
• Psoriatic Arthritis
• Enteropathic spondyloarthritis
• Peripheral spondyloarthritis
• Non radiographic axial spondyloarthritis
• Reactive arthritis

Ankylosing spondylitis, a type of spondyloarthritis, is an autoimmune disease that mainly involves the spine and sacroiliac joints. It is correlated with HLA-B27, a gene variant that helps influences immune responses.  The prevalence rate of having ankylosing spondylitis in the HLA-B27 population is around 5-6%.  However, about 80-90% with ankylosing spondylitis will be HLAB27+.

Psoriatic arthritis is another spondyloarthritis that is usually coupled with psoriasis.  However, not every person with psoriatic arthritis will need to have psoriasis.  Usually patients can have sausage like toes or fingers, nail pitting, as well as enthesitis.

Uveitis(a type of eye inflammation) can be seen with these different spondyloarthritis.  Usually when patients have uveitis, the eye can be red, painful, and very sensitive to light.  If this occurs, it is important to see any ophthalmologist as soon as possible.

Symptoms

Symptoms of spondyloarthritis may include

• Low back pain
• Morning Stiffness
• Tendonitis
• Enthesitis
• Painful swelling of joints
• Fingers and toes that swell up like sausages
• Pitting on the nails
• Skin changes such as psoriasis
• Heel pain
• Chronic diarrhea or bloody bowel movements
• Eye inflammation such as uveitis

If you have spondyloarthritis you have a higher chance of getting a form of eye inflammation called uveitis.  Also, patients with spondyloarthritis may develop inflammatory bowel disease such as ulcerative colitis and crohn’s disease.  Spondyloarthritis is more than just joint pain.  Sometimes patient’s may get inflammation at the entheses.  The entheses is the connection point between the tendon or ligament and bone.

Causes

The causes of spondyloarthritis is thought to be a combination of genetics and environmental factors.  Although many patients with spondyloarthritis are positive for HLA-B27, it is not the only implication to the development of disease.  For example, reactive arthritis can develop after an infection such as a urinary tract infection or gastroenteritis.  Other factors important such as diet, lifestyle, and environmental pollutants. can play a role as well.

Diagnosis

In order to be diagnosed properly, it is important to seek the expertise of a medical professional.  Usually for spondyloarthritis, a rheumatologist is the medical specialist that treats these diseases.  Diagnosis cannot be made on labs alone.  It takes a combination of symptoms and labs together in order for a diagnosis to be properly made.  Some of these symptoms can be similar to symptoms of other diseases which is why medical professional opinion is so important.

Treatment

Conventional medicine treatment includes:

• non steroidal anti inflammatory drugs(NSAIDS)
• disease modifying anti rheumatic drugs(DMARDs) such as methotrexate and leflunomide
• biologics such as TNF inhibitors, IL-17 inhibitors, IL12/23 inhibitors, and JAK inhibitors
• Physical therapy

Integrative treatment can include a number of different treatments such as diet modification, exercise, mind body medicine, stress reduction, ayurveda, acupuncture, traditional chinese medicine, naturopathic medicine, functional medicine.  Some of these treatments have varying levels of evidence for spondyloarthritis.  However, they can sometimes work.