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Spondylitis - Symptoms, Treatment And Causes

Last Updated: Nov 01, 2021

What is Spondylitis?

Arthritis of the spine is called Spondylitis. Pain and stiffness that starts from the neck and continues up to the lower back is called spondylitis.

It may also result in deformity of the spine leading to a stooped posture. Spondylitis is a condition that is debilitating and prevents one from performing the normal day to day activities.

Spondylitis affects a number of people irrespective of age or gender. Besides the pain, stiffness, bony growths on the spine, pain in ligament and tendons, a person may suffer from other conditions like fatigue, fever, loss of appetite, redness of eyes.

What is the difference between spondylosis and Spondylitis?

Although both the conditions i.e Spondylitis and spondylosis have an effect on the spine differences are there. While Spondylitis has an inflammatory effect on the spine, spondylosis has a degenerative effect. The former is characterized by an inflammation of the joints between vertebrae while the latter one shows degeneration of the intervertebral disc and also spine which shows the formation of bony spurs.

What are the types of spondylitis?

Types of spondylitis include:

  1. Ankylosing Spondylitis:

    In this, there is inflammation in the spine and pelvis which also causes inflammatory back pain. This usually starts at the age of 45 and it most of the time improves by continuous activity but not by resting.

    As time passes inflammation may lead to ankylosis which is the formation of new bone in the spine. Thus making the spine fixed in an immobile position.

  2. Enteropathic Arthritis:

    This is associated with inflammatory bowel disease. In this, there is inflammation of the intestine and it includes bowel which is again a dominant feature of enteropathic arthritis.

    Its symptoms include abdominal pain, weight loss, chronic diarrhoea, blood in the stool.

  3. Psoriatic Arthritis:

    In this, there is constant swelling and pain in the joints of the hands and feet. In some people, there is also a skin rash due to psoriatic arthritis. Sometimes there is also stiffness in the spine.

  4. Reactive Arthritis:

    In reactive arthritis infection takes place in the intestine or the urinary tract. This can also cause inflammation and pain in the joints, eyes, genitals, bladder, mucous membrane.

  5. Juvenile Spondyloarthritis:

    These symptoms begin in childhood and looks like normal spondylitis. In this, there is inflammation at the meeting points of tendons or ligaments.

What are the symptoms of spondylitis?

Most of the time spondylitis is due to age-related problems and they do not experience any exact symptoms.

The most common symptoms of spondylitis are mild pain and stiffness which may get worse after a certain period of time and by sitting for longer hours.

There can be some of the severe symptoms too which include:

  • Poor coordination
  • Pain in the muscles or spasm
  • A popping or grinding feeling while moving the spine
  • Weakness in the hand or legs
  • Loss of control on the bladder or bowel control
  • Difficulty in walking or loss of balance

Is Spondylitis a disability?

Spondylitis can be considered as a disability if it occurs in severe form and makes a person unable to do work or a job. In such cases, the person becomes eligible for availing of the monthly disability benefits from the Department of Social Security Administration. Some criteria need to be fulfilled for this which include submission of detailed medical records, lab tests, tests record, documentation, and confirmation from the doctor who is doing the treatment.

Is Spondylitis genetic?

The condition of Spondylitis may be genetic at some level but not completely. Inheritance of genes linked with ankylosis Spondylitis is not always associated with the development of the disorder in the person of a family even if some of the family members carry the disorder. However, it is true that genetic factor along with environmental factors has a role in developing the risk.

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What causes spondylitis?

Spondylitis is an aging phenomenon in which there is inflammation in the vertebrae. The most common cause of spondylitis is backache and neck pain.

What is the best treatment for spondylitis?

The best treatments for spondylitis are as follows:

Ankylosing Spondylitis:

1. Medication: The medicines which are given at the time of ankylosing spondylitis includes:

  1. Adalimumab (Humira)
  2. Certolizumab pegol (Cimzia)
  3. Etanercept (Enbrel)
  4. Golimumab (Simponi; Simponi Aria)
  5. Infliximab (Remicade)

2. Physical treatment and therapies are also provided to the people suffering from ankylosing spondylitis. It is done to improve the flexibility and strength of the body.

Enteropathic Arthritis:

In this various drug therapies are given which include:

  • Sulfasalazine and Aminosalicylates: These medicines are useful for treating ulcerative colitis but they are not helpful for crohn's disease.
  • TNF-alpha Inhibitors: This plays a big role in treating enteropathic arthritis and its injections are given under the skin or sometimes drip in the veins.
  • DMARDs: It helps in removing inflammation from the joints by interfering with the inflammatory response of the immune system.
  • Corticosteroids: It is given for only short-term and moderate to severe treatment.
  • NSAIDs: It is used for the reduction of pain and inflammation of the joints. But the medicines must be taken only if there is no side effects after taking this medication.

Psoriatic Arthritis:

The medications which are given during psoriatic arthritis are:

  • NSAIDs: these are used as a pain reliever and also reduce inflammation of the joints. The medicines are ibuprofen, naproxen sodium. But before taking these medications one must consult the doctor as there can be severe side effects.
  • DMARDs: this slows down the progression of psoriatic arthritis. Thus saving the tissues from further damage.
  • Immunosuppressants: this is given to keep the immune system in control as it is the most affected part in psoriatic arthritis.

Reactive Arthritis: The medications which are given during reactive arthritis are:

  • NSAIDs: These are used as a pain reliever and also reduce inflammation of the joints. The medicines are ibuprofen, naproxen sodium. But before taking these medications one must consult the doctor as there can be severe side effects.
  • Corticosteroids: It is given for only short-term and moderate to severe treatment.
  • Topical Steroid: It is used to treat skin rashes which is caused due to reactive arthritis.

These are some of the measures that people adopt to get rid of spondylitis: Acupuncture,occupational therapy, massage, ultrasound treatment, electrical stimulation, chiropractic treatment.

Medication:

The doctor may suggest the following medication:

Pain relief medication, drugs for easing nerve pain, topical creams, injections with the combination of steroid and anesthetic medication, a steroid medication, a muscle relaxant to reduce spasm.

Surgery:

Surgery might also be recommended to some patients if the medications are also not working and no there is no relief after the treatment. There may be image testing done by the doctor with the help of X-rays.

In advanced stages surgery is the only option. People who have spondylitis can be treated with knee or hip replacement surgery. These surgeries provide permanent relief to spondylitis patients.

Can spondylitis be cured?

There is no cure for spondylitis it can just get delayed or exercise may help people relax for a small period of time.

How can spondylitis be prevented?

These are the ways in which spondylitis can be prevented:

  • Avoid alcohol:

    Alcohol is not good for the bones as it weakens them. Therefore if you are suffering from spondylitis then you should avoid alcohol or should not consume it in large amounts.

  • Getting plenty of calcium and vitamin D:

    Calcium and vitamin D both are very important and useful for bone health. Calcium helps in building up the bones whereas Vitamin D is important for the absorption of calcium in the bones. Thus these two together are important and keeps spondylitis away.

  • Become active:

    You must keep doing stretching and should not keep your body stiff for a long time.

  • Keeping good posture:

    the alignment of your spine should be proper as it alleviates pain and prevents damage. Body’s flexibility should be maintained by doing neck, upper back and shoulder stretch.

  • Getting plenty of sleep:

    If you are suffering from spondylitis then you should get sleep in adequate amount. Sleeping in the right posture, on the proper mattress is very important.

  • Communicating with your doctor:

    talk with your doctor if you are going through the symptoms related to spondylitis. Doing lifestyle changes also help during spondylitis.

What are the Best Exercises for Spondylitis?

These are the exercises which are best for spondylitis:

  • Stretching up your spine
  • Plank for a strong core
  • Do neck stretches
  • Stretching hips to get relief from lower back pain
  • Taking deep breaths

What food is good for spondylosis?

Foods play an important role in the case of Spondylitis as a healthy and well-balanced diet is a key to better health. The main focus is to maintain a healthy weight which is important in this case. Some of the foods which are preferred include fresh fruits and vegetables, whole grains, sources of omega-3 fatty acids like fish oil and walnuts, adequate fluids i.e water, diet supplements for vitamin D, and food with low fat and low cholesterol.

These are the food that is good for spondylitis:

  • Plenty of green leafy vegetables, fruits, and whole-grain products.
  • Minimize processed food, and also avoid artificial sweeteners and preservatives.
  • Drink an adequate amount of water for the whole day.
  • Eating a well-balanced diet including vitamins, minerals, is required for people suffering from spondylitis.

What are the Risks and complications for spondylitis?

These are the complications which are related to spondylitis:

  • Inflammation of the eyes:

    A person who is suffering from spondylitis mostly suffer from inflammation of iritis (eyes).

  • Fatigue:

    One of the major complications during spondylitis as there are physical discomfort and uncontrolled pain in the joints.

  • Neurological complications:

    Problems start occurring in the nerves which are present at the base of the spine. It creates an impact on the life of the person which include sexual dysfunction, problems in bowel syndrome, weakness of the legs, etc.

  • Complications in the heart:

    If you are suffering from spondylitis then there can be chronic inflammation in the base of your heart specifically found around the aortic valve and at the origin of the aorta.

Is Spondylitis serious?

Spondylitis is a chronic disease that may persist throughout life. It is associated with inflammation in certain body regions such as the buttocks, pelvis, hips, heel, and joints, accompanied by severe pain in the particular region. The disease is progressive and may lead to possible lifelong complications such as eye-related issues, reduced flexibility, tiredness, osteoporosis, GI-related disorders, heart-related risks, and social as well as employment problems.

Is massage good for Spondylitis?

Massage proves to be an effective therapy in the case of Spondylitis as it provides relief from stiffness of muscles and pain. Massage, especially soft tissue massage is the most effective in reducing pain as well as stiffness. It acts as a stress reliever in such conditions and also facilitates better mobility with immediate effects.

What are the exercises for Spondylitis?

Since Spondylitis is a chronic and progressive disorder, incorporating exercises in the daily routine may prove helpful to manage and control this lifelong condition. Exercise-related to this should mainly focus on proper movement of affected muscles including muscles of the back, hip, buttocks, neck, and shoulder. Some of them include stretching of the spine by pressing up, wall sits, planks, leg raise while standing, chin tucks, rolling of shoulders, stretching of hips, walking, and deep breathing exercises.

Summary: Spondylosis is a condition that has a degenerative effect and shows degeneration of the intervertebral disc and also spine which shows the formation of bony spurs. It may be genetic at some level but not completely. Self-care techniques such as massage therapy are effective in such conditions. Food items including fresh fruits and vegetables, whole grains, sources of omega-3 fatty acids like fish oil and walnuts, adequate fluids, diet supplements for vitamin D, and food with low fat and low cholesterol are preferred.

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Written ByDr. E. Logesh MSPT (Master of Physical Therapy),BPTh/BPTPhysiotherapy
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