Spondyloarthritis (SpA) is a group of conditions that affect various joints and multiple systems throughout the body. Common characteristics of the condition include spinal and/or peripheral joint involvement, enthesitis (inflammation of the tendon and ligament insertions onto the bone), dactylitis (sausage like fingers), and association with other disorders such as psoriasis, inflammatory bowel disease, and infection.

Often called seronegative spondyloarthritis, the seronegative refers to no specific markers in the blood that are identified to diagnose the condition. However, people do have the HLA B27 gene that if present is highly characteristic of the disease. 

Types of Spondyloarthritis

There are five major subtypes of spondyloarthritis:

• Ankylosing Spondylitis (AS)
• Psoriatic Arthritis
• Reactive arthritis
• Enteropathic arthritis
• Undifferentiated spondyloarthritis 

Each syndrome does not necessarily represent a distinct syndrome as characteristics and features often overlap.

Spondyloarthropathies can be also classified into two groups:

• Predominately axial (spinal) involvement – Axial SpA
  • Ankylosing Spondylitis
  • Non-radiographic axial SpA (absence of plain radiographic changes)
• Predominately peripheral involvement – Peripheral SpA
  • SpA associated with Psoriatic Arthritis
  • SpA associated with Crohns disease and ulcerative colitis
  • Reactive arthritis

Causes of Spondyloarthritis

The definitive cause of spondyloarthopathies still remains unknown, although a triggering infection, mechanical stress and disruption of the external barrier causes immune and inflammatory mechanisms to respond, which are thought to be involved. It is an autoimmune disease, so the immune system is overactive and effects the body’s healthy tissues and creates increased inflammation.

SpA is a disease process that begins at the entheses and involves an immune system mechanism and pathway that when activated leads to chronic inflammatory disease including SpA. This is followed by characteristic bone loss (erosion) and new bone formation – a clinical manifestation of the disease.

How is a Diagnosis made?

Diagnosis is made by a Rheumatologist. Diagnosis of SpA is a major challenge as it is generally made by careful consideration of several criteria. Reasoning and combining clinical criteria of inflammatory back pain, enthesitis or arthritis with clinical features and history, thorough physical examination, testing and observation, laboratory (blood) testing, and radiological findings provides a diagnosis. 

Early identification is critical along with referral to a rheumatologist if SpA is suspect.

Treatment of Spondyloarthritis

Although there is no cure, and the course of progression of the disease variable, SpA can be managed in many ways. Treating the disease early can be effective in relieving symptoms and possibly preventing progression and further long- term problems. 

Every individual is different, and everyone’s symptoms, severity and progression of the disease is different. Your doctors will work with you to develop and refer you for a treatment plan specific to you. Improving movement patterns, Education, Exercise, Diet, Sleep and relevant lifestyle modification combined with medication is the gold standard.

The aims of treatment are to:

• Reduce pain, stiffness and fatigue
• Limit spine and joint damage as much as possible
• Control other skin or body problems
• Improve mobility of spine and joints, flexibility and strength 
• Improve cardiovascular health
• Improve inflammatory markers
• Improve function and quality of life

The treatment of SpA can broadly be divided into two types of management categories:

• Pharmacological or medication
• Physiotherapy 

Pharmacological or medication management to treat the disease as well as treat the co-existent conditions (such as psoriasis, uveitis) is critical and prescribed, managed, and reviewed by the treating Rheumatologist.

Allied Health play an important role in rheumatic disease and Physiotherapists and Exercise Physiologists play an integral role in ongoing therapy. A tailored treatment plan involving specific exercises, education and advice can assist with treatment aims. 

At Move For Better Health, we pride ourselves on our collaborative approach to treatment to ensure you can be the best you. We have a multidisciplinary approach to management regularly liaising with other health professionals involved in your care.

At our Malvern and Magill locations, we have Physiotherapy, Exercise Physiology, Clinical Psychology (with specialisation in sleep dysfunction), Podiatry and Dietetics. Being able to provide you with the recommendations of gold standard care for spondyloarthritis, please get in touch to discuss your treatment options with one of our friendly staff. You can:

• Call us on (08) 8373 5655
• Use our Online Booking Gateway (available 24/7) to choose your appointment time
• Drop in to see us in person
• Email us on info@moveforbetterhealth.com.au