Spondylitis is a type of arthritis that primarily affects the spine. It causes inflammation of the vertebrae, which can lead to severe pain and discomfort. In advanced cases, it can lead to erosion of the joint between the spine and the hip or development of new bone followed by fused vertebrae. The disease is most common among young people (ages 17 to 35), tends to be hereditary, and affects men two to three times more than women.
Physicians at our Center for Arthritis and Joint Diseases collaborate with Brigham and Women’s Hospital (BWH) specialists in orthopaedics, bone and joint radiology, occupational and physical therapy, pain management, physiatry, and other services to evaluate and treat spondylitis.
Spondylitis symptoms tend to originate in the lower back and buttocks and develop gradually over a period of weeks or months. It is not uncommon for these symptoms to disappear and reappear at irregular intervals.
Typical signs of spondylitis include:
Lower back pain and stiffness, particularly after long periods of rest
Radiating, rather than localized, back pain
Pain often starts on one side and spreads to other
Fever and loss of appetite during early stages
Painful breathing and limited breathing capacity – caused by curvature of the spine, inflammation and scarring of the lungs, or if joints between the ribs and spine are affected.
Additional symptoms may include:
Pain spreads to other joints
Mild eye inflammation
Organ damage – heart, lungs, and eyes
Stooped posture – in response to back pain
Stiff and straight spine
Following a complete medical history and a thorough physical examination, your physician may also order one or more of the following diagnostic tests to evaluate your condition:
X-ray – to detect bony abnormalities along the spine.
Erythrocyte sedimentation rate (ESR) – analyzes blood to evaluate inflammation.
Genetic testing – to determine whether a patient carries a copy of a specific gene (HLA-B27) that is present in over 95 percent of people with spondylitis.
Treatment for spondylitis is focused on reducing pain and stiffness and preventing deformities. Treatments may include:
Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling.
Short-term use of corticosteroids to relieve pain and swelling.
Tumor-necrosis-factor (TNF) blockers to reduce pain, stiffness, and swelling.
Disease-modifying anti-rheumatic drugs (DMARDs) to decrease inflammation and slow progress of spondylitis.
Short-term use of pain relievers and muscle relaxants to relieve severe pain and reduce muscle spasms.
Surgery – to replace a joint, to place rods in the spine, or to remove parts of thickened and hardened bone.
Physical therapy and exercise to strengthen back muscles, maintain flexibility, and promote an ideal posture.