Spondyloarthropathy is a family of inflammatory arthritis conditions that primarily affect the spine and joints, causing chronic pain, stiffness, and — if left untreated — progressive damage to the musculoskeletal system. If you have been told you may have ankylosing spondylitis, psoriatic arthritis, or another form of spondyloarthropathy, or if you are experiencing persistent back pain and stiffness that has gone unexplained, Dr. Adam Elisha, DO — a board-certified rheumatologist in Duluth, MN — specializes in diagnosing and managing spondyloarthropathy and other inflammatory joint conditions at St. Luke’s Rheumatology Associates.
What Is Spondyloarthropathy?
Spondyloarthropathy (also called spondyloarthritis, or SpA) is a group of related autoimmune and inflammatory diseases that share common features: inflammation of the spine and sacroiliac joints, a tendency to run in families, and an association with a genetic marker called HLA-B27. Unlike rheumatoid arthritis, which mainly affects the small joints of the hands and feet symmetrically, spondyloarthropathies often target the lower back, pelvis, and large joints of the legs — and can also cause inflammation in the eyes, skin, and bowel.
These conditions are chronic, meaning they require long-term management. With early diagnosis and the right treatment plan, most people with spondyloarthropathy are able to control symptoms, reduce inflammation, and protect their joints from long-term damage.
Types of Spondyloarthropathy
Spondyloarthropathy is an umbrella term that includes several distinct — but related — conditions. The most common types are described below.
Ankylosing Spondylitis (AS)
Ankylosing spondylitis is the most well-known form of spondyloarthropathy. It primarily causes inflammation of the spine and the sacroiliac joints — the joints where the spine meets the pelvis. Over time, this chronic inflammation can cause the vertebrae in the spine to fuse together, a process called ankylosis, which leads to reduced flexibility and a characteristic forward-stooped posture.
AS most commonly begins in young adults between the ages of 17 and 45, and it affects men more frequently than women, though women are increasingly recognized as being underdiagnosed. Common symptoms include:
- Chronic low back and hip pain and stiffness, especially in the morning or after long periods of rest
- Pain that improves with movement and exercise
- Fatigue
- Reduced range of motion in the spine and hips
- Inflammation of the eye (uveitis), causing pain, redness, and light sensitivity
The HLA-B27 gene is present in the majority of people with AS, though not everyone who carries this gene will develop the disease.
Psoriatic Arthritis (PsA)
Psoriatic arthritis is a form of inflammatory arthritis that develops in some people who have psoriasis — a skin condition that causes red, scaly patches. In about 30% of people with psoriasis, the immune system also attacks the joints, leading to psoriatic arthritis. In some cases, joint symptoms appear before any skin involvement is noticed.
PsA can affect joints throughout the body, including the fingers, toes, spine, and larger joints. Common symptoms include:
- Swollen, painful joints — often asymmetrical (affecting one side more than the other)
- Dactylitis — swelling of an entire finger or toe, sometimes called “sausage digits”
- Enthesitis — pain and inflammation where tendons and ligaments attach to bone, such as the heel or the bottom of the foot
- Nail changes, such as pitting, thickening, or separation from the nail bed
- Lower back and sacroiliac joint pain (when the spine is involved)
Reactive Arthritis
Reactive arthritis is joint inflammation that develops as a reaction to an infection elsewhere in the body — most commonly a gastrointestinal or sexually transmitted bacterial infection. It typically causes swelling and pain in the knees, ankles, and feet, and may also involve the eyes and urinary tract.
Enteropathic Arthritis (IBD-Associated)
Enteropathic arthritis is a form of spondyloarthropathy that occurs in people with inflammatory bowel disease (IBD) — particularly Crohn’s disease and ulcerative colitis. Up to 20% of people with IBD develop some form of joint inflammation.
Undifferentiated Spondyloarthropathy
Undifferentiated spondyloarthropathy is diagnosed when a patient has clear signs and symptoms of a spondyloarthropathy but does not fully meet the criteria for one of the specific subtypes. This is a common and recognized diagnosis.
Common Symptoms of Spondyloarthropathy
- Inflammatory back pain — chronic low back or buttock pain that starts gradually, is worse in the morning, and improves with activity (not rest)
- Stiffness lasting more than 30 minutes after waking up
- Swollen joints, particularly in the knees, ankles, or feet
- Heel pain or pain at other tendon insertion points
- Recurring eye redness or pain (uveitis)
- Skin rashes consistent with psoriasis
- Fatigue that is out of proportion to physical activity
How Is Spondyloarthropathy Diagnosed?
- Medical history and physical examination — including assessment of spinal mobility, joint tenderness, and a review of symptoms
- Blood tests — including HLA-B27 genetic testing, inflammatory markers such as CRP and ESR, and tests to rule out other conditions
- Imaging — X-rays of the sacroiliac joints and spine; MRI is often needed to detect early inflammation before structural changes appear on X-ray
Treatment Options
- NSAIDs — such as naproxen or ibuprofen, often a first-line treatment for pain and stiffness
- Physical therapy and exercise — essential, particularly in AS, to maintain posture and spinal flexibility
- Biologic medications — including TNF inhibitors (adalimumab, etanercept) and IL-17 inhibitors (secukinumab, ixekizumab)
- JAK inhibitors — oral medications approved for AS and PsA
- DMARDs — such as methotrexate or sulfasalazine, used particularly in psoriatic arthritis
- Corticosteroid injections — for localized joint or tendon inflammation
Spondyloarthropathy Care in Duluth, MN
If you are searching for a spondyloarthropathy specialist in Duluth or the surrounding area, Dr. Adam Elisha at St. Luke’s Rheumatology Associates provides comprehensive evaluation and ongoing management for ankylosing spondylitis, psoriatic arthritis, and all forms of spondyloarthropathy. Call (218) 249-6960 to schedule an appointment, or ask your primary care provider for a referral to rheumatology.
St. Luke’s Rheumatology Associates is located at 1000 E 1st St, Suite 302, Duluth, MN 55805.