Inflammatory spondyloarthropathy

Inflammatory spondyloarthropathy is a group of rheumatic diseases that affect the joints, ligaments and tendons in your spine, causing inflammation, pain and swelling in the joints and muscles. 


The different types of inflammatory spondyloarthropathy include:

  • Ankylosing spondylitis – this long-term disease causes inflammation of the joints between the spine and pelvis as well as the joints between the spinal bones. Over time, ankylosing spondylitis causes the spinal bones to fuse together.
  • Undifferentiated spondyloarthritis – this medical term describes a condition that causes symptoms of spondyloarthritis but does not meet the criteria for a spondyloarthritis diagnosis. Inflammation of the joints is absent or is too mild to be seen on X-rays. This disease is related to the rest of the conditions on this list.
  • Reactive arthritis – inflammatory disorder that affects the joints, urethra and eyes
  • Psoriatic arthritis – a type of arthritis that occurs with psoriasis
  • Enteropathic arthritis – associated with inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease. Enteropathic arthritis typically affects the peripheral joints in the lower extremities and closely follows bowel conditions.


Causes of inflammatory spondyloarthropathy vary with each individual condition in the group:

  • Ankylosing spondylitis
    • The cause of this disease is unknown but appears to be genetic. Ankylosing spondylitis typically begins between the ages of 20 and 40 and affects more men than women.
  • Undifferentiated spondyloarthritis
    • The cause is unknown yet appears to be genetic. It may be caused by a virus or bacteria and is triggered by intestinal inflammation.
  • Reactive arthritis
    • This arthritis has no definite, known cause, most commonly occurs in males over the age of 40 and possibly follows infections such as chlamydia, salmonella, campylobacter or Yersinia. Certain genes are believed to make you more prone to reactive arthritis.
  • Psoriatic arthritis
    • This arthritis is associated with the chronic skin disorder known as psoriasis. Approximately one in 20 people with psoriasis will develop psoriatic arthritis. The cause is unknown, yet genes are thought to play a role. People afflicted by psoriasis are more at risk for arthritis than the general population.
  • Enteropathic arthritis
    • It is not completely understood why there is a link between bowel disease and enteropathic arthritis. One theory covers the gastrointestinal tract and its ability to keep out foreign invaders such as bacteria and viruses. When the tract is attacked by bowel disease, the protective lining of the intestines is compromised, allowing bacteria to enter the bloodstream. These bacteria wreak havoc in the body and attack the joints. As the body attempts to attack the bacteria, joint swelling and inflammation occur. This possibly can lead to enteropathic arthritis.


This group of rheumatic conditions has a vast range of symptoms. Broken down by individual disease, the symptoms include:

  • Ankylosing spondylitis
    • Low back pain – this is the first symptom of the disease and is sporadic, because it comes and goes randomly. The pain may begin in your joints between the pelvis and spine. As the disease progresses, the pain eventually  may affect your entire spine.
    • Pain and stiffness – these symptoms are worse at night, in the morning and whenever the patient is not active. The pain sometimes gets better with exercise or activity, but can sometimes be so severe that it wakes you from sleep.
    • Loss of mobility – it is possible to lose mobility or motion in the lower spine or rib cage due to ankylosing spondylitis. When it affects your rib cage, it will affect your breathing because you're unable to fully expand your chest.
    • Less common symptoms of ankylosing spondylitis include:
      • Uveitis – swelling and irritation of  the middle layer of the eye
      • Heel pain – affects the joints in the foot
      • Hip pain – commonly occurs along with low back pain
      • Joint pain – and joint swelling in the ankles, knees and shoulders
      • Loss of appetite and weight loss – common with symptoms that affect your breathing and ability to sleep
      • Fatigue
      • Slight fever
  • Undifferentiated spondyloarthritis
    • Inflammatory back pain – swelling and irritation in the back due to inflamed spinal joints
    • Buttocks pain – alternating or one-sided pain in the buttocks
    • Enthesitis– inflammation where the tendon or ligament attaches to a bone
    • Arthritis – swollen, stiff and painful joints in the legs and possibly the arms
    • Swelling – in the fingers or toes
    • Heel pain
    • Fatigue
    • Uveitis
  • Reactive arthritis
    • Achilles tendon pain – when arthritis attacks the heel tendon
    • Joint pain – in the large joints, typically in the knees, hips and ankles
    • Eye symptoms – eye discharge, burning pain and redness
    • Skin lesions – on the palms and soles which resemble psoriasis
    • Ulcers – small and painless crater-like lesions in the mouth or on the tongue
    • Genital lesions – on the male or female organ
    • Incontinence – inability to control one’s bowels
    • Penis pain – resulting from lesions and other symptoms that affect this organ
    • Skin symptoms – redness or inflammation of the skin
    • Urethral discharge – abnormal loss of fluid from the urethra at the tip of the penis
    • Urination problems – urinary urgency, hesitancy and burning or stinging
    • Heel pain
    • Low back pain
  • Psoriatic arthritis
    • Inflammation – in the joints of the knees, ankles, feet and hands. Usually only a few joints are inflamed at once. The joints are swollen, hot and red and become very painful.
    • Joint stiffness – very common symptom of psoriatic arthritis and typically worse first thing in the morning
    • Spine inflammation – pain and stiffness in the lower back, buttocks, upper back and neck
    • Tendonitis – inflammation of the tendons and cartilage. Trouble walking and chest pain are side effects of tendonitis in the Achilles tendon and chest wall.
    • Inflammation of organs – the lungs and eyes, for example
  • Enteropathic arthritis
    • Back pain and stiffness
    • Swollen joints


Treatments for inflammatory spondyloarthropathy can range from nonsurgical treatments such as physical therapy and anti-inflammatory medicine to hip replacement surgery or other surgical procedures that target the affected joints.

The multidisciplinary team of spine experts at Northwell Health Orthopaedic Institute treats inflammatory spondyloarthropathy as well as a broad range of spine conditions that can occur at any stage of life.

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