Spondylitis
What is Spondylitis?
Spondylitis refers to a subset of complex arthritic conditions that affect the vertebrae, pelvis, or accessory structures of the spine. These arthritic disorders can cause inflammation, swelling, or stiffness of the joints and vertebrae. In extreme cases, spondylitis can lead to fusion of the vertebrae or severe kyphosis (a pronounced, abnormal forward arcing of the upper back).
Spondylitis is usually divided into two subgroups: cases in which rheumatoid factor is detected in the bloodstream and instances in which this factor is absent. Rheumatoid factor indicates the presence of the autoimmune disease Rheumatoid Arthritis (RA), in which the body’s immune system attacks the tissues that lubricate our joints. RA is one of the major causes of spondylitis.
The other subgroup of spondylitis occurs without rheumatoid factor and can emerge as a result of a variety of causes. One of the main types within this subgroup is Ankylosing Spondylitis, a condition which appears to be decidedly genetic. Ankylosing Spondylitis is a condition whereby severe inflammation can promote fusion of vertebrae or the sacroiliac joint. This can eventually cause immobility of the spine and kyphosis (or an abnormal forward curvature in the thoracic spine).
Although there is not a single cause of spondylitis, contributing factors to spondylitis may include:
- Osteoarthritis: Also called degenerative joint disease, the tissue between our joints can deteriorate with age or excessive strain, causing bone-on-bone friction. This process may lead to inflammation and pain—or in more extreme instances—spondylitis.
- Genetics: It has been found that 90-95% of people who experience Ankylosing Spondylitis have a genetic marker for this condition.
- Injury: Traumatic injuries to the spine caused by car accidents and falls may accelerate spine degeneration or cause inflammation to intensify; however, injury alone is almost never the sole cause of spondylitis.
- Spinal Infection: Acute or chronic infections of the spine can cause inflammation, which may lead to tissue deterioration of the spine or vertebral fusion.
- Tuberculosis: Extrapulmonary Tuberculosis—a type of tuberculosis that does not affect the lungs—can cause spinal infection and deflation of the intervertebral discs, the rubbery shock absorbers between our vertebrae. This bacterial infection can lead to inflammation of the spine, and in due time, kyphotic changes in spinal curvature.
What are the Symptoms of Spondylitis?
Spondylitis comes in all shapes and sizes, and as such, symptoms will vary from person to person. It may be simpler to think of spondylitis as a side effect of arthritic disorders, some of which appear in the symptoms below. Although individual symptoms will vary significantly, warning signs of spondylitis include:
- Pain: Back pain (or lumbago) is one of the chief symptoms of spondylitis; Lumbago from spondylitis results primarily from tissue damage and the bone-on-bone contact of arthritis.
- Swelling and Stiffness: Two additional, but common, symptoms of spondylitis are swelling and stiffness. These signs of inflammation can affect the back, hips, or sacroiliac joint. Many individuals with arthritis will wake up in the morning with pronounced stiffness, only to loosen up their joints after engaging in mild activity. This is one of the primary reasons why bed rest is often not considered a suitable treatment for spondylitis.
- Inflammation of the Intestines, Bladder, or Bowels: Spondylitis can also occur as a result of Enteropathic Arthritis. Symptoms that can co-occur with this type of arthritis may include diarrhea, abdominal pain, weight loss, and/or blood in stool.
- Psoriasis: Spondylitis is also associated with Psoriatic Arthritis, in which swelling can occur in the hands, feet, joints, or spine. This form of spondylitis is often accompanied by a skin rash (aka psoriasis).
- Eye Problems: Spondylitis can also affect the eyes in a condition known as uveitis. Eyes can become irritated or swollen; and, you might experience related symptoms of blurred vision or sensitivity to sunlight.
- Kyphosis: Kyphosis is a condition in which the thoracic spine is abnormally rounded forward, leading to a hunched-over appearance. This occurs as spinal vertebrae degenerate along with arthritic changes in the spine.
Are you experiencing any of the troubling symptoms above? Dr. Frazier—hailed twice by the New York Times Magazine as a “Super Doctor”—has nearly 20 years of experience in resolving spondylitis and other forms of arthritic pain!
What are the Treatments for Spondylitis?
At this time, there is no cure for spondylitis. However, there are many treatment options that can provide relief from the painful symptoms of spondylitis. After consulting with your physician, your doctor may recommend a combination of the following treatments: hot/cold therapy, physical therapy, targeted exercises or stretches, acupuncture, massage, lifestyle changes such as weight loss or smoking cessation, or in certain situations, back bracing.
Depending upon the specific cause of your spondylitis and the severity of your pain, a physician may also prescribe medications and/or injections such as: NSAIDs like Ibuprofen, corticosteroids, Methotrexate for those with Rheumatoid Arthritis, or other medications.
Unfortunately, surgery may be required for some individuals who are facing extreme cases of spondylitis. For those experiencing spinal instability, neurological symptoms such as tingling, immobility weakness, or severe kyphosis, surgery may be necessary to alleviate symptoms and provide relief.
For those individuals who do require surgical treatment, our Harvard-trained surgeon, Dr. Frazier, may recommend one of the following techniques:
- Foraminotomy: A minimally invasive procedure in which your surgeon will access your spine through a small 1 to 3-inch incision in the back or neck. Your surgeon will remove a part of the foramina (vertebral passageways for nerves), widening each opening to relieve pain-generating pressure on nerves.
- Orthopedic Surgery: Sometimes, minimally invasive surgery is not a possible route for spondylitis. If that is true, then NYC Spine is ready to help you navigate the recovery process. Orthopedic Surgery can involve any procedure that involves restructuring of the spine. This could include removing parts of vertebrae, inserting spinal instrumentation, or promoting spinal fusion (See our ALIF, TLIF, & XLIF procedures).
If you think you may have symptoms of spondylitis, or any other troubling spinal symptoms, Dr. Frazier is ready to help you find relief. With over 20 years of experience in the field, Dr. Frazier will work with you one-on-one to design a treatment plan that effectively addresses your pain.
Meet Dr. Daveed Frazier
Dr. Frazier is a Harvard-trained, board certified orthopedic spine surgeon. He’s held an academic appointment at Columbia University College of Physicians and Surgeons and New York’s SUNY Downstate. Dr. Frazier is also a respected lecturer, accomplished researcher, published author on spine disorders and treatment, and a consultant for several international spine companies.
After completing his undergraduate education at Brown University, Dr. Frazier attended Harvard Medical School, where he graduated cum laude. He completed a Harvard internship based at the New England Deaconess Hospital in Boston, MA, followed by a Harvard combined residency before becoming chief resident at Massachusetts General Hospital.