Understanding Spondyloarthritis: A Common Yet Overlooked Cause of Joint Pain

Spondyloarthritis (SpA) is a group of chronic inflammatory rheumatic diseases that primarily affect the spine and sacroiliac joints but may also involve peripheral joints, tendons, skin, eyes, and the gut. Despite being one of the most common causes of chronic back pain in young adults, it often goes undiagnosed for years.

What is Spondyloarthritis?

SpA is not a single disease but an umbrella term that includes ankylosing spondylitis, psoriatic arthritis, reactive arthritis, arthritis associated with inflammatory bowel disease, and undifferentiated SpA. A hallmark feature is inflammation at the sites where ligaments and tendons attach to bone, known as enthesitis. Patients often present with persistent back pain, stiffness in the morning, or swelling of joints.

Who is at Risk?

SpA usually begins before the age of 40, often in the 20s or 30s. Both men and women can be affected, although certain subtypes are more common in men. Genetics play an important role—many patients carry a gene called HLA-B27.

Symptoms Beyond the Joints

Unlike mechanical back pain, inflammatory back pain improves with movement and worsens with rest. Patients may also experience:

• Eye inflammation (uveitis) causing redness, pain, and blurred vision.
• Skin involvement such as psoriasis.
• Gut symptoms, particularly in those with Crohn’s disease or ulcerative colitis.

Diagnosis and Treatment

Early recognition is critical. Diagnosis relies on a combination of clinical features, blood tests, and imaging such as MRI, which can detect early inflammation.

Treatment has advanced significantly. Alongside exercise and physical therapy, medications such as NSAIDs, biologic therapies (anti-TNF, anti-IL-17 agents), and Jak inhibitors can dramatically reduce pain and stiffness, prevent joint damage, and improve quality of life.

Why Awareness Matters

Too often, SpA patients are treated for “ordinary back pain” and lose precious years before the correct diagnosis is made. Raising awareness among the public and primary care physicians is essential to ensure timely referral to rheumatologists. With early intervention, most patients can lead active, productive lives.

Author: 

Dr. Farzana Shumy 

MD (Rheumatology), MRCP (UK), FCPS (Medicine), FRCP (Edin), 

FACR fellow (America), APLAR Fellow (Japan), EULAR Certified (Rheumatology) 

Consultant- Rheumatology 

Evercare Hospital Dhaka