Spondylitis Association of America
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Spondylitis: Frequently Asked Questions

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What is spondylitis?
Spondylitis (pronounced spon-d-lie-tiss) is the name given to a group of chronic or long lasting diseases also called Spondyloarthritis (spon-dyl-oh-arthritis) or Spondyloarthropathy (spon-d-low-are-throp-ah-thee). These diseases are forms of inflammatory arthritis that primarily affect the spine, although other joints and organs can become involved. The group of diseases in the spondylitis family includes:

  • Ankylosing Spondylitis (AS) - Ankylosing spondylitis is the primary disease in the spondylitis family of diseases and is a form of chronic arthritis that primarily affects the spine, although other joints can become involved. Occurring primarily in young adults, (age of onset normally before age 35), AS causes inflammation of the spinal joints (vertebrae) that can lead to severe, chronic pain and discomfort.

  • Undifferentiated Spondyloarthropathy (USpA) - Undifferentiated Spondyloarthropathy (USpA) is a term used to describe symptoms and signs of spondylitis in someone who does not meet the criteria for a definitive diagnosis of AS or related disease. Over time, some people with USpA will develop a well-defined form of spondylitis such as ankylosing spondylitis.

  • Juvenile Spondyloarthropathy (JSpA) - Juvenile-onset spondyloarthritis (JSpA), also known as Juvenile Spondyloarthropathy, is the medical term for a group of childhood rheumatic diseases, which cause arthritis before the age of 16 and may span through adult life. JSpA typically causes pain and inflammation in the joints in the lower part of the body, for example, the pelvis, hips, knees and ankles.

  • Psoriatic Arthritis (PsA) - In 5-10% of those with psoriasis, arthritis also appears. In most cases, the psoriasis will precede the arthritis, sometimes by many years. When arthritis symptoms occur with psoriasis, it is called psoriatic arthritis (PsA).

  • Reactive Arthritis (ReA) - Reactive Arthritis (also known as Reiter's Syndrome) is a form of arthritis that can cause inflammation and pain in the joints, the skin, the eyes, the bladder, the genitals and the mucus membranes. Reactive arthritis is thought to occur as a "reaction" to an infection that started elsewhere in the body, generally in the genitourinary or gastrointestinal tract.

  • Enteropathic Arthritis - Enteropathic (en-ter-o-path-ic) arthritis is a form of chronic, inflammatory arthritis associated with the occurrence of an inflammatory bowel disease (IBD), the two best-known types of which are ulcerative colitis and Crohn's disease. The most common areas affected by enteropathic arthritis are inflammation of the peripheral (limb) joints, as well as the abdominal pain and possibly bloody diarrhea associated with the IBD component of the disease.

Note that the rest of this FAQ is geared toward ankylosing spondylitis (AS), the primary disease in this group of diseases. For more information on each specific disease, click on the links above.

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What kind of doctor treats ankylosing spondylitis?
The type of physician who primarily diagnoses and treats ankylosing spondylitis and related diseases is called a rheumatologist. Rheumatologists treat arthritis, certain autoimmune diseases, musculoskeletal pain disorders and osteoporosis. There are more than 100 types of these diseases, including ankylosing spondylitis (AS), rheumatoid arthritis, and lupus. Other professionals can also help treat AS and related diseases such as physical therapists, occupational therapists, etc.
Click here for more information.

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The FAQ Continues Below

What is the cause of ankylosing spondylitis?
Although the exact cause of AS is unknown, we do know that genetics play a key role. Most individuals who have AS also have a gene that produces a "genetic marker" - in this case, a protein - called HLA-B27. This marker is found in over 95% of people of European ancestry with AS. However, scientists know that other genes, along with a triggering environmental factor, such as a bacterial infection, are needed to trigger AS in susceptible people.

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What is the HLA-B27 gene?
HLA-B27 is a perfectly normal gene found in 8% of the general population. Generally speaking, no more than 2% of people born with this gene will eventually get spondylitis. The gene itself does not cause spondylitis, but people with HLA-B27 are more susceptible to getting spondylitis.

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If a parent, brother or sister has spondylitis, and I test positive for HLA-B27, what are my chances of getting the disease?
If a family member had spondylitis and you test positive for the HLA-B27 gene, your chance of getting the disease increases to 20%, if you are under age 40. If you are over 40, your chance of developing spondylitis is very low. If you have AS, the likelihood of passing it on to your children is relatively low. There is approximately a 50% chance that the child of one HLA-B27+ parent will inherit the gene, but only a small percentage of those will develop AS.

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How is ankylosing spondylitis diagnosed?
A thorough physical exam including x-rays, individual medical history, and a family history of AS, as well as blood work including a possible test for HLA-B27 are factors in making a diagnosis.
Click here for more information in our AS Diagnosis section.

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Is there a cure?
Currently, there is no known cure for ankylosing spondylitis, but there are treatments and medications available to reduce symptoms and manage the pain. Recent studies show that the new biologic medications can potentially slow or halt the disease progression in some people.
Click here for more information in our AS Treatment section.

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How is ankylosing spondylitis treated?
Exercise is essential. A common treatment regimen involves medication, exercise and physical therapy, and good posture practices.
Click here for more information in our AS Treatment section.

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What kind of exercise is best?
Before beginning any new exercise program, consult your physician or physical therapist. They can help provide modifications to suit your particular needs. Ask which exercises you should do and then check to see that you are doing them correctly. Water therapy, tai chi, and even walking are common forms of low impact exercises that many find helpful.
Click here for more information on exercise or click here to view our exercise videos.

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Why is good posture important?
Bone fusion does not occur in everyone with spondylitis, yet fusing in a non-upright position is a valid patient concern. It is encouraging to know that we can influence the pattern of fusion through good postural habits.
Click here for more information in our posture section.

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Will I become disabled?
The severity of AS varies greatly from person to person, and not everyone will experience the most serious complications or have spinal fusion. Some will experience only intermittent back pain and discomfort, but others will experience severe pain and stiffness over multiple areas of the body for long periods of time. According to Dr. Elaine Adams, "Our goal in 2005 is not to allow the postural changes of severe AS to happen anymore."

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Where can I learn more?
Here at SAA and on this website, Spondylitis.org, we have a wealth of information available on ankylosing spondylitis and related diseases. Please see the links below for more information:

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