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10 Types of Spondylitis

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ByAgkidzone Staff
Updated: Oct 25, 2024

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Spondylitis, or inflammation of the vertebrae, is a complex autoimmune and musculoskeletal disease. Over the years, how the medical community talks about and classifies spondylitis has evolved, particularly since new guidelines were introduced in the late 2000s. Diagnosing and treating this condition typically falls under the expertise of a rheumatologist. While spondylitis is known to cause inflammation, it manifests in different forms. Let’s dive into the common types and treatments associated with this condition.

Ankylosing Spondylitis
Ankylosing spondylitis is one of the more common and chronic forms of the disease. It primarily causes inflammation in the spine, chest, and pelvis, leading to symptoms such as back pain and stiffness. Over time, this inflammation can cause the vertebrae to fuse, which limits mobility. Many people with ankylosing spondylitis also experience inflammatory bowel disease, while some develop acute anterior uveitis—a swelling of the eye. This condition increases the risk of spinal cord injury and vertebral fractures due to the weakening of the bones.
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Psoriatic Spondylitis
Psoriatic spondylitis is tied to psoriatic arthritis, a type of arthritis that affects people with psoriasis, an autoimmune skin condition. While psoriatic arthritis often causes joint pain in the fingers, wrists, and knees, about 20% of people with this condition develop spinal involvement, leading to spondylitis. The exact cause is still being researched, but genetic and environmental factors play significant roles in its development.
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Enteropathic Arthritis
This type of spondylitis is closely linked with inflammatory bowel disease (IBD), making it a common extra-intestinal manifestation of conditions like Crohn’s disease and ulcerative colitis. Enteropathic arthritis affects between 17% and 39% of those with IBD. Though the mechanisms behind it aren't fully understood, it’s believed that genetic predispositions combined with gut infections trigger inflammation in the joints.
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Reactive Arthritis
Reactive arthritis, often triggered by bacterial or viral infections in other parts of the body—like the intestines, urinary tract, or genitals—can lead to spondylitis. Though less common, reactive arthritis causes inflammation in multiple joints, including the spine. Most cases resolve within 12 months, but the pain, often concentrated in the lower back, can be especially bad in the mornings or at night.
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Undifferentiated Spondyloarthritis
When a person has symptoms of spondylitis but doesn’t meet the criteria for a specific type, they might be diagnosed with undifferentiated spondyloarthritis. The main symptom is persistent pain, which can be mistaken for other conditions like fibromyalgia. Some doctors view this condition as a precursor to other forms of arthritis, such as psoriatic or reactive arthritis, but it is often treated similarly.
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Juvenile Spondyloarthritis
This type of spondylitis affects individuals younger than 16 years old. Though rare, about one in every six or seven cases of spondylitis starts during the teenage years. Juvenile spondyloarthritis can be particularly severe, but treatment options are continuously improving. Early intervention is key to managing symptoms and helping young patients live healthy, active lives.
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Peripheral Spondyloarthritis
Peripheral spondyloarthritis primarily causes inflammation in the joints outside of the spine, such as the knees, ankles, or shoulders. However, many people diagnosed with this condition eventually develop spinal symptoms, which has led to it being classified as part of the broader spondylitis spectrum. Recognizing peripheral spondyloarthritis early can ensure proper treatment and management.
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Axial Spondyloarthritis
Axial spondyloarthritis is a general term for spondylitis that affects the axial spine, including the spine, chest, and pelvis. This form encompasses several other types, such as ankylosing spondylitis, psoriatic arthritis, and enteropathic arthritis. It serves as an umbrella term for individuals experiencing spinal inflammation.
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Diagnosis and Treatment
Diagnosing spondylitis typically involves a combination of physical exams, medical history assessments, and imaging tests. Rheumatologists may order X-rays or MRI scans to get a clearer view of the spine and joints, along with blood tests to rule out other conditions. Once diagnosed, treatment plans may include a combination of medications, physical therapy, and lifestyle adjustments. For conditions like psoriatic arthritis, treatment may also focus on managing skin symptoms, while reactive arthritis often involves addressing the underlying infection causing the inflammation.
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The First Established Guidelines
In 2015, the American College of Rheumatology released the first set of treatment guidelines for spondylitis. These guidelines outline when to use nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids, as well as when to opt for physical therapy or even hip replacements in advanced cases. Early treatment with TNF inhibitors or other biologics has proven effective in managing symptoms and preventing long-term damage.
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This site offers information designed for educational purposes only. You should not rely on any information on this site as a substitute for professional medical advice, diagnosis, treatment, or as a substitute for, professional counseling care, advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional.

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