Spondyloarthritis, also called spondyloarthritis, is a chronic inflammatory rheumatic disease affecting mainly the spine (axial form) and sometimes the peripheral joints (knees, feet).
This pathology is characterized by an attack on the tendons at the level of the entheses (anchoring points of the tendons and ligaments on the bones). In France, it is estimated that approximately 300,000 people are affected. The disease usually begins before the age of 40.
Causes of spondyloarthritis
The causes of the disease are unknown, but spondyloarthritis occurs more in people who have an HLA-B27 antigen. This could be responsible for the persistence of certain germs in the body, which would lead to immune and inflammatory reactions. Several coexisting factors would come into play.
What should alert us
Localized back pain, especially in the middle of the night, in the buttocks, on one or both sides, in the pelvis, in the heel… These persistent pains are not calmed by rest.
Stiffness of the lower back Maximum when waking up, which can last several hours, the stiffness diminishes when resuming an activity. In more severe cases, which have become rare, there is complete ankylosis resulting from the ossification of the ligaments and joints surrounding the vertebrae. This was previously referred to as ankylosing spondylitis.
Complications In addition to the very disabling, almost permanent functional handicap (loss of mobility and limitation of movements), serious extra-articular attacks are possible (rare today): uveitis (inflammation of the eye, red and painful), respiratory insufficiency…
What medications?
Non-steroidal anti-inflammatory and analgesic NSAIDs, paracetamol, weak opioids… The objective is to calm the pain and inflammation and to fight against possible stiffening.
In the event of insufficient efficacy, a slow-acting treatment may be considered for peripheral forms (sulfasalazine, methotrexate).
AntiTNF alpha AntiTNF alpha is a major therapeutic advance in the management of spondyloarthritis refractory to conventional treatments.
By Christine Fallet
Published on 18/03/2016