Spondyloarthritis
Ankylosing spondylitis, psoriatic arthritis, and related spondyloarthropathies — specialist diagnosis and treatment.
Book a consultation →Spondyloarthritis (SpA) is a group of inflammatory diseases that primarily affect the spine and sacroiliac joints, but can also involve peripheral joints, eyes (uveitis), skin (psoriasis) and bowel. Ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are the main forms. The disease often begins in young adults (20–40 years) and can lead to severe movement restriction if untreated.
- Chronic inflammatory lower back pain (characteristically worse at rest)
- Morning stiffness in the back > 30 minutes
- Asymmetric pain and swelling of peripheral joints
- Enthesitis (pain where tendons/ligaments attach to bone)
- Uveitis (eye inflammation — redness, pain, light sensitivity)
- Skin or nail psoriasis (in psoriatic arthritis)
- Inflammatory bowel disease (Crohn's, ulcerative colitis)
The goal of treatment is to control inflammation, prevent structural damage and maintain function and quality of life.
- ✓NSAIDs as first-line therapy (ibuprofen, naproxen, indomethacin)
- ✓Anti-TNF inhibitors (Adalimumab, Etanercept, Certolizumab)
- ✓IL-17 inhibitors (Secukinumab, Ixekizumab) — especially for PsA
- ✓JAK inhibitors (Tofacitinib, Upadacitinib)
- ✓Intensive physiotherapy and regular exercise
- ✓Local treatments (corticosteroid injections for enthesitis)
How long can it take before a diagnosis is made?
Unfortunately, the average diagnostic delay is 7–10 years from symptom onset. Many patients are incorrectly treated for mechanical back pain. Early presentation to a rheumatologist is essential.
Will I end up in a wheelchair?
With modern treatment, ankylosis (complete spinal stiffening) is much rarer. Most patients maintain good spinal function if they start treatment early.
Is there a connection with HLA-B27?
Yes. About 85–90% of patients with ankylosing spondylitis are positive for HLA-B27. However, most people with HLA-B27 do not develop the disease — the gene is just a risk factor.
Can I exercise with spondyloarthritis?
Absolutely — and it is essential! Physiotherapy and regular exercise (swimming, yoga, stretching) are a core part of treatment. Active patients have much better outcomes.
Does spondyloarthritis affect women?
Yes, it is increasingly recognised that AS affects men and women almost equally. In women the symptoms may be less typical, which often leads to diagnostic delays.
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