Psoriatic spondylitis is the medical term for a type of psoriatic arthritis that affects the spine and joints in the pelvis. Symptoms can develop anywhere between the pelvis and the neck.
People with psoriatic spondylitis may experience pain, swelling, and stiffness in the neck and lower back. It can also affect the sacroiliac joints in the pelvis. Over time, the condition can make it more difficult for a person to move the spine.
What is psoriatic spondylitis?
Psoriatic spondylitis is a form of psoriatic arthritis. Psoriatic arthritis refers to a group of inflammatory joint problems related to psoriasis. However, not everyone with psoriatic arthritis has psoriasis. Psoriatic spondylitis occurs when the body’s immune system attacks its own tissue, leading to inflammation and often painful symptoms.
How common is it?
Psoriasis is one of the most common autoimmune diseases, affecting millions of people around the world, according to the National Psoriasis Foundation (FNP). The FNP also estimates that between 10 and 30 percent of people with psoriasis will develop psoriatic arthritis, although different sources give different estimates. About 20 percent of people with psoriatic arthritis develop psoriatic spondylitis, according to the Spondylitis Association.
Psoriatic spondylitis causes symptoms that are similar to other forms of arthritis that affect the spine and sacroiliac joints in the pelvis, such as ankylosing spondylitis and reactive arthritis.
Symptoms of psoriatic spondylitis include:
- Back pain.
- Stiffness in the back or neck that improves when moving.
- The stiffness worsens with periods of stillness, such as sleep.
- Trouble bending or moving your back
These symptoms can cause extreme pain and some people experience difficulties in their daily life. If left untreated, inflammation can cause long-term damage to the spine and joints.
Medical treatments aim to keep inflammation under control and prevent long-term joint damage and problems. Medication can also reduce a person’s risk of heart disease that can occur due to inflammation.
Symptoms of psoriatic spondylitis can come and go. When symptoms get worse, this is known as a flare. The location of pain and swelling can also change over time.
Doctors are still not sure why some people develop psoriatic disease, but others do not. Certain infections, such as strep throat, can trigger the overactive immune response that psoriatic spondylitis causes. However, psoriatic spondylitis is not contagious. The condition tends to run in families. One of the most important risk factors for psoriatic spondylitis is the HLA-B27 gene. This gene also has links to several different autoimmune diseases.
Blood tests can detect if a person carries the HLA-B27 gene. However, a positive result for the HLA-B27 gene does not mean that a person gets psoriatic spondylitis. Other genes can cause psoriatic spondylitis.
Psoriatic spondylitis usually develops in people who already have psoriasis, but this is not always the case. Age is also a risk factor. Psoriatic arthritis usually appears in people in their 30s to 50s.
Psoriatic spondylitis can cause long-term damage to the bones and joints of the spine, neck, and pelvis. It can also cause complications such as:
- Hearing loss.
- Some types of cancer, including lymphoma and non-melanoma skin cancer.
- Heart disease.
- Metabolic syndrome.
- Crohn’s disease.
- Liver disease
- Inflammation of the eyes, known as uveitis.