Spondylitis is a general term that means inflammation of the spine. The most common form of spondylitis other than Ankylosing Spondylitis is Psoriatic Spondylitis.

Psoriatic Spondylitis is an arthritic condition of the spine. It will often begin with psoriasis and progresses to psoriatic arthritis. Psoriasis is a rash that generally appears in small round patches primarily on the scalp, knees and elbows but can at times covers the entire body.

5-10% of patients with psoriasis also have arthritis. In most cases the psoriasis precedes the arthritis, often by several years. When arthritis symptoms occur with psoriasis, it is known as psoriatic arthritis (PsA).

About 20% psoriasis patients who develop PsA will eventually have related spinal problems such as chronic back pain. This condition is known as Psoriatic Spondylitis. The inflammation in the spine, if left untreated can lead to complete fusion of the spine – similar to Ankylosing Spondylitis. Patients with spinal involvement often test positive for the HLA-B27 genetic marker. This is a part of human DNA that is believed to play a role in the onset of arthritis.

Psoriatic Spondylitis Treatment
While there is presently no known cure for Psoriatic Spondylitis, there are treatments and medicines available to reduce symptoms and manage the pain and inflammation associated with the disease.

Medications
A variety of medications can be used to help manage the symptoms of PsA:

• NSAIDs (non-steroidal anti-inflammatory drugs) to reduce the inflammation, joint pain and stiffness.
  • IBUPROFEN (Generic NSAID)
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    ARTHROTEC (Diclofenac and Misoprostol)
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  • NAPROSYN, ALEVE and Others (Naproxen)
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  • MOBIC (Meloxicam)
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  • INDOCIN (Indomethacin)
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  • VOLTAREN (Diclofenac)
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  • CELEBREX (Celecoxib)
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• DMARDs (disease-modifying anti-rheumatic drugs) are sometimes prescribed in more severe cases. These include sulfasalazine and methotrexate.
• TNF-a inhibitors, a more recent class of biologic medication, is occasionally prescribed to those with advanced Psoriatic Spondylitis. These are sometimes referred to as injectables because they are taken by daily injection. They include:
  • ENBREL (Etanercept)
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  • HUMIRA (Adalimumab)
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  • REMICADE (Infliximab)
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  • SIMPONI (Golimumab)
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TNFa Inhibitors are very expensive medications. There are organizations that provide financial assistance to those who need these drugs but cannot afford them. For information about these organizations (bottom of the page) and more information about Psoriatic Spondylitis drugs visit the Spondylitis Association of America website at: http://www.spondylitis.org/about/medications.aspx

Physical Therapy Treatment
Physical therapy for Psoriatic Spondylitis generally includes heat for stiffness, ice and elecro-therapy for pain and swelling, stretching and therapeutic exercise to increase core strength and spinal stability.

Exercise is essential to the management of Psoriatic Spondylitis. Exercise helps keep the muscles around joints strong. Disuse of an affected joint will cause the muscles to become weak resulting in more pain.

Related arthritic disorders of the spine (spondyloarthropathies) :

Sacroiliitis
Sacroiliitis (sa-kro-il-ee-EYE-tis) is an inflammatory reaction of the sacroiliac joints. These joints connect the lower spine to the pelvis. Sacroiliitis can cause pain in the buttocks or lower back, and may even extend down one or both legs. Extended standing or climbing stairs often exacerbates the pain caused by sacroiliitis.

Sacroiliitis can be challenging to diagnose, because it may be mistaken for other causes of low back pain. Treatment of sacroiliitis may involve a combination of rest, physical therapy and anti-inflammatory medications. Treatment is similar to the treatments for Psoriatic Spondylitis.