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Thoracic spondyloarthropathies

Spondyloarthropathies (called spondyloarthritis) is a name given to a group of inflammatory conditions that affect the spinal joints. As such, it is a category of disease rather than a single, specific disorder. It differs from spondylopathy, which is a disease of the spinal bones themselves. However, many conditions involve both spondylopathy and spondyloarthropathy. These conditions include ankylosing spondylitis, Reactive syndrome (reactive arthritis), psoriatic arthritis and enteropathic arthritis (caused by inflammatory bowel disease). These conditions do not just affect the bones; they seem to cause irritation where ligaments and tendon attach to bones (enthesis). Thoracic spondyloarthropathies are less common than in the neck, low back and extremity joints (e.g. hands, feet, knee etc.).

Types of spondyloarthropathies

  • Axial spondyloarthritis (including ankylosing spondylitis)
  • Reactive arthritis
  • Enteropathic arthropathy (i.e., spondylitis associated with inflammatory bowel disease, e.g., Chrohn’s disease)
  • Psoriatic arthritis
  • Juvenile idiopathic arthritis

Seronegative spondylarthropathies

Spondyloarthropathy with inflammation is sometimes called axial spondyloarthritis. Spondyloarthropathy includes joints of the vertebral column from any type of joint disease (e.g., rheumatoid arthritis and osteoarthritis), but the term is usually used for a specific group of disorders with certain common features, termed seronegative spondyloarthropathies. These patients have an increased incidence of HLA-B27 (i.e., a functioning protein found on the wall of cells responsible in immune responses) as well as negative rheumatoid factor (i.e., an autoantibody that attacks your own tissues) and autoantibodies.

Symptoms

In a general sense, there are no specific spondyloarthropathies that affect the mid-back or thoracic spine only. The thoracic spine may or may not be involved. For example, in ankylosing spondylitis, the mid-back becomes stiff and eventually can fuse (ankylose) in advanced cases. These conditions are associated with deferent symptoms that affect more than just joints. They are associated with generalised joint pain in the hands and feet, back pain, eye inflammation (uveitis), gastrointestinal symptoms (inflammatory bowel disease), and rashes (psoriasis).

Treatment

Conservative management can serve an important role in the treatment of thoracic spondyloarthropathies. Spondyloarthropathies are a systemic and chronic condition that requires a team approach from medical specialists such as rheumatologists and general practitioners. Chiropractors can help with strategies in improving joint movement and joint pain. Improving the function of the spinal and peripheral joints is very important. Chiropractors and physiotherapists excel at treating joint, muscle and spine problems.

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