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Spondyloarthritis: Clinical Suspicion, Diagnosis, and Sports

Harper, Brock E.; Reveille, John D.

doi: 10.1249/JSR.0b013e3181967ac6
Section Articles: Spine Conditions

Spondyloarthritis (SpA), a family of inflammatory back diseases including ankylosing spondylitis, is an important and under-recognized cause of chronic back pain in younger patients who are likely to participate in sports and athletic activities. These diseases are characterized by the presence of inflammatory back pain - lumbar or buttock/hip pain lasting longer than 3 months associated with improvement with activity, worsening with rest, relief with non-steroidal anti-inflammatory drugs (NSAIDs), and morning stiffness lasting longer than 30 min. There are also characteristic radiographic findings involving the sacroiliac joints, vertebrae, and in certain diseases, the peripheral joints. Exercise has long been recognized as a key component of the therapy of SpA, yielding benefits in mobility, pain, stiffness, functionality, and depression. Sports also pose a risk to patients with SpA as these patients are at high risk of spinal fracture and spinal cord injury.

The University of Texas Health Science Center at Houston, Division of Rheumatology, Houston, TX

Address for correspondence: John D. Reveille, M.D., The University of Texas Health Science Center of Houston, Division of Rheumatology, 6431 Fannin Street, MSB 5.270, Houston, TX 77030 (E-mail:

© 2009 American College of Sports Medicine