What Are The Risk Factor For Spondyloarthritis? Practical Guide

What Are The Risk Factor For Spondyloarthritis? A Practical Guide

Table of Contents

Spondyloarthritis is a type of arthritis that damages the spine, and in some people, it also affects the joints of the hands and feet. It can also attack the skin, intestines and eyes. The main symptom of spondyloarthritis in most patients is pain in the lower back.

Spondyloarthritis is the name of a family of rheumatic infectious diseases that cause arthritis. This type of arthrosis is different from other arthrosis because it affects the place where the ligaments and tendons attach to the bone.


Related: “How Do You Slow Down Arthritis?

affected joints by Spondyloarthritis

The symptoms of spondyloarthritis are in two general ways:

  1. The first type is an infection that causes pain and stiffness in most parts of the spine, sometimes involving the hands, feet, arms, and thighs.
  2. The second type is bone destruction, which causes spine deformity and poor function of the shoulders and hips.
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Types of spondyloarthritis

It has the following two main types:

Axial spondyloarthritis: Pain is often felt in the lower back.

Peripheral spondyloarthritis

People who are at risk of developing spondyloarthritis

It is not always clear why some people develop spondyloarthritis, but if you have the following conditions, your risk of developing this disease is high:

  • One of your family members has spondyloarthritis.
  • Genetically, you have spondyloarthritis genes.
  • Have other infections.
  • Get infected quickly.
Types of spondyloarthritis

Spondyloarthritis symptoms

The symptoms of spondyloarthritis include the following (there may be other symptoms, so you must see a doctor):

Redness and pain in the eyes

Pain and swelling in the tendons of the fingers and toes, where the tendons and ligaments connect to the bone, usually at the back or bottom of the heel.

Psoriasis skin sensitivity

Abdominal pain and bloating

Intestinal inflammation

Amas or swelling of the fingers


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How is spondyloarthropathy diagnosed?

If your doctor suspects spondyloarthropathy, they will examine your body and joints and review your medical records.

You may be asked to have an X-ray or other imaging to check your hip joints (lower abdomen), which may show early signs of spondyloarthritis.

A blood test may show if you have a gene that increases your risk of developing spondyloarthropathy. It is called the HLA-B27 gene.

When you see your doctor for a diagnosis, they will start by reviewing your medical history, symptoms, and risk factors (for example, family history) for axial spondyloarthritis. After that, a physical examination will be done.

During a physical exam, your doctor will assess your mobility and look for joint inflammation in your spine, pelvis, and hips. He or she may ask you to move your body in specific ways (e.g., stretch your toes, lift your body. While lying down, rest your chin on your chest) to determine how much you can move. Affected and whether these movements cause you pain or not.

They may also perform a neurological evaluation to evaluate your sensory and motor functions, including your reflexes and muscle strength.

  • Experiments : Some blood tests may show if a person has axial spondyloarthritis. These blood tests look for the following:

Inflammatory markers: Blood tests can detect inflammatory markers that indicate inflammation in the body. Tests may detect erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, and plasma viscosity (PV) levels, all of which are typical markers of inflammation.

  • Genetics: A family history of axial spondyloarthritis is a risk factor for developing this disease. A blood test can determine whether you carry the HLA-B27 gene. Gene association with axSpA varies among different ethnic groups.

More than 95% of whites with axSpA carry this gene, whereas only 80% of people from Mediterranean countries and 50% of blacks with axSpA are HLA-B27 positive.

Although blood tests alone cannot provide enough evidence to diagnose axial spondyloarthritis, these blood markers can help your doctor learn about your risk factors.

blood test for Spondyloarthritis
  • Imaging: In order to accurately diagnose axial spondyloarthritis, your doctor will order imaging tests to see if axSpA has affected your spine and joints.

  This includes:


X-rays are a standard imaging test that doctors use to check for bone damage in the spine and sacroiliac joint. Along with showing bone damage, X-ray images may show that the joint space is widening or narrowing and detect bony fusion. Bone damage is only detectable in people with ankylosing spondylitis. X-rays do not detect bone or joint damage in people with non-radiographic axial spondyloarthritis (nr-axSpA).

  • Computed tomography (CT) scan: A CT scan produces detailed images of the inside of the body, including organs and bones. To diagnose axSpA, they detect structural changes in the bone, such as bone erosion or the formation of new bone fusion.
  • Magnetic resonance imaging (MRI): An MRI sends radio waves through the body to produce images of the body’s soft tissues. MRI can detect inflammation in the body before any damage occurs to the joints or bones. This is particularly effective in diagnosing axSpA in the early stages of the disease. If you have nr-axSpA, an MRI may show inflammation in the soft tissues around your spine and sacroiliac joint.
X-Ray Spondyloarthritis

When reviewing the images, your doctor will look for the following symptoms:

  • Bamboo spine (joints of the spine that join together and look like a long bone)
  • Erosion (wearing away) or thickening of the fibrous tissues around the joints, especially where the spine meets the pelvis.
  • Bone calcification
  • Loss of cartilage between joints
  • Abnormal kyphosis (hunchback)
  • Spinal fracture
  • Differential diagnoses

Treatment of spondyloarthritis

No known cure exists, but your doctor can help you manage the condition.

A rheumatology specialist will do the treatment of this disease. A rheumatology subspecialist is a doctor specializing in treating diseases such as arthritis.

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Depending on the type of spondyloarthropathy, you may also see these specialists:

Physiotherapists, exercise and physiotherapy can help the flexibility of joints.

Gastroenterologist, this specialist deals with diseases of the digestive system.

Eye doctor If you have a condition that affects your vision, you should see an eye doctor.

A non-steroidal anti-inflammatory drug (NSAID) is usually the first step. Aspirin, ibuprofen or naproxen are the most common types. They relieve pain and reduce swelling in the affected joints.

You may be prescribed a more potent medication if your symptoms do not improve after taking an NSAID.

You may receive a certain amount of corticosteroid in a swollen joint for quick but temporary pain relief.

  Moreover, the following methods help relieve the pain of this disease:

  • Physiotherapy
  • Non-steroidal anti-inflammatory drugs
  • Corticosteroid injections
  • Antirheumatic drugs


If you have reactive arthritis, you may be prescribed antibiotics.

Another class of drugs, known as disease-modifying antirheumatic drugs (DMARDs), may be prescribed to help treat arthritis in the arms and legs.

TNF inhibitors block a chemical in the blood that causes inflammation.

If your disease has caused extensive joint damage, doctors may consider surgery to replace an artificial joint. Knee and hip joint replacement is the most common type of surgery.

Sometimes, when the vertebrae are bent forward, doctors may perform surgery to straighten your spine. This is considered a risky practice.

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Beneficial and harmful foods for spondyloarthritis

Consuming the following foods aggravates the infection in the body, so they should be avoided:

  • Sugar
  • Fried food
  • alcohol
  • aspartame

Also, consuming the following foods helps fight infections in the body:

  • Different types of fruits and vegetables
  • cereal
  • fiber
  • fish oil

Also, remember that increasing the consumption of foods rich in antioxidants such as vitamins E and C, selenium, and fish oil for their omega-3 is necessary. It is also essential to get enough vitamin D and calcium.

Exercise in patients with spondyloarthritis

Due to spondyloarthritis, you should consult your physiotherapist before any exercise, but the following exercises are suitable for you:

  • yoga
  • Pilates
  • riding bike
  • Dance
  • fast walking


Axial spondyloarthritis is a rheumatological disease that affects the spine and axial joints. It can be diagnosed through physical examinations, imaging, and blood tests. Because chronic low back pain is one of the early symptoms of axSpA, it may be misdiagnosed.

If you experience persistent back pain, talk to your doctor. Early diagnosis of axial spondyloarthritis is the key to receiving treatment and preventing further damage to bones and joints. Living with chronic pain can be difficult, but early intervention and treatment can help reduce your pain and inflammation and improve your overall quality of life.

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Author and specialist

Dr. Majid Zahrabi,


  • Board Certified Neurosurgeon
  • DHA certificate holder
  • Plantation certificate holder, France
  • Certified holder of Discogol, France
  • A pioneer in the non-surgical treatment of disc herniation in the Middle East and CIS countries.
  • Under the training and coaching of Professor Jacques Theron (founder of Discogel Therapy) since 2008
  • More than 400 successful cervical and 1300 lumbar discogel injections
  • Trained and certified several neurosurgeons and spine surgeons in the Middle East and CIS countries for the treatment of Discogel
  • Strong belief in patient-centered care planning and participation
  • Neurosurgeon and spine surgeon at Imam Khomeini and Amir Mazandarani Hospital, Sari, Iran, with more than 430 surgeries annually, 2000-2011
  • Neurosurgeon and spine surgeon at Farmaniyeh, Nikan and Yas Sepid Hospital, Tehran, Iran, with more than 400 surgeries annually, 2011-2012
  • Neurosurgeon at Iranian Hospital, Dubai, 2022-2023
  • Since 2015, he has been working as a reference doctor for the treatment of intervertebral disc herniation with Discogel and has trained many doctors of spine-related specialties in various countries of the Middle East and CIS in person/practically and online.



  • Individual training sessions under the direct supervision of Professor Jacques Theron in Discogel treatment, 2008-2020
  • Training sessions under the supervision of Professor Thierry Boye on spinal implants, 2007
  • Participation and presentation in several national and international medical and neuro-spinal conferences
  • Board certificate by Iran Neurosurgery Board, 2001
  • Neurosurgery assistant training course, Isfahan University of Medical Sciences, Isfahan, Iran, 1996-2001 (In 2001, he graduated from Isfahan University of Medical Sciences with the first rank in the country.
  • His thesis the titled:The Application of human amniotic membrane in repair of dura matter in dogs.” ( It was happening for the first time in the world. )
  • General medical education, Tabriz University of Medical Sciences, Tabriz, Iran, 1984-1993


Published books:

  • CT scan of the brain for doctors
  • Etiology and treatment of painful spine disorders
  • Atlas of diagnosis, prevention, and treatment of spine disorders
  • The most common mistakes in the treatment of spinal disorders
  • Reading brain CT scan in simple language (3rd place in the book of the year)
  • Treatment of head and spine injuries

Publications and articles:

  • Bacteriostatic and bactericidal effects of DISCOGEL® (https://www.researchgate.net/)
  • Muscle recovery, reduction of pain, and improvement of movement strategies in patients with lumbar discopathy after injection of Discogel.
  • The article on the initial results of the treatment of intervertebral disc herniation with discogel injection, which won the second-best poster rank at the Pan Arab International Congress of Interventional Radiology (March 14-16, 2015) and was accepted for presentation at the Chicago Pain Congress.
  • The use of human amniotic membrane in dura mater repair in dogs, a study for the first time in the world.



  • Annual Congress of Physiotherapists of Iran, 2019
  • Chicago International Pain Congress, 2019
  • Iran International Pain Management Congress, 2018
  • Annual Congress of Physiotherapists of Iran, 2018
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Armenia for orthopedic specialists and neurosurgeons, 2017
  • First Live Workshop and Seminar on Minimally Invasive Disc Therapy (DISCON), 2017
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Azerbaijan for orthopedic specialists and neurosurgeons, 2016
  • Seminar of Iranian official managers, 2016
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Tajikistan for orthopedic specialists and neurosurgeons, 2016
  • International Neurological Intervention Congress in Iran, 2014
  • Educational seminar for nurses on treatment approaches for head and spine trauma, 2014
  • Educational seminar for general practitioners on treatment approaches for head and spine trauma, 2014
  • Speech at the Retraining Seminar for General Practitioners and Specialists in Dubai (Discon) in 2017
  • Speech in the internal retraining courses of Irani Hospital, Dubai
  • Holding lecture sessions and practical workshops on the treatment of intervertebral disc herniation with discogel injection in Azerbaijan, Tajikistan, Ukraine, Oman, and Armenia during the years 2015 to 2021.
  • Giving a lecture and holding a practical workshop for neurosurgeons in Vietnam at Ho Chi Minh City University in 2023

Dr. Majid Zohrabi started treating his patients in Dubai in 2022 and continues his activities in private medical centers in the UAE.