Spondyloarthritis

At Mayo Clinic Healthcare in London, our rheumatology specialists assess, diagnose, and manage spondyloarthritis and other forms of inflammatory arthritis. If you have persistent back pain, joint stiffness, or other symptoms that may be linked to spondyloarthritis, our consultant-led team can investigate the cause and recommend a treatment plan tailored to you.

Spondyloarthritis is a group of inflammatory conditions that can affect the spine, joints, and areas where tendons and ligaments attach to bones. It can also affect other parts of the body, including the eyes, skin, and digestive system.

Early assessment can help identify the condition, control inflammation, manage symptoms, and reduce the risk of longer-term complications.

Spondyloarthritis is a group of inflammatory arthritis conditions that share some common features. It can affect the joints in your spine and pelvis, as well as joints in your arms and legs.

The two main categories are axial spondyloarthritis and peripheral spondyloarthritis.

Axial spondyloarthritis

Axial spondyloarthritis mainly affects the spine and the joints that connect the spine to the pelvis.

Ankylosing spondylitis is a form of axial spondyloarthritis in which changes to the spine can be seen on X-rays.

Some people have symptoms and inflammation even though these changes cannot yet be seen on X-rays. This is known as non-radiographic axial spondyloarthritis.

Peripheral spondyloarthritis

Peripheral spondyloarthritis mainly affects joints outside the spine, such as the hips, knees, ankles, hands, and feet.

It can also cause inflammation where tendons and ligaments attach to bone.
The spondyloarthritis symptoms you experience will depend on the type of condition and which areas of your body are affected. Symptoms often develop gradually and may come and go over time.

You may experience:

Persistent lower back pain or stiffness

Back pain that is worse after periods of rest and improves with movement

Morning stiffness

Pain or stiffness in the hips, shoulders, knees, ankles, or other joints

Pain where tendons or ligaments attach to bones, such as at the heel

Swelling of a finger or toe

Fatigue

Eye inflammation, which can cause pain, redness, or sensitivity to light

Skin changes associated with psoriasis

Abdominal pain or diarrhoea associated with inflammatory bowel disease

Persistent back pain that begins at a younger age, particularly when it improves with movement rather than rest, may be a sign of axial spondyloarthritis.

If you have ongoing pain, stiffness, or other unexplained symptoms, a specialist assessment can help determine whether spondyloarthritis may be contributing to them.
The exact cause of spondyloarthritis is not fully understood. It is thought to develop because of a combination of genetic and environmental factors that affect how the immune system works.

Factors that may contribute include:

Genetic factors, including the HLA-B27 gene

A family history of spondyloarthritis or related inflammatory conditions

Other inflammatory conditions, such as psoriasis or inflammatory bowel disease

Previous infections, which can be associated with reactive arthritis

Having the HLA-B27 gene does not mean you will develop spondyloarthritis, and not everyone with spondyloarthritis has the gene.

Your consultant will consider your symptoms, medical history, and family history when assessing your condition.
Diagnosis begins with a detailed consultation and examination by your specialist.

Your assessment may include:

A review of your symptoms, including when they started and how they change with movement or rest

A review of your medical and family history

A physical examination of your spine and affected joints

An assessment of your flexibility, posture, and range of movement

Blood tests to look for signs of inflammation

Testing for the HLA-B27 gene, if needed

X-rays to assess changes to the joints and bones

Magnetic resonance imaging (MRI) to look for inflammation that may not be visible on X-rays

There is no single blood test that can confirm spondyloarthritis. Blood tests can help identify signs of inflammation or provide other useful information. Diagnostic imaging can help your consultant assess changes in the spine, joints, and surrounding tissues.

An MRI may be particularly useful when axial spondyloarthritis is suspected but changes cannot yet be seen on an X-ray.

The tests and assessments you need will depend on your symptoms, medical history, and what your specialist finds during your examination.
Treatment for spondyloarthritis aims to control inflammation, relieve pain and stiffness, maintain movement, and reduce the risk of longer-term complications. The right approach depends on the type of spondyloarthritis you have, which areas are affected, and how severe your symptoms are.

Your treatment plan may include:

Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation

Physiotherapy and exercise to maintain flexibility, strength, and mobility

Steroid injections for specific areas of pain or inflammation, when appropriate

Disease-modifying antirheumatic drugs (DMARDs) for some forms of peripheral spondyloarthritis

Biologic medicines if your symptoms are not adequately controlled with other treatments

Other targeted medicines, when appropriate

Exercise and physiotherapy are important parts of managing spondyloarthritis, particularly when the condition affects your spine. Your physiotherapist can recommend exercises based on your symptoms, mobility, and overall health.

Your treatment may need to change over time depending on how your symptoms respond and whether there are signs of ongoing inflammation.

Mayo Clinic Healthcare in London does not offer surgery. However, we work with leading healthcare professionals who can carry out these procedures when appropriate. If surgery is recommended, your consultant will explain your options and coordinate your ongoing care.
At Mayo Clinic Healthcare, your care is led by consultants experienced in inflammatory arthritis and complex rheumatology conditions.

Our approach includes:

Rheumatology specialists experienced in diagnosing and managing spondyloarthritis

A detailed assessment of your symptoms, medical history, and examination findings

Access to appropriate blood tests and imaging when needed

Assessment of symptoms affecting both the spine and other joints

Collaboration with other specialists when spondyloarthritis affects the eyes, skin, or digestive system

A treatment plan tailored to your symptoms, diagnosis, and daily life

Evidence-based recommendations to support long-term joint health

As part of the globally recognised Mayo Clinic network, we are committed to providing accurate diagnosis and high-quality, patient-centred care.

Private health insurance

Mayo Clinic Healthcare works with all major private health insurance providers, including AXA PPP, Aviva, BUPA, Health Partners Group, Vitality Health and WPA. Self-pay arrangements are also available.

Private assessment

If you have persistent back pain, joint stiffness, or other symptoms that may be linked to spondyloarthritis, our rheumatology specialists can assess your symptoms, investigate the possible cause, and recommend appropriate next steps.

Our team can help clarify your diagnosis, explain your treatment options, and recommend a personalised approach based on your individual needs.

Request an appointment with Mayo Clinic Healthcare or call +44 (0) 207 871 2575.

Medically Reviewed by

Dr Anna Nuttall, Consultant Rheumatologist