How We Can Help You for Spondyloarthritis and Spondylolisthesis
The doctors in the Stanford Medicine Spine Center have extensive experience in the diagnosis and treatment of the inflammatory disease spondyloarthritis and spondylolisthesis.
Using the latest techniques and technology, we help relieve symptoms that may include pain, stiffness, and swelling in the back, arms, or legs. Our team creates a treatment plan specifically for you, customized to your condition, your needs and goals, and your day-to-day lifestyle.
In addition, patients with spondyloarthritis or spondylolisthesis at the Stanford Medicine Spine Center may have opportunities to participate in research studies of new treatment approaches not yet available anywhere else.
What We Offer You for Spondyloarthritis and Spondylolisthesis
- Center of Excellence for advanced care of all spine-related conditions.
- Nationally recognized leadership in helping people from all over the world with spondyloarthritis and spondylolisthesis.
- Precise diagnosis options including the latest imaging technology.
- Team-based treatment planning that brings together orthopaedic surgeons, neurologists and neurosurgeons, pain management specialists, rheumatologists, physiatrists, and others to tailor care to your needs.
- Advanced treatment options emphasizing noninvasive approaches whenever possible, including exercises, physical therapy, and medication therapy, and, when needed, spine surgery.
- Comprehensive support services including care coordination from diagnosis to treatment to follow-up.
- Active research program to develop new diagnostic and treatment advances.
Treatments for Spondyloarthritis and Spondylolisthesis
The team members of the Stanford Medicine Spine Center use the most advanced techniques to treat spondyloarthritis and spondylolisthesis.
Our team includes doctors from orthopaedics, rheumatology, physiatry, neurology, and other specialties, working together to help ensure you receive an accurate diagnosis and the most effective treatment possible.
Our treatments focus on:
- Reducing symptoms
- Keeping your condition from getting worse
- Helping you continue or resume doing your daily activities
Our goal is to help you be able to do the activities you enjoy most—without pain, inflammation, stiffness, or other effects of your condition.
Physical therapy and exercise
Our treatment recommendations emphasize minimally invasive approaches and usually include physical therapy and exercise programs.
Physical therapy may focus on strengthening the muscles in the stomach and back. Most exercises are designed to help with safe stretching and mobility.
Nonsurgical treatment also may include:
- Ice or heat
- Rest: Your doctor may recommend you stop or cut down on sports and other activities that place excessive stress on your back. You and your doctor can see if this helps improve back pain and other symptoms.
- Bracing: In some cases, doctors recommend wearing a back brace for a period of time to limit movement in the spine and let a fracture heal.
Make sure you exercise regularly and eat a healthy diet.
If you smoke, drink, or take recreational drugs, talk with your care team. They can recommend programs to help you quit or reduce your use to improve your health.
There are several medication options for spondyloarthritis and spondylolisthesis. These include nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen, ibuprofen, meloxicam, or indomethacin. These may help relieve pain and inflammation.
Your doctor also may recommend an over-the-counter pain reliever such as acetaminophen.
For joint swelling that is in one area, not widespread, your doctor may recommend injections of corticosteroids directly into the joint or area around a tendon to provide relief.
Other medication options include disease-modifying anti-rheumatic drugs (also called DMARDs). These are used most often to help people whose condition affects joints in the arms or legs.
A new type of drugs called biologics may be effective in treating symptoms of spondyloarthritis. Examples include:
- Tumor necrosis factor alpha (TNF-alpha) blockers: for arthritis affecting both the spine and joints of the arms and legs. Examples include:
- Infliximab, given by IV infusion usually every six to eight weeks
- Etanercept, given by injection usually once a week
- Adalimumab, injected under the skin usually once a week
- Certolizumab, injected under the skin usually once every two or four weeks, depending on dose
- Golimumab, injected under the skin usually once a month
- Interleukin (IL)-17 blockers: given to treat inflammation and psoriasis.
Surgical treatment may be the best option for some cases. Procedures may include:
- Joint replacement, such as hip replacement surgery, to relieve pain and disability caused by joint destruction resulting from loss of cartilage. In a total hip replacement procedure, the surgeon replaces the hip with a prosthesis.
- Spine surgery, when necessary, to fix fractures caused by injury or flexion deformities that prevent straightening of the neck. Examples of procedures include spinal fusion, where a vertebra is attached to the bone below it.
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest clinical trials.
Open trials refer to studies that are currently recruiting participants or that may recruit participants in the near future.
What Are Spondyloarthritis and Spondylolisthesis?
Spondyloarthritis (pronounced “spahn-dill-oh-arth-RY-tiss”) and spondylolisthesis (pronounced “spahn-dill-oh-liss-THEE-siss”) are forms of inflammatory disease. These conditions affect joints and entheses (pronounced “en-THEE-seez”), the sites where tendons and ligaments attach to bones.
Spondyloarthritis is a broader term and may be more generally called “degenerative disc disease”; a defect or fracture occurs in one or more of the vertebral bones that form your spinal column. Spondylolisthesis occurs when one vertebral bone slips on top of another, usually at the base of the spine.