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Spondylitis and Hidradenitis Suppurativa: Is There a Connection?

Medically reviewed by Ariel D. Teitel, M.D., M.B.A.
Written by Marnie Willman
Posted on August 29, 2022

If you’re living with hidradenitis suppurativa (HS), you may be more likely to develop certain health conditions than individuals in the general population. These include inflammatory joint conditions like spondylitis.

Read on to better understand the connection between these two conditions, and what the treatment options are for people who have both HS and spondylitis.

What Is the Relationship Between HS and Spondylitis?

Spondylitis, or spondyloarthritis, describes a variety of inflammatory joint conditions that primarily affect the spine and cause pain and stiffness. In the most severe cases of spondylitis, the vertebrae of the spine can fuse together.

Both HS and spondylitis have significant immune system involvement and inflammation. It’s unclear whether there is a direct link between HS and spondylitis.

One recent study found that individuals living with HS had a higher risk of developing spondylitis than people in the general population. Another study of 640 people with HS found 3.7 percent also had spondylitis.

If you have HS, you’re more susceptible to developing spondylitis or rheumatoid arthritis, which are both varieties of inflammatory arthritis. Those living with HS are also at an increased risk of other inflammatory conditions, including inflammatory bowel diseases like Crohn’s disease.

Risk Factors for HS and Spondylitis

Some risk factors are prevalent among both conditions. The onset of both HS and spondylitis typically occurs in one’s 20s and 30s. In addition, spondylitis and HS are known to be related to the HLA-B27 gene. However, many people have this gene and do not develop HS or spondylitis.

Does Having Both Conditions Affect Treatment Options?

Treatment for both HS and spondylitis can include pain relievers, corticosteroids, and biologics. Always tell your doctor, dermatologist, or rheumatology specialist if you have both HS and spondylitis. It’s important for your health care team to work together to avoid any possible negative medication interactions.

HS treatments typically include antibiotics, corticosteroids, hormonal therapy, and biologic therapy. The biologic therapies for hidradenitis suppurativa include tumor necrosis factor (TNF) alpha inhibitors and interleukin inhibitors. These treatments help alleviate pain, discomfort, and visible symptoms and improve quality of life.

Spondylitis treatments include painkillers, anti-inflammatory drugs, corticosteroids, and biologics. Both conditions can also be helped by a nutritious diet, exercise, and other healthy lifestyle habits.

Meeting with a dermatologist, rheumatologist, or other specialist for routine follow-ups is an essential part of your health care regimen if you’re living with spondylitis or HS. This is the best way to ensure you’re getting the right treatment for your unique situation. They can also keep you up to date on current clinical trials, case reports, and other news about your condition.

Are There Overlapping Medications?

Because of the symptom similarities between HS and spondylitis, some medications can be used to treat either condition (and often both). Reducing inflammation and pain are treatment goals of both HS and spondylitis.

Discuss the best treatment course with your doctor to ensure you’re taking the right medications to tackle the symptoms of both conditions.

Talk With Others Who Understand

On myHSteam, the social network for people with hidradenitis suppurativa and their loved ones, more than 27,000 members come together to ask questions, give advice, and share their stories with others who understand life with hidradenitis suppurativa.

Are you living with hidradenitis suppurativa or spondylitis? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on August 29, 2022

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Still not treating HS as autoimmune disease.

August 19, 2023
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Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Marnie Willman is a Ph.D. candidate in medical microbiology and infectious diseases at the University of Manitoba. Learn more about her here.

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