When untreated, the joints remain painful for several weeks but unlike other forms of arthritis there is generally no permanent damage. Once the inflammation disappears the function of the joint returns to normal. Patients on prednisone find that the immediate relief of joint pain adds to the euphoric feeling of health. This type of arthritis is more common in colitis and its severity usually parallels the degree of inflammation in the colon. Treatment of and improvement of the colitis usually translates into improvement in the arthritis as well.
Patients improve on corticosteroids and even on sulfasalazine.
Colectomy appears to cure the arthritis associated with ulcerative colitis but this does not seem to be the case for Crohn's. The cause of this form is unknown but it is suggested that some of the inflammation represents an immunologic response to substances that may enter the body through the inflamed bowel wall. The other type is spinal arthritis or spondylitis, which is joint pain and stiffness in the vertebrae of the spinal column. Unlike peripheral arthritis, spondylitis may not parallel the course of the associated IBD nor is it improved with treatment for the bowel inflammation. Also, unlike peripheral arthritis, spinal arthritis may result in fusion of the bones of the vertebral column leading to a permanent decrease in the range of motion of the back.