Fever and Axial Spondyloarthritis

Reviewed by: HU Medical Review Board | Last reviewed: May 2020 | Last updated: June 2021

Symptoms associated with the AxSpA spectrum can vary. While some are more characteristic to the condition, like inflammatory back pain, others may initially seem unrelated. Knowing the range of possible symptoms can help you in letting your health care provider know about any new symptoms. It can also help in getting you appropriate treatment sooner, rather than waiting until they worsen.

Not everyone will have every symptom, and the frequency and severity of symptoms can vary at different points along the AxSpA spectrum, especially as the condition progresses. Awareness of symptoms can help you get treatment earlier, which can help relieve discomfort or pain and improve quality of life.

Fever is one of the symptoms that may seem unrelated to conditions on the AxSpA spectrum, but can be related to the conditions. Fever is a common symptom of both infectious and inflammatory diseases and conditions.1 The conditions on the AxSpA spectrum are also systemic, which means they can affect multiple areas of the body, as opposed to only one organ, causing a variety of symptoms.

What is fever and can axial spondyloarthritis cause fever?

A fever is a body temperature over 100.4 degrees Fahrenheit. The average typical human body temperature is 98.6 degrees Fahrenheit (37 degrees Celsius).2 Some people may have a body temperature that usually runs a bit lower or a little higher, but this is the average. Fevers are not usually a reason to be too concerned; it is a normal bodily response to fighting infection. Sometimes they can be accompanied by flu-like symptoms like aches or chills.

Symptoms of a fever can include:2

  1. Raised temperature or flushed skin
  2. Chills
  3. Body aches
  4. Fatigue

Different conditions on the AxSpA spectrum are more associated with fever than others. Reactive arthritis (ReA) has been strongly associated with fever, but the relationship between fever and SpA has not been extensively studied. One study found that up to 33 percent of those with ReA presented with fever when they went to the hospital for treatment of symptoms.3

Fever may be present with other symptoms of SpA. This symptom has been associated with higher levels of systemic inflammation.3 Among those with SpA who presented with fever in one study, peripheral SpA was more common than axial SpA.2 This means the symptoms of SpA affected the limbs, rather than the spine or pelvis.

If a fever is higher than 102 degrees Fahrenheit (38.9 degrees Celsius), it should be treated.2

Why fever occurs

In typical fevers, an infection has occurred and the fever is the body’s natural response to get rid of the infection. It shows that the body is fighting the infection. With inflammatory conditions, proteins called cytokines that cause inflammation bind to receptors in the brain, which then sets off a response that triggers a fever.1 There may be other inflammation-related ways a fever is caused, but more research is needed.

In reactive arthritis (ReA), the inflammatory arthritis is a response to an infection or bacteria.4 Fever can be strongly associated with this condition on the AxSpA spectrum.

How fever is treated

With a typical fever, special treatment isn’t necessary if it’s below 102 degrees Fahrenheit. The fever is a good thing; it’s fighting infection. Altering that bodily response means interfering with that. Rest and drinking lots of fluids should be enough.

With higher temperatures, aspirin, acetaminophen, or ibuprofen can help.2 Children should not take aspirin.

People presenting with symptoms of SpA with fever are more likely to be treated with systemic corticosteroids than those with SpA symptoms and no fever.3

If you have a fever, it’s important to figure out if it is an immune response to your SpA, or if it is your body fighting an infection. Calling your doctor and letting them know what your temperature is, along with any other symptoms, can help guide your treatment decisions.

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