Removing your tonsils increases risk of developing severe arthritis, study finds

Having your tonsils removed as a child can increase your risk of a severe form of arthritis. (Getty Images)
Having your tonsils removed as a child can increase your risk of a severe form of arthritis. (Getty Images)

People who had their tonsils removed as a child increase their risk of developing a severe form of arthritis by a third, a new study has found.

The research, published in the journal RMD Open, also said that having older siblings can heighten the risk of developing ankylosing spondylitis, a type of chronic inflammatory arthritis.

The season you are born in can also influence the risk, with scientists finding that those born in summer or autumn had a ‘significantly lower’ risk of developing the disease than those born in winter.

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Researchers said these findings back up the theory that childhood infections can play a role in the development of ankylosing spondylitis, which is characterised by inflammation of the spine, joints, and tendon - resulting in pain, stiffness, and fatigue.

According to the NHS, genetic predisposition is the leading cause of ankylosing spondylitis, but new research indicates that early life factors could also play a role.

older siblings
Having older siblings can also increase your risk of ankylosing spondylitis. (Getty Images)

"Serious childhood infections were associated with a 13% heightened risk after accounting for potentially influential factors, while tonsil removal before the age of 16 was associated with a 30% heightened risk," Study author Dr Matilda Morin said.

"Multiple birth, as opposed to singleton birth, was associated with a 23% heightened risk, while being born in the summer or autumn months was associated with a significantly lower risk than being born in the winter."

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To find this data, the Swedish researchers used national Swedish population registries to compare exposure to various early life risk factors in adults with and without the condition.

In total, 6,771 people born from 1973 onwards were diagnosed with ankylosing spondylitis between 2001 and 2022.

It found that early life risk factors for developing the disease included: your mother’s age at birth delivery, your mother’s weight in early pregnancy, whether she smoked; length of pregnancy; your birth weight; whether it was a singular or multiple birth (twins); Caesarean section delivery; maternal infections during pregnancy; and season of birth.

Detail of a woman holding her hand in pain caused by a carpal tunnel.
Ankylosing spondylitis is a chronic inflammatory form of arthritis. (Getty Images)

Other factors considered were the number of siblings people had, serious childhood infections from birth up to the age of 15, and tonsil or appendix removal before the age of 16.

It found that those who had at least one older sibling, not just siblings in general, had a 12 to 15% heightened risk.

The findings suggest that several factors were associated with a heightened risk of an ankylosing spondylitis diagnosis, among them having just one or more older siblings - a 12 to 15% heightened risk. One older sibling posed an 18% heightened risk, while two or more older siblings saw the risk of developing the disease increase by 34%.

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"The mechanism behind this risk increase cannot be determined from our data but it has been shown that infants with older siblings are more exposed to infections early in life than infants without siblings," Dr Morin said.

"Having older siblings and a history of tonsillectomy in childhood were independently associated with the development of ankylosing spondylitis, even after adjustment for family shared factors in a sibling comparison analysis. This strengthens the hypothesis that childhood infections play a role in the aetiology of the condition."

Additional reporting by SWNS.

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