Axial SpA – These conditions predominantly involve the spine. AS and nr-axSpA are both types of axSpA. Sometimes these patients also show minor features of peripheral spondyloarthritis. Peripheral SpA – These conditions predominantly affect the joints of the arms and legs, heels, and entire fingers and toes.
Axial spondyloarthritis is used to describe patients who have both non-radiographic and radiographic axial spondyloarthritis. Non-radiographic axial spondyloarthritis does not show on x-ray, but there are changes on MRI. Radiographic axial spondyloarthritis is also known as ankylosing spondylitis (AS).
Treatment for spondylitis is focused on reducing pain and stiffness and preventing deformities. Treatments may include: Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling. Short-term use of corticosteroids to relieve pain and swelling.
A diagnosis of AS can usually be confirmed if an X-ray shows inflammation of the sacroiliac joints (sacroiliitis) and you have at least 1 of the following: at least 3 months of lower back pain that gets better with exercise and doesn't improve with rest. limited movement in your lower back (lumbar spine)
How Axial Spondyloarthritis Is Diagnosed. There's no “gold standard” feature for diagnosing axSpA. It's diagnosed through a combination of patient history, physical examination, blood tests (both for HLA-B27 and for markers of inflammation, such as C-reactive protein), and imaging tests, such as X-ray and MRI.
Axial spondyloarthritis is a type of inflammatory arthritis that often causes chronic back pain in young adults. There's no cure, but your provider can help you create a treatment plan to manage it. With the right care, you can get relief from pain and other symptoms and live a full, active life.
The disease can occur at any age, but typically begins between ages 20 and 40. AS is more common in men than in women. However, nr-axSpA may be just as common in women as in men. It is less common among African Americans than people of other racial backgrounds.
Don't do movements that cause pain
Carefully consider high-impact exercises, such as running, or jarring and twisting sports, such as tennis, squash, and racquetball. These could increase pain in the spine, hips, and knees.
Most people develop symptoms of ankylosing spondylitis before age 45. However, some people develop the disease when they are children or teens. Other conditions. People who have Crohn's disease, ulcerative colitis, or psoriasis may be more likely to develop the disease.
Spondylosis is caused by wear and tear on the components of the spine. The major risk factor for developing spondylosis is age. In fact, by age 60 most people will show signs of spondylosis on X-ray.
Treatment for axSpA usually starts with nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy and exercise. As long as your disease isn't too advanced, NSAIDs and regular movement are usually enough to keep things under control.
Axial Spondyloarthritis - also known as axSpA or axial SpA - is a painful, chronic arthritis that mainly affects the joints of the spine. It can also affect other joints in the body, as well as tendons and ligaments.
“Non-radiographic” means the disease causes symptoms, but there's no visible damage on X-rays, the way there is with a related type of inflammatory arthritis called ankylosing spondylitis (more on that below). “Axial” refers to joints that the disease primarily affects: the spine, chest, and hip bone.
Sleep on your back to ease ankylosing spondylitis symptoms
Many people find relief from their ankylosing spondylitis symptoms by sleeping on their back. I tell my patients that the key to sleeping in this position is to maintain the natural curvature of their spine.
Advanced Ankylosing Spondylitis
If you have more advanced AS, your doctor may tell you that your spine has fused. That happens when new bone grows between some of the small bones that form your spine, joining them together. The more this happens, the less movement you have in your spine.
That's because stress can exacerbate ankylosing spondylitis symptoms, including pain, according to the Spondylitis Association of America. Stress may also trigger an ankylosing spondylitis flare, a period of increased inflammation and worsening symptoms.
NSAIDs for management of symptoms and inflammation in axSpA
NSAIDs remain the first-line drug treatment, in those without contra-indications, for symptoms in axSpA [1,2].
Erythrocyte sedimentation rate (ESR or sed rate).
The ESR can gauge how much inflammation is in your body by measuring how quickly red blood cells (erythrocytes) separate from other cells in the blood and collect as sediment in the bottom of a test tube.
MRI. If axial spondyloarthritis is suspected but hasn't clearly appeared with an X-ray or other assessments, a magnetic resonance imaging (MRI) test may be the next step. Because an MRI is a more sensitive test than an X-ray, it can sometimes pick up sacroiliitis that the X-ray may have missed.
There are no specific lab tests to identify ankylosing spondylitis. Certain blood tests can check for markers of inflammation, but many different health problems can cause inflammation. Blood can be tested for the HLA-B27 gene.
X-rays and MRIs are the two most common imaging tests used to help diagnose ankylosing spondylitis, but they each have their limitations and challenges. European medical guidelines call for conventional X-rays of the sacroiliac joints as the first imaging method to help diagnose AS.
(1) Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs including the Coxib class are the first-line drugs for ankylosing spondylitis.