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Axial Spondyloarthritis

Chronic pain, stiffness, and exhaustion are hallmarks of axial spondyloarthritis (axSpA). This inflammatory rheumatic illness mostly affects the spinal column and the joints connecting the spine to the hip. About 1% of the U.S. population has this type of arthritis, which tends to develop in people before age 45 and mostly from ages 20 to 30. When this disease causes enough damage to be seen on an X-ray, it’s called ankylosing spondylitis.

Symptoms

axSpA produces inflammation in a person’s spine and joints. The length and intensity of symptoms can change over time as the illness progresses. The most common symptoms of axSpA are:

Back pain. The condition’s most predominant symptom is inflammatory back pain, which tends to worsen at night and improve with activity. It’s common to have chronic back pain that lasts for three months or more.
Joint pain. Swelling and pain in the toes, heels, ankles, knees, rib cage, upper spine, shoulders and neck.
Sleep problems. Periods of extended pain and discomfort make it difficult to fall and stay asleep.
Abdominal pain. Swelling in and around the digestive tract causes severe stomach pain and diarrhea.
The condition causes physical and mental exhaustion, primarily as a result of sleep disruptions and ongoing pain.
Heel pain. 17% of people with axSpA develop plantar fasciitis, which feels like stabbing pains in the heel.
Inflammation of fingers or toes.

Causes

More than 90% of the people who develop axSpA have the HLA-B27 gene. That indicates a genetic element, but most of the people with the gene do not get the disease. Researchers think axSpA may occur when people with the HLA-B27 gene are exposed to certain bacterial, viral or environmental triggers.

Complications

Certain complications are associated with axSpA. Not all people with the condition will experience all the complications.

Osteoporosis. Weakening of the bones
inflammation of the eye
Digestive tract. Pain and diarrhea.
Cardiovascular disease. Greater risk of heart attack and stroke.
Lungs. Shortness of breath and impaired function.

Diagnosis And Treatment

Doctors use several pieces of information to diagnose axSpA. These data pieces include:

Patient history records

Physical exam data
Results from blood tests
Imaging tests, such as MRIs and X-rays

Lifestyle

There are many lifestyle changes you can make to improve axSpA symptoms, including:

Avoid smoking
Keep good posture
Eat healthily
Use a cushion when sitting
Don’t lift heavy items

Medications

Medication offers several treatment options for most people with axSpA. These medications include:

Doctors often prescribe high doses of aspirin, ibuprofen and naproxen sodium and other NSAIDs to relieve pain and control inflammatory arthritis.
For those who can’t take NSAIDs, analgesics like acetaminophen reduce pain, but they don’t reduce inflammation.
Disease-modifying antirheumatic drugs (DMARDs) may be used if NSAIDs are not effective, especially when joints other than those in the back and pelvis are involved.
A tumor necrosis factor (TNF) inhibitor is the best-working biologic for axSpA. TNF inhibitors and other biologics are beneficial when other treatments don’t work.
Injections can be used to provide immediate symptom relief.

Exercise

Aerobic exercise and deep breathing routines strengthen the back and neck and make it easier to maintain good posture. Before working out, take a warm shower to loosen your joints and help you become more flexible.

Physical Therapy

Work with a physical therapist to create a customized treatment plan for your axSpA symptoms. Physical therapy is especially important when there is spinal involvement.

Surgery

Hip and knee replacements and back surgery may become necessary if other measures fail. In worst-case scenarios, you may need surgery to relieve axSpA symptoms. Back, hip, and knee surgeries are very common and successful for those with axSpA.

Call Us for Help

Florida Medical Clinic Orlando Health is dedicated to providing you with arthritis-related pain relief. The specialists in our Department of Rheumatology will do all it can to help you get back to doing the things you love.

Proudly Serving: Land O’ Lakes, Seminole Heights, and Zephyrhills.