Axial Spondyloarthritis (AS)
Axial spondyloarthritis is a chronic inflammatory condition primarily affecting the spine and sacroiliac joints, leading to pain and stiffness.
Axial spondyloarthritis (AS), also known as ankylosing spondylitis, is a type of arthritis that primarily affects the spine and the joints where the spine connects to the pelvis (the sacroiliac joints). This condition can cause chronic pain and stiffness in the lower back and hips, especially in the morning or after sitting for long periods. Over time, AS can lead to a loss of flexibility in the spine and may even cause some vertebrae to fuse together, which can result in a hunched posture.
We diagnose axial spondyloarthropathy based on symptoms, physical examinations, and imaging tests like X-rays or MRIs that can reveal changes in the spine and sacroiliac joints. Blood tests may also be done to check for specific markers, such as the HLA-B27 gene, which is commonly associated with this condition.
Treatment for axial spondyloarthritis focuses on reducing pain and inflammation while maintaining mobility. Nonsteroidal anti-inflammatory drugs (NSAIDs) and biologics are common treatments and are very effective at treating pain and slowing progression of the disease. Physical therapy and regular exercise are essential parts of management, as they can help improve flexibility and strengthen the back muscles. Regular follow-ups are important for monitoring the condition and adjusting treatment as needed.
Axial spondyloarthritis FAQ
What are the most common symptoms in axial spondyloarthritis?
The most common symptoms of axial spondyloarthritis are back pain and stiffness, especially in the lower back and hips. The pain is often worse in the morning or after sitting for a long time but improves with movement. Some people also experience fatigue and pain in other joints.
How is axial spondyloarthritis diagnosed?
Axial spondyloarthritis is diagnosed through a combination of symptoms, a physical exam, imaging tests like X-rays or MRI, and blood tests. We look for signs of inflammation in the spine and may test for a gene called HLA-B27, which is linked to the disease.
What causes axial spondyloarthritis?
The exact cause of axial spondyloarthritis isn’t known, but genetics play a strong role. The HLA-B27 gene is present in many people with the condition. Environmental factors, infections, and immune system issues may also contribute to the development of the disease.
How is axial spondyloarthritis treated?
Treatment for axial spondyloarthritis includes anti-inflammatory medications like NSAIDs, physical therapy, and routine stretching. For most cases, biologic medications like TNF inhibitors or IL-17 inhibitors are used to reduce inflammation and prevent joint damage.
What do x-rays show in people with axial spondyloarthritis?
In axial spondyloarthritis, X-rays may show inflammation in the sacroiliac joints (where the spine meets the pelvis) and changes in the vertebrae of the spine. These changes can include bone erosion, joint narrowing, or bone formation called syndesmophytes. Early in the disease, X-rays may look normal, so MRIs are sometimes used for more detail.
Is axial spondyloarthritis related to gut health?
Yes, axial spondyloarthritis (AS) is related to gut health. Some people with AS have inflammation in the gut, even if they don’t have digestive symptoms. Conditions like Crohn’s disease and ulcerative colitis, which affect the intestines, are more common in people with AS. Gut bacteria and immune system changes in the digestive tract may play a role in the disease. However, there is no known diet that prevents or treats the condition.