Axial spondyloarthritis, or axSpA, is a type of inflammatory arthritis mainly affecting the spine and the joints connecting the lower spine to the pelvis, known as the sacroiliac joints. Around 3 million Americans have this condition, which usually leads to symptoms such as low back pain, stiffness, and fatigue emerging in early adulthood. As a systemic disease, it can also affect other joints and parts of the body as it progresses.
The exact cause of axSpA isn’t known, but researchers believe that a mix of genetic and environmental factors contribute to its development. Treatment options are available to help reduce symptoms, improve physical function, slow disease progression, and prevent complications like joint damage. There are two types of axSpA: ankylosing spondylitis and nonradiographic axial spondyloarthritis. While they share core symptoms, there are key differences between them.
Symptoms usually develop gradually before age 45 and last for three months or longer. As the condition progresses, it can lead to gastrointestinal issues like abdominal pain, diarrhea, bloody stools, and rectal bleeding, and it can be associated with inflammatory bowel disease (IBD).
Being an autoimmune disease, axSpA occurs when the immune system wrongly attacks healthy tissues, causing inflammation in the spine and sacroiliac joints. While the HLA-B27 gene is strongly linked to axSpA—with up to 90% of people with ankylosing spondylitis and 70% with nonradiographic axSpA carrying it—having the gene doesn’t guarantee developing the disease. This suggests other factors, including environmental triggers like infections and gut microbiome imbalances, may play a role.
If you have frequent back or joint pain, it’s important to consult with a healthcare provider for testing, as diagnosing axSpA can be challenging. A combination of physical exams, blood tests, and imaging scans help in understanding symptoms and risk factors. There’s no single test to diagnose axSpA, so doctors use multiple approaches to reach a diagnosis.
Although there is no cure for axSpA, several treatment options help manage pain, maintain function, slow progression, and prevent complications. Treatment plans may include medications, physical therapy, and, in severe cases, surgery to improve joint function and reduce pain. Exercising regularly and working with a physical therapist can maintain flexibility and strength.
While there’s no known way to prevent axSpA, managing symptoms and following a treatment plan can help improve quality of life and slow disease progression. Many people with axSpA also have other conditions, which might require additional care.
Living with axSpA and chronic pain can be overwhelming, but managing the condition through treatment and healthy habits can lead to a fulfilling, active life. It’s helpful to talk to healthcare providers and support groups to navigate life with axSpA, providing both understanding and community.
