Axial spondyloarthritis (axial SpA) is an uncommon cause of low back pain. SpA stands for spondylitis, which is the medical term for an inflamed spine. About 5 in every 1000 people with back pain are diagnosed with axial SpA. Axial SpA is group of conditions that involve long-term inflammation of the joints and ligaments of the spine, as well as other body parts. For example, in addition to back pain, people with axial SpA might report having other painful joints, red and irritated eyes or skin, or an upset stomach. Axial SpA is more common in men and in those under the age of 40.
--What causes axial SpA?
The cause of axial SpA is not well understood. Some believe it is an autoimmune problem, which is a problem where the body’s protective mechanisms are working in overdrive. It is this overprotective immune system that leads to inflammation of the spine and other body parts. There is no cure, but medications prescribed by a rheumatologist can manage symptoms effectively.
--How do I know if I have axial SpA?
Axial SpA needs to be diagnosed by a rheumatologist. You cannot diagnose axial SpA yourself. Your physiotherapist is trained to distinguish between possible axial SpA and other causes of low back pain. They will do this by asking you a series of questions about your pain and by examining your back. If your physiotherapist suspects that you have axial SpA they will discuss with you the option of referral for further investigations with you.
--How can physiotherapy help with axial SpA?
Physiotherapists can help you decide whether you need referral for additional testing and treatment. Once a diagnosis of axial SpA is suspected, often the initial course of treatment is conservative. This can include education, exercises and self-management. It is important for you to remain active and mobile.
--How effective is physiotherapy for axial SpA?
Your physiotherapist can play a role as part of a team to manage axial SpA. There is some evidence that exercise programs for axial SpA can improve mobility and function. More studies are needed to evaluate the effectiveness of physiotherapy for people with axial SpA.
--What can I do at home?
It is best to discuss this with your rheumatologist and physiotherapist so you can get a specific program best suited to you. Some of the key things are education on axial SpA, advice on self-management, exercise and careful monitoring of your medicines and condition by your rheumatologist.
--How long until I feel better?
There are different types of axial SpA, and some are more severe than others. Of those people who display initial symptoms of SpA, only around five per cent progress to the more severe type. While SpA is typically a long-term form of arthritis that requires ongoing management, some people recover spontaneously. It may help you to know that some people with axial SpA have represented their country in sport.
