Every day with Axial Spondyloarthritis raises a new question

What Is Axial Spondyloarthritis?

Axial spondyloarthritis (axSpA) is a long-term inflammatory form of arthritis that mainly affects the spine and the sacroiliac joints, which connect the lower spine to the pelvis. It can cause back pain, stiffness and fatigue.

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AxSpA includes ankylosing spondylitis and non-radiographic axial spondyloarthritis. Both forms can cause similar symptoms, even when changes are not visible on an X-ray.

What Causes Axial Spondyloarthritis?

The exact cause is not fully understood. Genetic factors play a role, and the condition is associated with a genetic marker called HLA-B27.

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Many people who carry HLA-B27 never develop the condition. People without this marker can also have axSpA, so it cannot be used on its own to confirm or exclude a diagnosis.

Living With Axial Spondyloarthritis

Back pain, stiffness and fatigue can affect everyday activities. Symptoms often develop gradually and may come and go, with periods when they improve or become more noticeable.

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Ongoing care usually includes exercise, physiotherapy and medication. Regular appointments with a rheumatology team help assess symptoms, monitor movement and review treatment.

Types of Axial Spondyloarthritis

Radiographic axial spondyloarthritis, also called ankylosing spondylitis, involves characteristic changes in the sacroiliac joints that are visible on an X-ray.

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Non-radiographic axial spondyloarthritis does not show these characteristic changes on an X-ray. An MRI may show inflammation, but diagnosis depends on the overall clinical assessment rather than imaging alone.

How Is Axial Spondyloarthritis Treated?

Treatment aims to relieve pain and inflammation and maintain movement and physical function. It usually combines regular exercise, physiotherapy and medication.

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Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used first. If symptoms remain active or these medicines are unsuitable, a rheumatologist may consider biologic medicines or targeted treatments such as JAK inhibitors. The choice depends on individual needs and response to treatment.

Exercise and Movement With Axial Spondyloarthritis

Regular movement is an important part of treatment. Exercise can help maintain spinal flexibility, improve posture and reduce stiffness.

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A physiotherapist can develop an exercise program suited to your needs and abilities. This may include stretching, strengthening and exercises in water. Your physiotherapist or rheumatologist can advise on suitable activities.

Who Is at Risk of Developing Axial Spondyloarthritis?

AxSpA often first develops in adolescence or early adulthood. A family history of the condition and carrying HLA-B27 can increase the likelihood of developing it.

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Having a risk factor does not mean someone will develop axSpA. Symptoms, examination findings, blood tests and imaging all contribute to the assessment.

What Are the Symptoms of Axial Spondyloarthritis?

Common symptoms include back or buttock pain, stiffness and fatigue. Pain often improves with movement and does not improve with rest. Symptoms may be worse in the morning or at night and can interrupt sleep.

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Other symptoms can include painful or swollen joints and inflammation where tendons or ligaments attach to bone, such as around the heel. Some people also have associated conditions, including uveitis, psoriasis or inflammatory bowel disease.

How Is Axial Spondyloarthritis Diagnosed?

A rheumatologist assesses symptoms, medical history and physical examination findings alongside blood tests and imaging. X-rays and MRI scans may be used to look for changes or inflammation in the sacroiliac joints and spine.

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There is no single definitive test. Normal blood tests or an X-ray without characteristic changes do not rule out axSpA. Testing for HLA-B27 can support the assessment but cannot confirm the diagnosis by itself.

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