Have Chronic Back Pain? You Could Be Dealing With Axial Spondyloarthritis

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We’ve all experienced back pain at some time or another. Sitting hunched over a laptop for an entire day will do it. So will moving big boxes, tossing a toddler over your shoulder at an odd angle or carrying a heavy purse on a long shopping day. These forms of back pain, which are all mechanical in nature, tend to come on fast and can be fixed with rest, stretching or the help of a physiotherapist or chiropractor.

But there’s another type of back pain that appears without any clear source of strain or injury—typically before age 45. It’s called axial spondyloarthritis and it can be debilitating. Here’s what you need to know about this inflammatory condition.

What is axial spondyloarthritis?

Axial spondyloarthritis exists under the more general umbrella of spondylarthritis (SpA), which refers to a group of immune-mediated diseases in which the immune system attacks healthy cells and tissues.

Axial spondyloarthritis (axSpA) more specifically, is a chronic, progressive form of inflammatory arthritis that can be incredibly painful and most commonly affects the lower spine and sacroiliac joints (where the spine and pelvis meet). Pain may also occur in the neck, hips and knees—especially in women.

Reader’s Digest conducted a Facebook Live with Dr. Élie Karam, Chair of the Board at the Canadian Spondyloarthritis Association, and Dr. Alexander Tsoukas, an assistant professor at McGill University and the Director of the Spondyloarthritis Centre at the McGill University Health Centre. In our informative chat, we took an inside look into Axial Spondyloarthritis – a specific form of arthritis that affects the back and sacroiliac joints. We also explored amazing support resources that are available to patients and their families. Check out the full discussion in the video above. This live chat was sponsored by a research-based biopharmaceutical company.

Types of axial spondyloarthritis

There are two types of axial spondyloarthritis:

• Radiographic: With radiographic axial spondyloarthritis, changes to the sacroiliac joints and/or spine are visible by X-ray. It’s also known as ankylosing spondylitis (AS).
• Non-radiographic: With non-radiographic axial spondyloarthritis, changes are not visible by X-ray. However, in 70 per cent of people with symptoms, changes to the sacroiliac joints and/or spine will be visible by MRI.

Symptoms of axial spondyloarthritis

If you experience these symptoms, it’s time to get a referral to a rheumatologist.

• Back or buttock pain that has a gradual onset over weeks or months
• Pain or stiffness in the early morning that wears off as you move
• Back pain that lasts for more than three months
• Pain relief after exercise; pain onset after rest
• Tiredness, fatigue and interrupted sleep
• Loss of appetite
• Weight loss
• Mild fever in the early stages
• Pain that is dull and persistent
• Pain that either starts in or spreads to the joints of the hands or feet
• Iritis (inflammation of the eye’s iris) or uveitis (inflammation of the eye’s uvea)

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Even if you don’t relate to all these symptoms, you should speak to your doctor if you are younger than 45 years old, have back pain that’s lasted more than three months and have stiffness in the morning that’s reduced with activity.

Related conditions

About 10 per cent of people with axial spondyloarthritis will also have Inflammatory Bowel Disease (ulcerative colitis or Crohn’s disease), while five to 10 per cent will have psoriasis.

Why early diagnosis matters

Typically, damage to the spine or sacroiliac joints won’t be visible by X-ray until seven or eight years after disease onset, once permanent damage has already occurred. However, MRIs can often detect changes sooner and early treatment can reduce the impact of axial spondyloarthritis. If you think you’re experiencing symptoms of axSpA, talk to your doctor ASAP.

Treatment and living well with AxSpA

A condition like axial spondyloarthritis may be challenging, but you deserve to live a full, meaningful life. Making a treatment plan with a rheumatologist is key, as is developing a lifestyle that involves physical activity, healthy food that works for your unique body and support groups that can introduce you to other people who understand what you’re going through.

To learn more about axial spondyloarthritis and take an axSpA quiz, visit the Canadian Spondyloarthritis Association at sparthritis.ca.