Ankylosing Spondylitis (AS) is a condition that causes lower back pain and stiffness, and over time leads to permanent fusion in the joints of the lower back. AxSpA is shorthand for Axial Spondyloarthritis, which is a similar condition. There is debate as to whether they are variations of the same condition, but they certainly have a number of similarities.
Like rheumatoid arthritis, AxSpA and Ankylosing Spondylitis (AS) are inflammatory, autoimmune conditions. They have to be diagnosed by a rheumatologist, but blood tests can show signs, as can the symptoms you present to your GP or osteopath.
Symptoms of Ankylosing Spondylitis and AxSpA
Alongside the usual lower back pain, AS and AxSpA may also come with:
- Stiffness lasting over 30 minutes upon waking
- A personal or family history of related conditions, such as RA, ulcerative colitis, or Crohn’s disease
- Relief when using anti-inflammatory medications
- Heel pain
- Swollen fingers
- Inflammation in the eye
AxSpA can be mistaken for typical back pain. Unfortunately, this means it can be disregarded until the condition has progressed.
As mentioned above, AxSpA and AS are inflammatory conditions. During periods of inflammation, the joints in the lower back are attacked by the body’s immune system, causing pain and stiffness. These episodes subside, and the body tries to heal the damage. Unfortunately, the body heals over the joints, laying down excess bone and causing fusion over time.
The bone laid down incorrectly is not as strong as healthy bone, and is more prone to fracture. For this reason, it is not recommended to manipulate spinal joints of someone with AS or AxSpA.
Diagnosis and Management
Although your osteopath or GP can suspect AS or AxSpA, we can’t formally diagnose it. We can, however, support you in getting to a specialist who can. We can use screening tools and report our findings to your GP to encourage a referral to rheumatology.
When diagnosed formally, you may be offered stronger medications than can be prescribed normally. These disease modifying drugs (DMARDs) treat the root of the problem, limiting the process that leads to joint damage and fusion.
These drugs take a while to have an effect, so until you are comfortable, you may find osteopathy to help with your pain. It won’t stop the process of the disease, but short, gentle treatments may help to manage inflammation in the short term. We can also help devise and support your exercise plan. Gentle exercise is good for inflammatory conditions like these, but high intensity exercise is likely to cause a stronger reaction.
If your back pain is not being properly addressed, book in with one of our osteopaths.