How to manage non-radiographic spondyloarthritis?

Question

Hello doctor,

I am a 29-year-old woman recently diagnosed with non-radiographic spondylar arthritis after experiencing persistent lower back pain and stiffness for over a year, especially in the mornings. The symptoms started after a severe viral infection, which my doctor thinks might have triggered the condition. My human leukocyte antigen B27 (HLA-B27) test came back positive, and my c-reactive protein (CRP) is slightly elevated at 15 mg/L, though my X-rays showed no visible joint damage. A magnetic resonance imaging (MRI) of my sacroiliac joints revealed mild inflammation, confirming the diagnosis. I have been prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy, but the pain has not improved significantly, and my doctor is now considering starting biologics. I am worried about the side effects of biologics and whether they are necessary at this stage.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Based on the inputs given to me about your pain, I would like to suggest the following. These include:

Massage your butt properly with a tennis ball. While you sit on the tennis ball, exert comfortable pressure on the tennis ball, roll the ball, and concentrate on the areas of pain a bit. After rolling, apply ice for 15 mins. This can be done every two hours or at least three to four times a day.

Stretch your glute muscles while standing by placing your knee and leg on the dining table or a slightly high platform. While standing on the opposite leg, bend the leg as far as you can, then bend forward until you touch your knee to the shoulder. Do not roll. Hold this position for 30 seconds.

Do practice these exercises:

Cobra raises - six repetitions of three sets.
Bridging - 15 repetitions of three sets.
Clamshell - six repetitions of three sets.
Donkey kicks - 15 repetitions of three sets.
Reverse dead bugs - 15 repetitions on each side of three sets.

Post-exercise, do static stretches for

Gluteus.
Hamstrings.
Piriformis.

Low back cobra stretch: Each stretch is to be maintained for 30 seconds and done 3 to 5 times.

Biologics is another treatment option. Nothing to worry about this. I feel your issue will be resolved with these exercises.

Do revert to me in case you need any further information.

Thank you.