How to manage non-radiographic spondyloarthritis?

Question

Hello doctor,

I am 55 years old. I recently received my scan results, and my doctor informed me that I have non-radiographic spondyloarthritis. I have been experiencing significant back stiffness and pain lately, and this pain is severely impacting my daily life, which has become so severe that I had to quit my job, as I can no longer manage the travel involved.

Is this different from the more common types of arthritis?
Can you explain the difference between non-radiographic spondyloarthritis and other forms of arthritis?
Is it likely to worsen over time?
Most importantly, what can I do to manage this pain and improve my quality of life?

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Non-radiographic spondyloarthritis (nr-axSpA) is a form of inflammatory arthritis that primarily affects the spine and sacroiliac joints, similar to ankylosing spondylitis, but without the characteristic changes seen on X-rays. Here is a breakdown of your concerns:

Differences from other types of arthritis:

1. Radiographic vs. non-radiographic: Radiographic spondyloarthritis (like ankylosing spondylitis) shows visible damage on X-rays, while non-radiographic spondyloarthritis does not. However, both can present with similar symptoms.

2. Symptoms: Both types can cause back pain, stiffness (especially in the morning or after periods of inactivity), and fatigue. The symptoms can fluctuate in intensity.

3. Progression: While nr-axSpA can lead to chronic pain and disability, not everyone will experience severe progression. The course of the disease can vary significantly from person to person.

Management strategies

1. Medications:

Nonsteroidal anti-inflammatory drugs (NSAIDs): These can help reduce inflammation and pain. If over-the-counter NSAIDs are not effective, your doctor may prescribe stronger options.
Disease-modifying antirheumatic drugs (DMARDs): Medications like Sulfasalazine can be effective, especially if peripheral joints are also involved.
Biologics: If symptoms are severe or persistent, biologic agents (like TNF inhibitors) may be considered.

2. Physical therapy: A physical therapist can develop a personalized exercise program focusing on stretching, strengthening, and maintaining mobility. Regular exercise can help reduce stiffness and improve function.

3. Exercise: Engage in low-impact aerobic activities, such as swimming or cycling, along with flexibility and stretching exercises. Yoga and pilates can also be beneficial for flexibility and strength.

4. Lifestyle modifications:

Posture and ergonomics: Pay attention to your posture, especially if you are sitting for long periods. Consider ergonomic furniture and supportive seating.
Weight management: Maintaining a healthy weight can reduce strain on your joints.

5. Pain management techniques: Consider complementary approaches like heat/cold therapy, acupuncture, or mindfulness practices to help manage pain.

Monitoring and follow-up

Regular check-ups: Keep up with regular appointments to monitor your condition and treatment efficacy. Discuss any changes in your symptoms or concerns about progression.
Patient education: Learn more about your condition, as understanding your health can empower you in managing symptoms and seeking appropriate care.

While non-radiographic spondyloarthritis can be challenging, effective management strategies are available. Collaborate closely with your healthcare provider to tailor a treatment plan that addresses your pain and helps you maintain daily function. With the right approach, you can work towards improving your quality of life.

I hope I have answered your query.

Let me know if I can assist you further.

Thank you.