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Finding the Right Treatment for Axial Spondyloarthritis

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7 Tips for Relieving Pain From Axial Spondyloarthritis

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Evelyn Creekmore on January 7, 2022
  • man-with-back-pain-sitting-up-in-bed
    Managing axial spondyloarthritis pain: You’ve got options.
    At least 2.7 million adults in the United States are living with axial spondyloarthritis, or axSpA. The chronic condition causes painful inflammation in the neck, back, pelvis, or other parts of the body and makes moving more difficult. Men are more likely to have axSpA than women, and symptoms usually begin before age 30. Managing the pain of axial spondyloarthritis usually requires more than medication. Learn why exercise is key and what scientists are discovering about alternative therapies so you can find some relief.
  • physical therapist with shoulder patient and theraband
    1. Try physical therapy.
    Physical therapy for axSpA involves stretching, massage, and exercises guided by a trained physical therapist. The goal of physical therapy, as with many treatments for axSpA, is not only to reduce pain, but also to improve quality of life and productivity at work. While massage can also be a part of chiropractic treatment, doctors usually discourage people with axSpA from seeing a chiropractor for spinal manipulation, since it has a higher risk of spinal injury and fractures for those with axSpA.
  • Ready for anything
    2. Commit to regular exercise.
    Exercise is key to an axSpA treatment plan, even if the plan also includes medication. An axSpA exercise program is personalized to the individual and typically includes specific exercises to strengthen muscles, improve mobility, increase flexibility, and reduce stiffness. The program is usually modified over time, increasing in intensity when symptoms are better and decreasing in intensity when symptoms are worse. Some studies show that group exercise programs, led by a qualified expert, get even better results than exercising alone.
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  • group-of-people-exercising-in-water
    3. Look into hydrotherapy.
    Hydrotherapy to treat axSpA adds the element of water to stretching and exercising to make movement easier and more comfortable. When you move in a pool, your body is lighter. In water just waist deep, you weigh about half what you do on land. Water also provides natural shock absorption for your joints. Hydrotherapy pools are typically warmer than swimming pools, which loosens your muscles and helps you relax. Ask your doctor about hydrotherapy facilities in your area. 
  • Acupuncture
    4. Give acupuncture a try.
    Studies have shown that traditional Chinese acupuncture can relieve axSpA pain, and numerous research efforts are ongoing. You may even be eligible for a clinical trial. Acupuncture involves inserting thin needles into specific areas of the body to release endorphin hormones that make you feel good and “override” pain. Before you begin acupuncture, get your doctor’s opinion. If it’s a go, make sure you receive treatment from a trained expert who uses sanitary needles.
  • woman-receiving-TENS-treatment-on-neck
    5. Explore electric stimulation.
    Like hydrotherapy and acupuncture, transcutaneous electrical nerve stimulation (TENS) is considered a complementary, or alternative, therapy in managing axial spondyloarthritis pain. TENS therapy involves sending a low voltage of electricity through the skin to the nerves. The electricity prevents the nerves’ pain messages from reaching the brain, eliminating pain temporarily. Normally, TENS therapy takes place at home. A member of your healthcare team will likely give you a small machine with electrodes and show you how to use it.
  • African American male pharmacist talking to African American male customer about prescription
    6. Turn to prescription medications.
    Effective prescription medications are available to help manage the pain of axSpA. Doctors typically first recommend a type of medication called nonsteroidal anti-inflammatory drugs, or NSAIDs. This class of medication achieves relief from back pain for 60% of those who take it for axSpA. If the desired level of relief isn’t achieved, corticosteroid injections or biologic medications that reduce inflammation or boost immune system strength at the cellular level may be suggested.
  • Surgeons
    7. Look to surgery.
    With so many non-surgical options available to relieve axial spondyloarthritis pain, surgery isn’t usually needed—or recommended. However, your doctor may explore surgery if your level of pain remains severe despite different treatment approaches, or if joint damage is so extreme that you need a joint replacement. The earlier you seek treatment for your axSpA pain, and the more closely you follow your treatment plan, the less likely it is that invasive measures will be necessary in the future.
Managing Axial Spondyloarthritis Pain | Axial Spondyloarthritis
  1. Living with Spondylitis. Spondylitis Association of America.
  2. Neuropathic Pain in Axial Spondyloarthritis. Spondylitis Association of America.
  3. Ankylosing Spondylitis. John Hopkins Arthritis Center.
  4. Spondyloarthritis in over 16s: diagnosis and management. National Institute for Health and Care Excellence.
  5. Living well with axial SpA (AS). National Axial Spondyloarthritis Society.
  6. Hydrotherapy. National Axial Spondyloarthritis Society.
  7. Complementary Treatments. Spondylitis Association of America.
  8. Transcutaneous Electrical Nerve Stimulation (TENS). Cleveland Clinic.
  9. Non-Medicinal Approaches To Treating Spondyloarthritis. Spondylitis Association of America.
  10. Axial spondyloarthritis: is there a treatment of choice? US National Library of Medicine National Institutes of Health.
  11. Pharmacological management of axial spondyloarthritis in adults. US National Library of Medicine National Institutes of Health.
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Last Review Date: 2022 Jan 7
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