Understanding Axial Spondyloarthritis: Symptoms, Causes, and Management
Axial Spondyloarthritis (AxSpA) is a chronic inflammatory disease that primarily affects the spine and the sacroiliac joints, which connect the lower spine to the pelvis. It is part of a broader group of conditions known as spondyloarthropathies. Unlike typical osteoarthritis, which involves wear and tear of the joints, AxSpA is driven by inflammation, leading to pain, stiffness, and, in some cases, progressive spinal fusion. The condition can significantly impact daily activities, mobility, and overall quality of life if left untreated.
The hallmark symptom of AxSpA is persistent back pain, especially in individuals under 45 years old. This pain often improves with physical activity but worsens during periods of rest or in the morning. Stiffness is another common symptom, frequently noticeable upon waking or after prolonged inactivity. Some individuals may also experience inflammation in other joints, such as the shoulders, hips, and knees, as well as peripheral manifestations like enthesitis—pain at sites where tendons or ligaments attach to bones. Eye inflammation (uveitis), fatigue, and, rarely, gastrointestinal issues may also be associated with the condition.
The exact cause of AxSpA is not fully understood, but genetics plays a significant role. A strong association exists with the HLA-B27 gene, though not all carriers develop the disease. Environmental factors, such as infections, may trigger the onset in genetically predisposed individuals. Early diagnosis is crucial to prevent irreversible structural damage and to maintain function. However, diagnosis can be challenging due to the gradual onset of symptoms and the overlap with other causes of back pain. Imaging techniques, including X-rays and MRI, alongside clinical assessment, are key tools in confirming AxSpA.