Treatments for Axial Spondyloarthritis
Managing axial spondyloarthritis (axSpA) — encompassing both non-radiographic axSpA (nr-axSpA) and ankylosing spondylitis (AS) — is focused on:
Easing pain and stiffness.
Preventing any structural changes.
Assisting you in maintaining your regular activities.
Disease management integrates medications, physical therapy, exercise, and adopting a wholesome lifestyle. Various treatments are available, including medications, physical activities, and other beneficial lifestyle habits, with surgery as an option when needed. It's essential to collaborate with your physician to tailor the most effective treatment strategy for you.
Medications
For many individuals with axSpA, medications play a pivotal role in their treatment journey. Let's explore some common options:
NSAIDs: Often the starting point for axSpA treatment, these drugs can be prescribed in higher doses to manage inflammation effectively.
Sulfasalazine: Although DMARDs aren't typically recommended for spinal-only issues, Sulfasalazine can be a choice when other joints are impacted and NSAIDs aren't providing sufficient relief.
Biologics: If you find that your condition is particularly aggressive or NSAIDs aren't effective, biologics might be introduced. The most effective type for axSpA is the TNF inhibitor. If there's no response to an anti-TNF drug, your doctor might explore biologics that block IL-17. Currently, several biologics like Humira, Cimzia, Enbrel, Simponi, Remicade, Taltz, and Cosentyx have been green-lighted for use in AS. Of these, Cimzia, Taltz, and Cosentyx have received FDA approval for nr-axSpA treatment.
Analgesics: If NSAIDs aren't suitable for you, acetaminophen can be a helpful alternative for pain relief, though it doesn't combat inflammation.
Glucocorticoids: Direct injections into areas like the knees or shoulders can offer rapid relief. However, they're rarely used for the spine and aren't consumed orally for axSpA.
NSAIDs: Often the starting point for axSpA treatment, these drugs can be prescribed in higher doses to manage inflammation effectively.
Sulfasalazine: Although DMARDs aren't typically recommended for spinal-only issues, Sulfasalazine can be a choice when other joints are impacted and NSAIDs aren't providing sufficient relief.
Biologics: If you find that your condition is particularly aggressive or NSAIDs aren't effective, biologics might be introduced. The most effective type for axSpA is the TNF inhibitor. If there's no response to an anti-TNF drug, your doctor might explore biologics that block IL-17. Currently, several biologics like Humira, Cimzia, Enbrel, Simponi, Remicade, Taltz, and Cosentyx have been green-lighted for use in AS. Of these, Cimzia, Taltz, and Cosentyx have received FDA approval for nr-axSpA treatment.
Analgesics: If NSAIDs aren't suitable for you, acetaminophen can be a helpful alternative for pain relief, though it doesn't combat inflammation.
Glucocorticoids: Direct injections into areas like the knees or shoulders can offer rapid relief. However, they're rarely used for the spine and aren't consumed orally for axSpA.
It's important to remember that all medications have potential risks and side effects. Engage in a conversation with your doctor to fully understand the implications of any prescribed medication.
Physical Therapy and Exercise
Engaging in regular physical activity plays a key role in your overall wellness journey. The aim is to maintain flexibility in your neck and back. It's highly beneficial to collaborate with a skilled physical therapist, particularly if you have concerns related to your spine. Such a therapist can craft a tailored strength and mobility regimen for you, guiding you on movements that optimize your health without causing any harm.
Incorporating exercises that fortify your back and neck, and promote flexibility, can enhance or uphold your posture. Embrace deep breathing routines and aerobic exercises to ensure your chest and rib cage remain agile. Swimming is an excellent choice, as it nurtures strength and flexibility in vital areas like your spine, neck, shoulders, and hips. However, if swimming isn't accessible, focusing on strength, flexibility, and cardiovascular workouts is the way to go.
For a smoother workout experience, consider a warm bath or shower to relax your joints and muscles. Remember to start gently, opting for times when you feel most energetic and comfortable. And if you have any heart or lung concerns, it's always a good idea to consult with your doctor before beginning any exercise.
Living With AxSpA
Empower Your Health Journey
In conjunction with physical therapy and medications, you possess the tools to actively enhance your health and overall well-being.
Take the Lead
Engage actively in your healing process.
Learn to manage your health efficiently.
Assemble a supportive healthcare team.
Monitor symptoms, medications, and any changes in your well-being.
Schedule regular health check-ups and keep up with vaccinations.
Always engage in open dialogue with your healthcare team.
Prioritize Correct Posture
Whether resting, sitting, or standing, ensure you have the right posture to safeguard your joints.
Opt for a quality mattress and consider sleeping on your back. When doing so, using a slim pillow or none at all can be beneficial.
Aim for a straight-back posture during walking or sitting.
It's best to avoid corsets and braces in managing AS.
Prioritize Clean Lungs Cease smoking, as it can exacerbate lung complications associated with axSpA and can hinder the efficacy of medications.
Embrace Useful Tools
Should mobility be a challenge, there are tools to simplify daily activities. An occupational therapist is a great resource for advice on these aids.
Nurture Your Mental Well-being
Living with a chronic ailment can be challenging emotionally. Yet, there are ways to handle these feelings, uplift your spirit, and find peace.
Connect with Your Loved One
Physical limitations might affect intimacy, but through open communication and understanding, both partners can find ways to adapt and maintain a strong bond.
Optimize Your Workspace
Most individuals with axSpA continue to lead active work lives. Whether your job is indoors or outdoors, consider
Avoiding extended periods of lifting or stooping.
Elevating your computer screen to maintain good posture.
Regularly shifting positions and taking brief walks.
Using supportive cushions while seated.
Incorporating short rest intervals in your day.
Nutrition Matters
While there's no designated diet for AS, consuming plenty of vegetables, fruits, fish, and beneficial fats, like olive oil, complements a healthy lifestyle.
Alleviate Pain and Fatigue
Apart from prescribed treatments, consider:
Pacing your activities and seeking assistance when required.
Employing hot and cold treatments for relief.
Practicing relaxation techniques like deep breathing.
Consider massages to alleviate pain and stress.
Trying topical pain relievers.
Exploring acupuncture as a potential pain relief method.
Surgery
While we always strive for non-surgical options, there are times when joint surgery might be the best path to enhance your mobility. Many individuals with axSpA have experienced positive outcomes from hip and knee replacements. If your spine has significant forward bending, a surgical procedure could offer a solution. However, due to the intricate nature of this surgery, it's performed in select medical centers.
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