Axial Spondyloarthritis (Ankylosing Spondylitis)

Specialised and dedicated AS clinics may result in better outcome. Treatment of AS is focused on alleviating symptoms and managing the progression of the condition, to regain and maintain the mobility of the spine and reduce of inflammation in the joints, digits and tendons of the upper and lower limbs.

Although most medications prescribed treat only the symptoms of AS, there is evidence that NSAIDs (non-steroidal anti-inflammatory drugs) may reduce the rate of disease progression in the spine NSAIDs are also important to reduce inflammation, pain and stiffness of the digits, joints and tendons in your upper and lower limbs. Other

pain relieving drugs may also be used.

Depending on the joints involved and the severity of the condition, steroids and DMARDs (disease-modifying

anti-rheumatic drugs) may be prescribed to reduce the inflammation of your joints. In patients who respond poorly to NSAIDs and DMARDs, you may be considered for biologic therapy.

The current approved biologic therapy for AS includes the TNF alpha blockers. They are very effective in treating both the spinal and peripheral joint symptoms of SpA. These drugs are injected subcutaneously (under the skin) or may require infusion in the hospital at regular intervals.

However, anti-TNF treatment is expensive and not without side effects, including an increased risk for serious infections, eg development of active tuberculosis in patients with latent TB. 

Your doctor will discuss the cost and weigh the benefits and risks with you when considering treatment with biologic therapies.

Exercise, including stretching, helps reduce stiffness of the spine and limbs.

Generally, swimming is recommended for all forms of arthritis. Other physical therapies must be recommended and approved by a rheumatologist in consultation with a physiotherapist. In order to be effective, all exercises need to be done regularly and on a long term basis.