What is the treatment for non-radiographic spondylar arthritis?

Question

Hi doctor,

I am a 49-year-old male. I have not taken any medication in the past years. However, a few months back, I was having severe pain in my back, buttock region, and in my neck too. My back felt stiff and I could not do anything properly. I got this checked and my doctor said that I have non-radiographic spondyloarthritis. It was so devastating to hear that. I started taking pain relievers for it and I am still under medications. I wanted to know whether there is any permanent cure for this. Is there any advanced treatment? What else can I do to reduce and control my pain? How to live a normal life with arthritis? Kindly suggest ways.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

Non-radiographic axial spondyloarthritis (nr-axSpA) can indeed be challenging to diagnose, especially since early signs may not show up on standard X-rays. Investigations beneficial in this condition include:

1. MRI (magnetic resonance imaging) is one of the best methods to detect early inflammation and changes in the spine and affected joints. It has the potential to identify early signs of inflammation.

2. An X-ray shall be used to identify structural changes in the bone, but they may not show early signs of inflammation. Changes typically become visible only in the later stages of the disease. However it is essential to take an X-ray since it can still help rule out other conditions or assess the extent of existing damage.

3. CT (computed tomography) scans are usually not very useful for early diagnosis of nr-axSpA compared to MRI.

Other important points for aiding in diagnosis:

Clinical Assessment: A thorough clinical evaluation is essential, including a detailed history of your symptoms, physical examination, and assessment of mobility.
Laboratory Tests: Blood tests can help identify markers associated with spondyloarthritis.

Treatment options:

1. Medication Adjustments: If painkillers are not providing relief, you may need:

Biologics: Biologics are targeted therapies that can help reduce inflammation and disease activity. Many patients experience significant relief from pain and improvement in mobility with biologics. They can also help reduce morning stiffness.

2. Physical Therapy: A tailored exercise program can improve flexibility, reduce stiffness, and strengthen muscles around your joints.

3. Lifestyle Changes:

Exercise: Regular low-impact activities (like swimming or cycling) can improve mobility and reduce symptoms.
Posture: Maintaining good posture can help alleviate back pain.

Alternative medications:

Disease-Modifying Anti-Rheumatic Drugs (DMARDs): Sometimes, DMARDs can be helpful for pain control.
Corticosteroids: Short courses may be considered for flare-ups, but they are generally not used long-term.

Currently, there is no cure for this disease, but effective management strategies can significantly improve quality of life and control symptoms.

Living a normal life:

Mind-Body Techniques: Practices like yoga or meditation can help manage stress and improve mental well-being.
Support Groups: Connecting with others who have similar experiences can provide emotional support and practical tips.
Regular Check-ins: Have a regular checkup with your healthcare provider to monitor your condition and adjust treatments as needed.

You are not alone in this, and there are ways to improve your situation.

I hope this information will help you.

Thanks.