Non-radiographic axial Spondyloarthritis (nr-axSpA) is an autoimmune disease which causes arthritis in the spine and pelvis. While ‘non-radiographic axial Spondyloarthritis’ is a very complicated name, it can be understood as:
The symptoms of nr-axSpA usually begin between the ages of 15 and 40 years and are often very similar to the symptoms of a related form of arthritis, known as ankylosing spondylitis. Symptoms can vary from person to person, but commonly include:
The cause of the condition is not known. Unlike other types of back pain, nr-axSpA isn’t caused by particular jobs, activities or injuries. Doctors believe it is closely related to another form of inflammatory arthritis known as ankylosing spondylitis (AS). In fact, one or two out of every 10 patients diagnosed with nr-axSpA will progress to AS within a few years. Often, these individuals possess a gene called HLA-B27.
Many people in the early stages of nr-axSpA think they have common back pain and do not seek help. However, it is important to have nr-axSpA diagnosed as early as possible in order to allow for effective treatment. After initial assessment by a general practitioner, a rheumatologist will diagnose nr-axSpA based on an evaluation of your symptoms, a physical examination, blood tests (C-reactive protein [CRP], erythrocyte sedimentation rate [ESR] and/or HLA-B27) and imaging tests such as x-ray and MRI. X-rays however may not identify the joint damage.
With the right treatment, most people with nraxSpA can lead full and active lives. Many people find there are times when their symptoms worsen (known as a ‘flare’), and times when their symptoms get better. In most cases it can be well controlled with treatment and may even resolve over time. However, some people may have severe, long lasting pain. This used to be common but can now usually be prevented by starting proper treatment, as early as possible.
Currently there is no cure for nr-axSpA. However, treatment for the condition has improved dramatically, with new medicines that are extremely helpful in controlling the condition. Be wary of any products or therapies that claim to cure nr-axSpA.
Your rheumatologist will tailor your treatment to your symptoms and the severity of your condition. There is no way of predicting exactly which treatment will work best for you. Each treatment has its own benefits and risks. Treatment for nr-axSpA usually involves:
See a rheumatologist. A rheumatologist can diagnose nr-axSpA and make sure you get the right treatment. If you have the symptoms of nr-axSpA and have not seen a rheumatologist, ask your doctor about a referral. See the Working with your healthcare team information sheet.
Learn about nr-axSpA and play an active role in your treatment. Not all information you read or hear about is trustworthy so always talk to your doctor or healthcare team about treatments you are thinking about trying. Reliable sources of further information are also listed in the section below. Additionally, your local Arthritis Office can provide details for self-management courses.
Learn ways to manage pain. See our resources on dealing with pain.
Live a healthy life. Eat a healthy diet, stop smoking and reduce stress to help your overall health and wellbeing.
Stay active. It is important to do regular sports and activities for general fitness and wellbeing. See the physical activity resources or ask your physiotherapist for advice.
Acknowledge your feelings and seek support. As there is no cure for nr-axSpA and it can affect many parts of your life, it is natural to feel scared, frustrated, sad and sometimes angry. Be aware of these feelings and get help if they start affecting your daily life. See our resources on mental wellbeing.
Contact your local Arthritis Office for more information on arthritis.