by Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs are usually the first line of treatment for managing the symptoms of Axial Spondyloarthritis. These medications help reduce inflammation and pain by blocking cyclooxygenase (COX) enzymes. Common Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) prescribed for axSpA include ibuprofen, naproxen, and celecoxib. While NSAIDs provide effective relief for many patients, they may cause side effects like stomach irritation, ulcers, and kidney problems if taken long-term or in high doses. Regular use also increases the risk of cardiovascular issues. For these reasons, NSAIDs are generally limited to intermittent use as needed for flare-ups and not meant for continuous everyday treatment.
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
When NSAIDs are not enough to control symptoms, DMARDs may be added to the treatment plan. The primary DMARD used for axSpA is sulfasalazine. As a disease-modifying medication, sulfasalazine not only reduces pain and swelling but may also slow the progression of structural damage over the long run. Common side effects include nausea, vomiting, headache and rash. Close monitoring by a doctor is needed, as sulfasalazine can potentially harm the liver or cause other rare but serious reactions in some people. For patients who do not respond well or cannot tolerate sulfasalazine, other DMARDs occasionally prescribed include methotrexate, leflunomide or hydroxychloroquine.
Biologic DMARDs
For cases of axSpA that are particularly active and do not fully respond to NSAIDs and traditional DMARDs, biologic DMARD injections or infusions may provide better disease control. Biologics selectively target specific components of the immune system that drive axSpA inflammation, such as tumor necrosis factor (TNF). The TNF inhibitors most commonly used for axSpA are etanercept, adalimumab, infliximab, golimumab and certolizumab pegol. While generally well-tolerated, biologics carry potential risks like infections, allergic reactions, and rarely autoimmune issues, so ongoing safety monitoring by a doctor is essential. Biologics are also very expensive, requiring prior insurance approval in many cases. For most patients, biologics lead to fewer symptoms and less spinal inflammation over time based on MRIs or X-rays.
Physical Therapy and Exercise
Exercise and physical therapy play a key role in Axial Spondyloarthritis (axSpA) Treatment. Gentle stretching and strengthening exercises help maintain mobility and function by fighting stiffness. Low-impact activities like walking, swimming, and yoga are recommended, while high-impact exercises that pound joints heavily are not. Physical therapists can create customized exercise plans tailored to each patient’s abilities, symptoms, and goals. Heat packs, cold packs, massage and hydrotherapy may also relieve pain and loosen muscles. Regular exercise has psychological benefits too, raising mood and countering stress which can aggravate symptoms. Finding enjoyable physical activities that fit into a daily routine is important for long-term self-management.
Surgery
For some people with advanced axSpA that does not improve with medications, surgery may be required to repair orthopedic damage or restore mobility. Common procedures include hip or knee replacement if those joints are severely affected. Spinal fusion surgery may be an option for individuals with chronic back pain and deformity. This aims to stabilize problematic vertebrae using bone grafts and metal implants. However, surgery carries surgical risks and is generally a last resort treatment. It is most successful when combined with medication management and preventative measures like exercise and posture modification techniques. Ongoing physiotherapy after surgery is crucial for recovery and preventing further issues.
Complementary and Alternative Therapies
While conventional medical treatments provide the mainstay of axSpA management, complementary and alternative therapies can serve as helpful adjuncts for some patients. Mind-body practices like yoga, tai chi, meditation and deep breathing help alleviate stress, improve sleep, and increase physical flexibility. Acupuncture may temporarily relieve localized joint and muscle soreness through manual stimulation of pressure points. Supplements with alleged anti-inflammatory properties including turmeric, ginger, omega-3 fatty acids and SAMe have not been definitively proven effective for axSpA in scientific studies but require less medical oversight than prescription medications. Chiropractic spine manipulation and massage could potentially ease stiffness or discomfort in limited areas for those who find it relieving. As always, consult a doctor before starting any new complementary therapies.
Psychosocial Support
Ongoing psychosocial support is essential for living well with the challenges of axSpA. Group support networks with others experiencing similar issues provide empathy, encouragement and strategies for coping. Individual or family counseling may assist in adjusting to changed levels of functioning or disability and minimize stress levels. It is natural to experience sadness, fear or anger about diagnosis, symptoms, or side effects impacting quality of life at various times. Speaking to a mental health professional confidentially can help processes difficult emotions. Peer-led online forums complement in-person support by offering an outlet any time. Maintaining social connections and meaningful activities as tolerated helps counter depression or social isolation which tends to exacerbate physical symptoms over time. A multidisciplinary treatment approach addressing mind and body yields optimal axSpA management outcomes.
The variety of Axial Spondyloarthritis (axSpA) Treatment options reviewed in this article demonstrates the multifaceted nature of effectively managing axial spondyloarthritis long-term for most patients. While there is no cure available currently, combination therapies customized to disease severity and individual needs can significantly reduce inflammation, preserve mobility, lessen pain and improve overall functioning and quality of life for many living with this chronic rheumatic condition. Close cooperation between healthcare providers, adherence to prescribed care, and proactive patient self-care measures all play important roles in achieving optimal outcomes. Ongoing research continues working towards better therapies that may modify disease progression or one day possibly halt it for good.
*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
Money Singh is a seasoned content writer with over four years of experience in the market research sector. Her expertise spans various industries, including food and beverages, biotechnology, chemical and materials, defense and aerospace, consumer goods, etc.
