The First Medications for Axial Spondyloarthritis

Whether you have nonradiographic axial spondyloarthritis (nr-axSpA) or ankylosing spondylitis (AS), your treatment plan will aim to: 

• Reduce pain and stiffness.
• Prevent your back from locking in place.
• Help you continue normal activities.

Work closely with your doctor to come up with a care plan that’s right for you.

Treatment Options

Treatment for axSpA usually starts with nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy and exercise. As long as your disease isn’t too advanced, NSAIDs and regular movement are usually enough to keep things under control. 

NSAIDs. Medicines like naproxyn (Naprosyn) or indomethacin (Indocin), can relieve pain and inflammation. That makes it easier to get the exercise you need to keep your back mobile. 
All medicines have side-effects, including NSAIDs. Risk increases with higher doses and longer use. High doses are usually needed to control symptoms of axSpA. And these medicines work better if you take them every day instead of when your pain gets bad. Talk with your doctor about side effects and how you can lessen them. 

Pain relievers. Acetaminophen (Tylenol) may be used to reduce pain if you aren’t able to take NSAIDs. But it won’t stop inflammation.

Steroids (glucocorticoids). Sometimes joints other than in your spine can be affected by axSpA. If your knee, ankle or wrist swells or starts to hurt, your doctor may inject it with a steroid. This will ease the pain and swelling for a few weeks. Steroids are not injected in the spine or given by mouth for axSpA.

The Power of Movement

Posture training and daily exercise can have big benefits if you have axSpA. It can help to keep your spine from stiffening up and keep you standing up straight. 

Don’t worry if you haven’t exercised much. You’ll work with a physical therapist to design a program just for you. And if you’re an athlete, you often can continue to train and play. But contact sports may not be an option if you have severe axSpA.
Swimming is great for just about everyone. It increases flexibility in your spine, neck, shoulders and hips – all joints that can be affected by axSpA. And it can be a terrific workout for your heart and lungs.