What is axial spondyloarthritis (axSpA)?

What are the symptoms of axial spondyloarthritis (AxSpa)?

Axial spondyloarthritis – Conversation Series

Why is exercise so important when living with axial spondyloarthritis (axSpA)?

What is ankylosing spondylitis (AS)?

What is Axial Spondyloarthritis (axSpA)?

Axial spondyloarthritis (axial SpA or axSpA) is an umbrella term for ankylosing spondylitis and non-radiographic axial spondyloarthritis.

The older term ankylosing spondylitis or AS, refers to people that have established spinal involvement. The ‘ankylosing’ part stands for fusions, meaning people have had symptoms for many, many years. Ankylosing spondylitis is an inflammatory form of arthritis where the main symptom is back pain and changes can be seen to the sacroiliac joints on x-rays.

For people in the first few years of their condition, there’s a phase before evidence becomes visible on x-rays but inflammation can be seen via MRI and other symptoms are present. This is known as non-radiographic axial spondyloarthritis. Using the term axial spondyloarthritis incorporates all phases of the condition.

Axial Spondyloarthritis is a form of inflammatory arthritis. It is a painful, chronic inflammatory disease, that primarily affects the spine and sacroiliac joints. However, feet, knees and ankles can also experience pain and stiffness, along with other symptoms such as sclerosis, inflammatory bowel problems and uveitis.


“If you have the sort of back pain that gets better with movement, gets worse with rest, that might go down into the buttocks, where the sacroiliac joints are; that sort of pain and that’s very different to more standard back pain, that’s what we call inflammatory back pain and that’s what we think as the cardinal symptom of people that have axial spondyloarthritis.” Dr Barry O’Shea, Consultant Rheumatologist from St. James’s Hospital


What are the symptoms of axial spondyloarthritis (AxSpa)?

  • Significant early morning stiffness where it can take up to ninety minutes to get going in the morning
  • Back pain that improves with activity
  • Back pain that gets worse with rest

These symptoms would indicate inflammatory back pain as opposed to standard back pain that many people will experience in their lives.


Axial Spondyloarthritis – Conversation Series

Below are videos from Dr Barry O’Shea, Consultant Rheumatologist in St. James’s Hospital, Dublin, and Breon White, Clinical Specialist Physiotherapist at the Mater Hospital, Dublin. 

Dr O’Shea has a special interest in axial spondyloarthritis, while Breon has been involved with an axial spondyloarthritis programme in the Mater Hospital for over fifteen years.

During these conversations, the medical consultants and specialists provide well researched answers to common questions asked by those diagnosed with axial spondyloarthritis.

Some of the questions answered include:

  • Is axial spondyloarthritis common?
  • What are the causes or risk factors of axial spondyloarthritis?
  • Is axial spondyloarthritis more common in men?
  • How is axial spondyloarthritis diagnosed?
  • Why can it take a long time to be diagnosed with axial spondyloarthritis?
  • How is axial spondyloarthritis treated?
  • How important is self-management of axial spondyloarthritis?
  • What are the benefits of physical activity in axial spondyloarthritis?
  • How to maintain or begin an exercise programme with axial spondyloarthritis?
  • Is diet important to manage axial spondyloarthritis?
  • What lifestyle changes will help manage axial spondyloarthritis?


Download video transcription

Why is exercise so important when living with axial spondyloarthritis (AxSpa)?

In TCD studies, patients with axial spondyloarthritis have a lower level of physical fitness compared to the non-axial spondyloarthritis population cohort. Specifically; reduced cardiovascular function, reduced flexibility, reduced strength, poor bone health and they were less physically active. Exercise is probably one of the most efficient ways of managing the condition, as huge improvements can be seen for axial spondyloarthritis patients with better cardiovascular health, better bone health, better muscle strength, better flexibility and improved chest expansion to breathe a bit easier.

Download video transcription


What is ankylosing spondylitis (AS)?

"Ankylosing" means fusing together and "spondylitis" means inflammation of the spine which causes stiffness, tenderness and discomfort. Although it mainly affects the spine, ankylosing spondylitis can also cause pain and/or swelling in the shoulders, hips, knees, heels, chest/ribs, and small joints of the hands and feet. Sometimes the eyes are also affected. In rare cases, the heart and lungs can be affected too.

The severity of ankylosing spondylitis symptoms varies greatly, but in severe cases, ankylosing spondylitis can seriously impact on everyday life and lead to disability.

Over time, ankylosing spondylitis can cause the spine to become rigid and curved, giving the person a "bent forward" posture. This is known as kyphosis. It's important to note that not everyone with ankylosing spondylitis will develop kyphosis.


Download our Living with ankylosing spondylitis booklet

For more information and support contact the Arthritis Ireland helpline on 0818 252 846 [email protected] or find your local branch for community activities


Supported by Novartis