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The pain arose when Paige Cerulli was in high school.
Gym class started with sit-ups and push-ups.
Kate Dehler
As Cerulli grew older, things got so bad that she feared walking too far from home.
I was afraid Id be in too much pain to get back, she says.
And sleeping was almost impossible.
Still, physicians continued to dismiss Cerulli, which made her question herself.
But at the same time, she could remember a time when she didnt live in pain.
I suspected there was something significantly wrong with me.
I wondered if I had some sort of spinal deformity, she recalls.
This mouthful of a condition is a chronic bang out of arthritis that causes spine inflamation.
Patients like Cerulli will often have symptoms like debilitating back pain and stiffness that worsen with rest.
Read on to learn the symptoms of the condition, how its diagnosed, and the most common treatments.
What is axial spondyloarthritis?
Axial spondyloarthritis is a pop in of arthritis sparked by chronic inflammation.
This causes the bones in the spine to start fusing.
There are two types of axial spondyloarthritis:
Not every case of nr-axSpA progresses to AS.
There are two main symptoms of axial spondyloarthritisand a few associated health issues.
Though axial spondyloarthritis doesnt have many symptoms, the main ones can significantly impact peoples lives.
The condition can also cause other health issues like eye and stomach pain.
People with axial spondyloarthritis typically notice their back pain before their 45th birthday.
Its a peculiar pattern of back pain that we call inflammatory back pain, Dr. Magrey says.
Additionally, unlike mechanical back pain, which usually comes on with activity, this comes on with rest.
On top of this, people with the condition may notice that their spin feels stiff.
Combined with the pain, it can limit their mobility.
This isnt just being tired.
Its unclear exactly why this pervasive fatigue occurs.
Then theres the fact that sleep is anything but easy when youre stiff and in pain.
Lack of sleep then exacerbates pain, creating a vicious cycle.
Up to one third of people with axial spondyloarthritis will develop uveitis, or eye inflammation.
These people often report eye pain, red eyes, blurry vision, and sensitivity to light.
This is another issue that scientists havent yet figured out.
Steroid eye drops may help ease the inflammation and symptoms.
As if back pain isnt bad enough, axial spondyloarthritis also commonly causes inflammatory bowel disease (IBD).
Treatment for IBD usually calls for medication, though some people require surgery.
Whats unclear is which occurs first and exactly why these conditions overlap, though both are inflammatory.
Inflammation and stiffness in the upper spine and rib cage may lead to chest discomfort and shortness of breath.
Axial spondyloarthritis may also lead to impaired lung function, even if you dont have any symptoms.
Diagnosing axial spondyloarthritis is a process.
People deal with axial spondyloarthritis for a long timeon average 13 yearsbefore receiving an accurate diagnosis.
A lot of people ignore it in the beginning, Dr. Magrey says.
They think its routine back pain and that over-the-counter painkillers or exercise can help.
Additionally, providers may not be aware of the condition, which can lead to misdiagnosis.
To make matters worse, no one test can diagnose axial spondyloarthritis.
They may also move your joints through various movements to check your mobility.
All of these are associated with axial spondyloarthritis.
Blood tests:Doctors may check your level of something called C reactive protein, or CRP.
This marker of inflammation is often elevated in people with AS.
They may also test for the HLA-B27 gene.
Between 80 and 95% of people with AS have this marker.
However, its less common among people with nr-axSpA, especially among women.
However, an X-ray may not detect subtler signs of the disease.
Treatment for axial spondyloarthritis is often progressive.
Physical therapy is often a big part of AxSpA treatment, as are pain medications.
If one drug doesnt work, your provider will likely prescribe a more potent pain reliever.
The focus is on strengthening and stretching the back, Dr. Magrey says.
But most patients need prescription anti-inflammatory options to feel a difference.
As the name implies, these injections block TNFs, which are proteins that cause inflammation.
IL-17 is a cytokine, or protein, that cause inflammation.
IL-17 inhibitors like secukinumab are typically only prescribed if NSAIDs and TNFis dont help.
Like TNFis, IL-17 inhibitors have been shown to decrease pain while improving mobility and quality of life.
JAKs are enzymes that regulate cytokine signaling, soyou guessed itthey play a role in inflammation.
Lifestyle changes can also help.
Although medication and PT are the main treatments for axial spondyloarthritis, dont discount your everyday habits.
Along with physical therapy, staying active is key to managing axial spondyloarthritis.
Find what feels good for you and what you could stick with.
You will never get better if you keep smoking, Dr. Magrey says.
Its a risk factor for disease progression.
Theres little research on diet and axial spondyloarthritis.
Overall, being aware of axial spondyloarthritis may help you avoid the pain and frustration that Cerulli faced.
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