00:00:00:00 - 00:00:31:09
Dr. Norton
Hello. My name is Dr. Norton and I'd like to discuss axial spondyloarthritis, also known as axSpA. axSpA is a chronic inflammatory condition consisting of two subtypes. Nonradiographic axial spondyloarthritis, known as nr-axSpA and ankylosing spondylitis known as AS. They have shared symptoms. I will review those symptoms along with tools for diagnosis. I will also describe conversations I have with my patients about treatment.

00:00:31:11 - 00:00:56:13
Dr. Norton
Sometimes patients have questions and concerns about medications. Healthcare providers will help their patients weigh the potential risks and benefits of treatment options when determining the best course of treatment. The main symptom of axSpA is inflammatory back pain. This pain is very different from mechanical back pain, which is caused by a strain or injury or degenerative arthritis. With inflammatory back pain,

00:00:56:13 - 00:01:23:20
Dr. Norton
people often struggle with pain and stiffness in the morning and then feel better throughout the day after they've been more active. Other common symptoms of axSpA are fatigue and alternating buttock and hip pain. Tools that doctors use to measure axSpA disease activity are the BASDAI, which stands for the Bath Ankylosing Spondylitis Disease Activity Index, or the BASMI, which is the Bath Ankylosing Spondylitis Metrology Index.

00:01:24:00 - 00:01:50:15
Dr. Norton
Both of these are assessments that help measure axSpA disease activity and how it's impacting someone's daily life. Many doctors, like myself, will use the BASDAI questionnaire as well as a physical exam to assess patients. There are additional criteria that we talk about, like family history of conditions like psoriasis, peripheral arthritis, inflammatory bowel disease and uveitis, which is inflammation of the eye.

00:01:50:20 - 00:02:14:03
Dr. Norton
Beyond that, during our appointments, we talk about symptoms such as pain and how they are functioning in daily life, whether they're losing range of motion or being woken up in their early morning due to pain. I suggest to my patients to keep a journal of symptoms to see if anything specific might contribute to periods of heightened axSpA symptoms, also called flares.

00:02:14:05 - 00:02:42:21
Dr. Norton
For many people, stress is a culprit. If my patients can identify what their potential triggers are, then we can start to address them in a constructive manner. Pain early in the disease usually responds well to NSAIDs, nonsteroidal anti-inflammatory drugs, which are pain relief medications. As the disease progresses, NSAIDs tend to work less, so doctors will ask about their effectiveness during appointments and start to consider other pain management options.

00:02:42:23 - 00:03:10:16
Dr. Norton
If axSpA isn't treated, it will continue to progress and potentially cause joint damage or spine damage that is irreversible. So if we can treat patients early on, before that has happened and if they can stay on treatment, we know that they have a better chance of managing their pain, experiencing fewer flares, and slowing disease progression. I tell my patients to think of treatment as a tool in their toolbox that helps them stay active and healthy.

00:03:10:18 - 00:03:29:13
Dr. Norton
It can also help to have a positive outlook when approaching a treatment plan, since one's outlook can affect their experience. These days, treatment can help people with axSpA lead a healthy, active life so that this disease is not at the forefront of their lives.