Early Identification of Axial Spondyloarthritis
If you’ve been struggling with ongoing back pain—especially if it started young, sticks around for months, or feels worse in the morning—it might be time to think beyond a simple sprain or posture issue. One possible cause that many people (and even some healthcare providers) overlook is axial spondyloarthritis, or axSpA—a type of inflammatory arthritis that affects the spine and pelvis. In this blog, we’ll break down what axSpA is, how it’s different from everyday back pain, and why physiotherapists are often the first to spot it.
What Is Axial Spondyloarthritis (axSpA)?
AxSpA is a chronic condition where the body’s immune system causes inflammation in the spine and sacroiliac joints (where your spine meets your pelvis). Over time, this can lead to pain, stiffness, and reduced mobility.
It often starts in young adults, usually under 45, and can take years to get properly diagnosed. That’s because the symptoms can look a lot like common back pain.
There are two main types:
Radiographic axSpA (also known as ankylosing spondylitis) – changes show up clearly on an x-ray.
Non-radiographic axSpA – symptoms are there, but imaging may not show much early on.
How Is axSpA Different from Regular Back Pain?
Here’s how inflammatory back pain (like axSpA) often behaves:
✅ Starts before age 45
✅ Lasts more than 3 months
✅ Worse in the morning or after rest
✅ Improves with movement or exercise
✅ May cause waking during the second half of the night
✅ Not linked to injury
✅ May come with other symptoms like sore eyes (uveitis), gut issues (IBD), or skin rashes (psoriasis)
If any of this sounds familiar, it’s worth a closer look.
Why See a Physio First?
Physiotherapists are often the first professionals people turn to when their back pain won’t go away. That puts us in a key position to spot the signs early.
We can:
Take a detailed history to understand your symptoms better
Ask specific questions that help rule out mechanical vs inflammatory causes
Refer you to your GP or a rheumatologist if axSpA is suspected
Design a gentle, effective movement plan to support your mobility and reduce stiffness
Even if you’ve already seen other healthcare providers, a physio with experience in spotting axSpA can help push the process forward.
How Is It Treated?
If you’re diagnosed with axSpA, treatment usually includes:
Medication, like anti-inflammatories or biologics, prescribed by a specialist
Exercise therapy, led by a physio, to help keep your spine mobile, your posture strong, and your daily life active
While exercise won’t stop the disease, it’s one of the best tools to stay in control of your symptoms and independence.
When Should You Get Checked?
If you’ve had back pain for longer than 3 months and especially if:
It started before age 45
It improves with exercise, not rest
You have morning stiffness or night pain
You’ve had eye inflammation, gut problems, or psoriasis
…it’s worth speaking to a physio or GP who understands axSpA.
Final Thoughts
Axial spondyloarthritis is often missed or mistaken for “just back pain.” But early identification and the right care can make a big difference. If your back pain isn’t behaving like typical strains or sprains, don’t ignore it—talk to a physiotherapist who knows what to look for.
If you have any questions on whether physio is the best option for you, or you have any questions about MVMNT in general, feel free to contact via email.
- Jay Towolawi, Specialist Sports Physiotherapist and MVMNT Founder.