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Axial spondyloarthritis

Spondylitis ankylosans (morbus Bechtěrev) · Axiální spondyloartritida (Bechtěrevova nemoc)

What it is

Inflammation of the spine and sacroiliac joints that can fuse them.

Symptoms & signs

  • Inflammatory back pain under 45
  • better with movement, worse with rest
  • night pain
  • morning stiffness
  • stooped posture late

🚩 Get help if…

  • call 112 / 911 now New neck or back pain after even a minor fall
  • call 112 / 911 now Numb groin or buttocks, or losing control of bladder or bowel
  • see a doctor soon Painful red eye with blurred vision or light sensitivity
  • see a doctor soon Fever, cough or night sweats on TNF inhibitors

Where it strikes

Medical treatment

  • NSAIDs continuously
  • TNF inhibitors
  • IL-17 inhibitors (secukinumab)
  • JAK inhibitors
  • physiotherapy is essential
  • Bimekizumab (IL-17A and F blocker) — approved (EMA 2023, FDA 2024)

Natural & lifestyle

  • Daily extension and mobility exercise
  • swimming
  • stop smoking
  • posture work
  • sleep on a firm mattress

Emerging & experimental

  • Early-disease treatment windows
  • MRI-based diagnosis

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Spa and radon therapy — trials show pain relief lasting months mixed evidence
  • Curcumin — small studies early / small studies
  • Low-starch diet (Klebsiella theory) — patients report benefit; untested anecdotal / traditional

ICD codes