Axial spondyloarthritis (axSpA) is a type of chronic inflammatory condition and refers to both radiographic (ankylosing spondylitis, AS) and non-radiographic (nr-axSpA) forms of the disease.
The spine and sacroiliac joints are typically affected in axSpA, hence causing lower back pain, stiffness and fatigue. It can also affect peripheral joints such as the hips, knees and ankles, resulting in problems with walking, getting out of bed, bending forward and performing other daily activities. There might also be other manifestations such heel pain (e.g. enthesitis), skin rashes (e.g. psoriasis), and inflammation of the eye (e.g. uveitis). Disease onset generally happens before the age of 40 and affects both males and females equally. If untreated, persistent inflammation may lead to structural damage and fusion of the spine, resulting in severe limitation in movement and reduced quality of life.
Find out more on the condition here >
The SGH axSpA programme focuses on the diagnosis, evaluation and care of patients with axSpA. Goals of the programme include initiating prompt, excellent and holistic care and treatment for axSpA. As the manifestations of axSpA are complex and might involve a range of organ systems, patients will benefit from specialist medical care, together with inter-disciplinary care provided by nurses, pharmacists, physiotherapists, occupational therapists and specialists from other departments. Some examples include:
Spondyloarthritis (SpA) clinic: This clinic focuses on the prompt diagnosis, evaluation and treatment of patients with axSpA. The diagnosis is formed after enquiring about the patient’s history, family medical history, examining the spine as well as performing blood investigations, x-rays and magnetic resonance imaging, when necessary. Patients are seen by the Rheumatologist specialising in axSpA and supported by the Rheumatology nurse.
Rheumatology obstetrics clinic: The disease may affect women of child-bearing age. This clinic sees patients with axSpA and other autoimmune diseases for pre-pregnancy counselling, and provides obstetrics care throughout their pregnancy. Patients are seen by the Obstetrician specialising in high-risk pregnancies and the Rheumatologist together.
Physiotherapy: Physiotherapy is beneficial for all patients with axSpA. Patients will be prescribed with individualised home exercises, which aim to alleviate pain and stiffness, as well as to improve mobility, muscle strength, cardiovascular fitness, lung capacity and functional capabilities.
Occupational Therapy: Occupational therapy is beneficial for patients with axSpA. Patients will be prescribed with advice on ergonomics and ways to maximally participate in activities of daily living. Personalised advice for vehicle modification and driving advice will also be provided for patients with axSpA. Patients with axSpA will be empowered to pursue meaningful activity engagements through activity modification and use of adaptive devices.
While there has been major progress in the understanding of axSpA and availability of regulated drugs, more needs to be done in terms of understanding its pathogenesis, impact on patients’ quality of life and developing better treatment methods, to ensure that more patients benefit. Our research efforts focus on:
Find out more on our research in Axial Spondyloarthritis here >
