Diagnosis and management of axial spondyloarthritis

Low back pain is among the most common conditions treated by physician associates in family medicine, internal medicine, and emergency medicine clinics. Inflammatory low back pain is the most frequent manifestation of axial spondyloarthritis (axSpA). AxSpA has a prevalence of 1.0% to 1.4% in the United States. The diagnosis of axSpA includes both clinical and radiographic components. With the advancement of biologic pharmacologic agents, the American College of Rheumatology, Spondylitis Association of America, and Spondyloarthritis Treatment Network have provided updated recommendations for the pharmacologic and nonpharmacologic management of axSpA. The recognition of axSpA and comorbid peripheral spondyloarthropathies is important, as the management of axSpA differs from routine musculoskeletal back pain. Treatment guidelines focus on symptom management, functionality, and disease progression.