Axial Spondyloarthritis and High-Intensity Exercise

Last year, a group of Norwegian researchers published a study in which they found that a high-intensity program of cardiovascular and strength-training exercise was safe and effective for easing pain, stiffness, and inflammation in people with axial spondyloarthritis (axSpA). But it’s one thing to use exercise as an add-on to a treatment regimen — can physical activity actually replace drugs entirely?

New research from the same research team suggests it might be possible, at least for some patients.

At the European E-Congress of Rheumatology 2020, held virtually by the European League Against Rheumatism (EULAR), lead author Sella Aarrestad Provan, MD, PhD, explained that axSpA patients were randomly assigned to participate in a supervised exercise program or take a TNF inhibitor biologic (a targeted medication that reduces inflammation). Disease activity was assessed at baseline and again three months later.

According to the authors, “there were no significant differences in change in disease activity at three months between patients participating in [the exercise intervention] and patients starting a TNFi.” They concluded that “high-intensity exercise has comparable three-month effectiveness to TNF inhibitors in patients with axSpA. This confirms the important role of high-intensity exercise in the treatment of axSpA.”

The exercise group only consisted of 50 patients, so more research on this topic will likely be needed.

Most rheumatologists already recommend some level of exercise for people with axSpA. Back stretches and low-impact activities like swimming are often especially helpful.

If you’re new to exercise or have been newly diagnosed with axSpA, ask your doctor about whether certain types of activities are best for you. You might also consider working with a physical therapist who has experience developing fitness plans for people with inflammatory conditions.

Found This Study Interesting? Get Involved

If you are diagnosed with arthritis or another musculoskeletal condition, we encourage you to participate in future studies by joining CreakyJoints’ patient research registry, ArthritisPower. ArthritisPower is the first-ever patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. Learn more and sign up here.

Provan SA, et al. High Intensity Exercise Has Comparable 3-Month Effectiveness to TNF-Inhibitors on Disease Activity in Patients With Axial Spondyloarthritis. Post-hoc Analyses of Data From the ESpA Trial. Annals of the Rheumatic Diseases. Volume 79, Supplement 1. 2020.

Sveass SH, et al. High Intensity Exercise for 3 Months Reduces Disease Activity in Axial Spondyloarthritis (axSpA): A Multicentre Randomised Trial of 100 patients. British Journal of Sports Medicine. March 2020. doi:

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