Axial Spondyloarthritis Seminar
Axial Spondyloarthritis Seminar:
Inaugural meeting between NASS, Osteopaths and Chiropractors held at the
Norfolk and Norwich University Hospital.
Last
week I was delighted to be involved in the inaugural meeting between the
National Axial Spondyloarthritis Society (NASS), osteopaths and chiropractors.
Forty osteopaths and chiropractors attended to listen to a variety of speakers
updating them on Axial Spondyloarthritis, including Ankylosing Spondylitis (axial SpA, AS).
The
main aims of this seminar were to help reduce the delay to diagnosis of axial SpA (AS) (currently an average 8.5 years!) through increasing awareness of the symptoms,
improving screening of patients with back pain and improving the links for
referring patients for relevant investigations. We also aimed to improve the
care for people with axial SpA (AS) by updating manual therapists on recent research and
treatments, including different ways osteopaths and chiropractors can help
people with axial SpA (AS).
Professor Karl Gaffney, Consultant Rheumatologist in Norwich.
Professor Karl Gaffney is a consultant rheumatologist at the Norfolk and Norwich
University Hospital and trustee of NASS. Professor Gaffney gave an engaging
presentation explaining the symptoms of axial SpA (AS) and how to recognise the
‘extra-articular manifestations’ such as uveitis, inflammatory bowel conditions,
joint pains and enthesitis (such as heel pain or tennis elbow).
He
then explained the relevant investigations needed to diagnose axial SpA (AS). If an
osteopath or chiropractor thinks a patient may have axial SpA (AS), they should refer them
to the GP to be referred on to a rheumatologist for these tests.
Finally, Professor Gaffney then explained the recent research around axial SpA (AS) and how this has
informed the development of treatments. It’s really reassuring that new
developments have improved the treatment of axial SpA (AS), but it shows how essential it
is to diagnosis this condition swiftly to reduce the risk of bony changes in
the spine before treatment begins.
Panel
discussion about the referral pathway.
We
then undertook a panel discussion with input from the audience, discussing the current
barriers osteopaths and chiropractors face when trying to refer patients with
suspected axial SpA (AS). It seems everyone has had mixed experiences of this process.
It
felt very positive to then brainstorm ideas to reduce the difficulties we face
when referring patients. I’m looking forward to improving this process to make
it easier to refer patients quickly for the right investigations or to see a
rheumatologist.
Andrea
Lucchetti and Mandy Rush, Chiropractors in Wymondham and Diss.
Andrea
and Mandy’s talk about the chiropractor’s perspective gave a really important
insight into recognising the symptoms of inflammatory back pain, including an
interesting case study of a current patient. They emphasised that because
chiropractors and osteopaths are primary healthcare practitioners, patients
often self-refer to us and their symptoms haven’t been screened by anyone else.
This highlights the need to be vigilant for these symptoms and to ask patients
specific questions to screen for the extra-articular manifestations of AS and
family history.
Chiropractors
and osteopaths also have a lot of time to spend with patients, putting us in
the unique position to get to know patients and provide help for their overall
health. Andrea then directed us to the SPADE tool and showed how this
can be used in clinic when we’re considering AS as a cause for someone’s pain.
It can also be used when we’re considering referring a patient to their GP for
investigations.
Zoë
Clark, Osteopath in Norwich and Diss.
I
spoke about the osteopath’s perspective, then focused on the long-term
management and help we can provide for people with axial SpA (AS). I explained how
osteopaths and chiropractors can play an important part of someone’s health team,
with care always focused on the patient at the centre. I also explained how we
can empower patients and educate them about their own health, so they can
manage symptoms well without our help, but also recognise the role each person
plays in their mutli-disciplinary team to know who is best to contact when they
require support.
We
can also really get to know our patients and learn what activities and hobbies
their symptoms are currently stopping them from doing. This way we can help
them form achievable goals and a plan to improve their quality of life.
Through
hands-on treatment and tailored exercises, we can help people reduce their pain
and improve/maintain their mobility and function. I highlighted specific
treatments and areas to focus on. Finally, I ran through the red flags that can
occur for patients with axial SpA (AS) and the need to look out for them and refer patients
on when necessary.
Sally
Dickinson, Information and Communications Manager for NASS.
Sally
Dickinson is Information and Communications Manager for NASS and explained the
fantastic work that NASS do providing free information about axial SpA (AS), support for
patients and pushing for research developments and improved treatments. NASS is
a very small charity, but the work they do is excellent and really important.
For osteopaths and chiropractors, NASS can provide lots of information about
diagnosing and treating axial SpA (AS), as well as free resources we can pass on to
patients to help them manage their health.
I’d
like to give a big thank you to everyone at NASS involved with organising this
event, Professor Karl Gaffney, the Institute of Osteopathy and the Royal College of
Chiropractors. Of course, a big thank you to everyone who attended and got
involved with the evening. Hopefully this is just the first step to improving
the care for people with axial SpA (AS) via osteopaths and chiropractors.

Zoë Clark is a registered osteopath trained at the British College of Osteopathic Medicine in London. Practicing in Howe near Norwich (01508 558373) and Burston, near Diss (07543 557746) in Norfolk.
Call me on 07532 283649
Email zoeclarkosteopath@gmail.com
'Like' my Facebook page www.facebook.com/ZoeClarkOsteopathy
'Follow' me on Twitter @ZoeClarkOsteo
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