Ankylosing Spondylitis & AxSpa Treatment in North London
Living with Ankylosing spondylitis
I know what it feels like to wake up at 3am with your back on fire, wondering if it will ever get better. I know the frustration of being told it is “just back pain” when you know something deeper is going on. I know, because I live with axial spondyloarthritis myself.
As the principal osteopath at Compass Health Clinic, my personal experience with AxSpa is not something I keep separate from my clinical work. It shapes how I treat every patient who walks through the door with suspected or diagnosed ankylosing spondylitis. It means that when you describe your symptoms, I do not just understand them clinically — I understand them personally. And it means the whole team at Compass Health Clinic has been trained to understand what AxSpa patients are going through, so whoever you see at the clinic, you will be met with genuine understanding and expertise.
If you are dealing with AxSpa, you deserve a clinic that truly gets it. At Compass Health Clinic in North Finchley, we combine first-hand experience with evidence-based treatment to help you manage your condition and get back to living the life you want to live.
What is Ankylosing Spondylitis?
Ankylosing spondylitis, now more broadly known as axial spondyloarthritis (AxSpa), is a chronic inflammatory condition that primarily affects the spine and pelvis. Unlike mechanical back pain, which is caused by muscles and joints, AxSpa is driven by inflammation in the body’s immune system attacking the joints and ligaments of the spine.
The condition exists on a spectrum. Some people have what is called non-radiographic axial spondyloarthritis, where the inflammation is present but has not yet caused visible changes on X-ray. Others have ankylosing spondylitis, where structural changes to the spine can be seen on imaging. Both are the same underlying condition at different stages, and both deserve early treatment.
AxSpa affects around 1 in 200 people in the UK. Despite this, the average time from first symptoms to diagnosis is still around 8.5 years. This delay often happens because the early symptoms — persistent back pain, morning stiffness, fatigue — are mistakenly attributed to general musculoskeletal problems or dismissed as “normal” for someone’s age. It is one of the reasons I am so passionate about identifying AxSpa early: the sooner it is diagnosed, the sooner the right treatment can begin, and the better the long-term outcomes.
AxSpa Symptoms: What to Look Out For
The symptoms of axial spondyloarthritis can vary significantly from person to person, which is part of what makes it difficult to diagnose. However, there are some hallmark features that distinguish AxSpa from ordinary back pain:
- Persistent back pain lasting more than three months, particularly in the lower back and buttocks, that comes on gradually rather than after a specific injury.
- Pain that is worse at rest and better with movement. This is a key distinguishing feature. If your back pain wakes you in the second half of the night, or is at its worst when you have been sitting or lying still, that pattern is worth paying attention to.
- Morning stiffness lasting more than 30 minutes. Some people describe feeling like they have seized up overnight and need 30 minutes to an hour of movement before they start to loosen up.
- Fatigue. Not just tiredness, but a deep, persistent exhaustion that is not relieved by rest. AxSpa fatigue is driven by the underlying inflammatory process and can be one of the most debilitating aspects of the condition.
Pain in other areas. AxSpa can also affect the ribs and chest wall (making it uncomfortable to take a deep breath), the neck, the hips, and the heels. It can also cause inflammation in the eyes (called uveitis or iritis), the skin, and the bowel.
AxSpa Symptoms in Women
Ankylosing spondylitis has historically been considered a condition that mainly affects men, but this is outdated. AxSpa affects women almost as frequently — it is just often missed or misdiagnosed.
Women with AxSpa tend to experience symptoms differently. While men often feel pain primarily in the lower back, women more commonly report pain in the upper back, ribs and neck. The pain may also be more widespread and accompanied by greater levels of fatigue. Because these symptoms do not fit the “classic” textbook presentation of ankylosing spondylitis, women are frequently told they have fibromyalgia, stress, or non-specific back pain.
If you are a woman experiencing persistent back, rib or neck pain that is worse after rest, improves with activity, and has been present for more than three months, it is worth discussing AxSpa with a healthcare professional. At Compass Health Clinic, we are experienced in recognising AxSpa presentations in both men and women, and we can support you in getting the right referral if we suspect the condition.
How We Help People with AxSpa at Compass Health Clinic
Because I live with AxSpa, the whole team at Compass Health Clinic understands what this condition means in real life — not just what the textbooks say. We know that AxSpa is not just about back pain. It is about the 3am wake-ups, the brain fog, the frustration of cancelling plans because you are having a bad day, the anxiety about whether it will get worse, and the feeling that nobody really understands what you are going through.
Our approach to treating ankylosing spondylitis is built around three pillars:
1. Getting You the Right Medical Support
If you come to us with suspected AxSpa that has not yet been diagnosed, our first priority is to help you get referred to a rheumatologist as quickly as possible. Early diagnosis and early access to the right medication — often a biologic or a disease-modifying drug — is the single most important factor in managing AxSpa long term. Medication helps control the inflammation that drives the condition, preventing potential irreversible changes to the spine and other joints.
We will never try to replace your rheumatologist. Our role is to work alongside your medical team, providing the musculoskeletal support and rehabilitation that complements your medication. Think of it as a partnership: your rheumatologist manages the disease process, and we help you manage the daily impact on your body and your life.
2. Hands-On Treatment and Rehabilitation
Our osteopaths and physiotherapists use gentle manual therapy to help maintain and improve spinal mobility, reduce muscle tension, and manage pain. AxSpa can lead to stiffness and guarding patterns that limit movement over time, and regular hands-on treatment helps counteract this.
We also prescribe specific, evidence-based exercises tailored to AxSpa. Exercise is one of the most powerful tools for managing ankylosing spondylitis — it helps maintain flexibility, strengthens the muscles that support your spine, and has been shown to reduce pain and fatigue. But it needs to be the right exercise, at the right level, at the right time. We create programmes that are realistic, progressive, and adapted to how you are feeling, because we know that AxSpa fluctuates and your exercise capacity changes with it.
For patients experiencing peripheral symptoms — such as heel pain from enthesitis or tendon problems in the Achilles or plantar fascia — we also offer shockwave therapy and dry needling as part of your treatment plan.
3. Supporting You Beyond the Physical
Living with a chronic condition affects more than just your body. The uncertainty, the frustration, the impact on your work and relationships — these are real and they matter. At Compass Health Clinic, we are trained in psychologically informed practice, which means we do not just treat the physical symptoms. We can support you with:
- Pacing strategies — learning to manage your energy and activity levels so that you reduce the boom-and-bust cycle that many people with AxSpa fall into.
- Acceptance and Commitment Therapy (ACT) principles — evidence-based psychological techniques that help you develop a healthier relationship with pain and build a meaningful life alongside your condition, rather than waiting for the pain to go away before you start living.
- Sleep support — AxSpa and sleep have a complicated relationship. Night pain, stiffness, and the fatigue cycle can all disrupt your rest. We provide practical advice on sleep hygiene and positioning that can make a real difference.
- Workplace support — we provide supporting documents for your employer explaining your condition, your needs, and how they can help. Many people with AxSpa struggle at work not because they cannot do the job, but because their employer does not understand the condition.
- Flare management plans — knowing what to do when things get worse is empowering. We help you build a plan for flare days so you feel in control rather than at the mercy of the condition.
Why Patients with AxSpa Choose Compass Health Clinic
We understand that you have a choice about where you receive treatment, and for something as personal as AxSpa, that choice matters. Here is what makes our approach different:
- First-hand understanding. Our principal osteopath lives with AxSpa. This is not just a condition we have read about — it is one we live with and treat every day. That personal understanding shapes how the entire team approaches AxSpa care.
- A team trained in AxSpa. Every practitioner at Compass Health Clinic has been educated about AxSpa, its varied presentations, and the specific considerations for treating patients with inflammatory arthritis. Whoever you see, you will not have to explain your condition from scratch.
- Evidence-based, whole-person care. We combine manual therapy, exercise prescription, pain science education and psychologically informed practice to address all aspects of living with AxSpa — not just the back pain.
- Clear referral pathways. If you need a rheumatology referral, imaging, or any other onward care, we can help facilitate that. We work alongside the medical system, not in isolation from it.
A 5-star rated clinic. With over 100 five-star Google reviews, our patients consistently highlight our thorough approach, our genuine care, and the difference our treatment has made to their lives.
NASS and AxSpa Downloadable Resources
Please visit the offical NASS website if you’d like more information on Ankylosing Spondylitis, including information on various exercises, information on how to get diagnosed, as well as support groups to help you during your journey with AxSpa.
Frequently Asked Questions About Axial Spondyloarthritis:
Q: What are the symptoms of ankylosing spondylitis?
A: The most common symptoms of ankylosing spondylitis (also known as axial spondyloarthritis or AxSpa) include persistent low back pain and stiffness, particularly in the morning or after sitting for long periods. The pain tends to improve with movement and worsen at rest, which is a key distinguishing feature. You may also experience stiffness lasting more than 30 minutes each morning, pain in the upper back and ribs, fatigue, and in some cases inflammation in the eyes, bowels or skin. Symptoms can come in waves, lasting weeks or months, and vary significantly from person to person. |
Q: Are ankylosing spondylitis symptoms different in women?
A: Yes, symptoms can present differently in women. Men tend to experience pain primarily in the lower back, while women more often feel symptoms in the upper back, ribs and neck. This difference is one reason why ankylosing spondylitis is frequently missed or misdiagnosed in women — it may be put down to general back pain or stress. If you are a woman experiencing persistent back or rib pain that is worse after rest and improves with movement, it is worth discussing AxSpa with one of our osteopaths or physiotherpists. |
Q: Can ankylosing spondylitis be cured?
A: There is currently no cure for ankylosing spondylitis, but it can be managed very effectively. As an osteopath living with AxSpa myself, I understand how daunting a diagnosis can feel — but the reality is that with the right combination of medication, exercise and hands-on treatment, most people with AxSpa can lead full, active lives. The most important step is getting an early diagnosis and working with a rheumatologist to find the right medication to control inflammation and prevent long-term changes to the spine. |
Q: How can an osteopath or physiotherapists help with ankylosing spondylitis?
A: Osteopathy and physiotherapy can play a valuable role alongside your rheumatology care. At Compass Health Clinic, we use gentle hands-on techniques to help maintain spinal mobility, reduce muscle tension, and manage pain. We also prescribe specific exercises tailored to AxSpa, provide advice on pacing and activity management, and can support you with referral pathways to rheumatology if you have not yet been diagnosed. Our approach always works in partnership with your medical team. We can also support those with AxSpa using psychologically informed practice such as Acceptance and Commitment Therapy, to help you deal with the impact living in pain can have. |
Q: Does ankylosing spondylitis cause fatigue?
A: Yes, fatigue is one of the most common and often most frustrating symptoms of AxSpa. It is not just ordinary tiredness — it can feel like a deep exhaustion that is not relieved by rest. The fatigue is driven by the underlying inflammatory process and can be made worse by disrupted sleep, pain and reduced activity. Managing fatigue involves a combination of optimising your medication with your rheumatologist, gentle regular exercise, pacing your activities, and addressing sleep quality. |
We're ready to help you navigate your pain when you are
We help those with Ankylosing Spondylitis in Finchley inside the Yoga Hook yoga studio near Tally Ho Corner.