Abstract
Axial spondyloarthritis (axSpA) is an inflammatory rheumatic condition that is often subject to diagnostic delays. Individuals with axSpA report using complementary and alternative therapies prior to and following diagnosis, though little is known concerning reasons underlying use of such therapies. This study provides detailed insights into the motivation and experiences of complementary and alternative medicine use within a population of individuals with axSpA. Open-ended surveys were completed by 30 individuals (20–69 years; 17 females) diagnosed with axSpA. Subsequent telephone interviews were conducted with eight individuals (39–70 years; five females) diagnosed with axSpA. Data were analyzed using reflexive inductive thematic analysis. Themes of “a learning curve”, “barriers to complementary and alternative therapy use” and “complementary or mutually exclusive” illustrated how participants” increasing understanding of their condition empowered them to explore complementary and alternative therapies use as an adjunct to mainstream care. Individuals with axSpA recommended greater integration between mainstream and complementary and alternative therapies, valuing informed advice from mainstream healthcare professionals before selecting appropriate complementary and alternative therapies for potential use. Healthcare professionals should be proactive in discussing complementary and alternative therapy use with patients and supply them with details of organizations that can provide good-quality information.
Highlights
Axial spondyloarthritis is a chronic inflammatory rheumatic condition affecting the spine and peripheral joints, and is associated with ongoing pain, restricted movement and varying degrees of long-term disability [1]
“I booked to see [chiropractor] and during the consultation I gave him a detailed account about my medical history. It was at this point that he suggested that I may be suffering from ankylosing spondylitis (AS) [axSpA] and wrote a letter to my GP recommending that I be blood tested for this
Participants revealed the experiential processes underpinning their selection of specific Complementary and Alternative Medicine Therapies (CAM) therapies over the course of their axSpA; the subtle factors which enhanced or undermined their confidence in CAM therapy use; and the potential benefits of a more holistic approach to axSpA management which integrates mainstream and CAM therapies
Summary
Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic condition affecting the spine and peripheral joints, and is associated with ongoing pain, restricted movement and varying degrees of long-term disability [1]. AxSpA comprises non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS). This revised classification introduced in 2009 was to enable earlier diagnosis of the condition, previously typically taking 8–10 years. The classification of AS is reliant on the demonstration of changes on an X-ray, which is often apparent many years after the onset of symptoms. By encompassing changes on MRI which often occur earlier in the disease course, the nr-axSpA classification have been validated in this disease area. Distinguishing axSpA from more common mechanical back pain conditions can be challenging for non-specialist practitioners [5] and many individuals with axSpA experience delays of up to 9.8–10.4 years between initial symptom onset and formal diagnosis [6,7]
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