What is non-radiographic
axial spondyloarthritis


Lean into learning about nr-axSpA

Non-radiographic axial spondyloarthritis (pronounced non ray-dee-oh-gra-fick aks-ee-al spon-dill-low-arth-reye-tiss), or nr-axSpA,  is a chronic inflammatory disease that affects the spine  and other areas of the body.

When you have nr-axSpA, an immune system response causes inflammation in your spinal joints. The inflammation contributes to pain and stiffness. And over time, it is thought that up to 40% of people with nr-axSpA may develop ankylosing spondylitis (AS). In some severe cases, AS can cause sections of the spine to fuse. This is why it’s important to seek treatment early. Don’t let your nr-axSpA go untreated—speak openly with a rheumatologist.

10-40 percent.

10-40 percent.

Nr-axSpA can cause inflammation, pain, and stiffness in other areas of the body, like:

Spine icon.


Shoulder icon.


Hips icon.


Ribs icon.


Knee icon.


Heels icon.


Nr-axSpA can also affect the joints of the hands and feet.

What are symptoms of non-radiographic axial spondyloarthritis?

The onset of nr-axSpA symptoms and their impact can vary, though lower back, hip, and buttock pain usually starts before age 45. Symptoms of nr-axSpA can get worse over time, and it often takes years for this condition to be diagnosed.

Signs of nr-axSpA inflammatory back pain include:

  • Pain and stiffness that is usually worse with inactivity (especially in the morning and at night)
  • Pain and stiffness that improves with physical activity
  • Symptoms lasting more than 3 months



The causes of non-radiographic axial spondyloarthritis are unknown.

Some contributing factors can include environment, different stressors, and family history. It’s possible  nr-axSpA  is passed down through the HLA-B27 gene. Blood tests can detect the HLA-B27 protein and help with making a diagnosis. Ask your rheumatologist for more info at your next visit.


What best describes the status of your

Pick one

Diagnosed and taking an NSAID (like aspirin or ibuprofen)

It may be time to talk to your rheumatologist about whether your current treatment is helping you get relief. Use a customized checklist to help you prepare for the conversation.

Start the Appointment Checklist

Diagnosed and on a biologic (injection or infusion) or oral small molecule

Prepare to talk treatment options and goals at your next rheumatologist visit—and ask about RINVOQ.

Set treatment goals

Diagnosed with AS

You deserve to be supported at your next rheumatologist appointment. Use the customized AS checklist to help you prepare for the conversation.

Go to AS Appointment Checklist

Not diagnosed

It’s time to get honest about your symptoms with a rheumatologist—a doctor who specializes in diseases like nr-axSpA.

Partner with a rheumatologist

How does nr-axSpA impact men and women differently?

Both women and men with non-radiographic axial spondyloarthritis (nr-axSpA) often start experiencing symptoms in their 20s. Some women may feel symptoms in the neck and other joints first, while men are more likely to feel lower back pain first.

Additionally, people with widespread pain, which occurs in at least 25% of females with axSpA, are sometimes misdiagnosed. This may explain why the delay in diagnosis is sometimes longer in women than in men.