Private Axial Spondyloarthritis Specialist in London

Axial spondyloarthritis is an inflammatory condition that mainly affects the spine and sacroiliac joints. These joints sit where the lower spine meets the pelvis.

It can cause back pain, buttock pain, stiffness, night pain and reduced spinal mobility. It may also be associated with heel pain, tendon inflammation, peripheral joint symptoms, uveitis, psoriasis or inflammatory bowel disease.

Axial spondyloarthritis is the broader term. It includes ankylosing spondylitis, where changes may be visible on X-ray, and non-radiographic axial spondyloarthritis, where X-rays may be normal but symptoms, examination findings, blood tests or MRI may still suggest inflammatory disease.

Many patients still use the term ankylosing spondylitis, but axial spondyloarthritis is often used to describe the wider spectrum of disease.

Axial spondyloarthritis is diagnosed by looking at the overall clinical picture, not from one test alone.

Assessment may include the pattern of back pain and stiffness, examination findings, family history, associated features such as uveitis, psoriasis or inflammatory bowel disease, blood tests and imaging such as X-rays or MRI where clinically appropriate.

Back pain may be inflammatory if it starts before the age of 45, lasts for more than three months, improves with movement, does not improve with rest, wakes you at night or is associated with prolonged morning stiffness.

Alternating buttock pain, heel pain, uveitis, psoriasis, inflammatory bowel disease or a family history of related inflammatory conditions may also increase suspicion.

Yes. CRP and ESR can be normal in axial spondyloarthritis, even when symptoms are inflammatory.

Normal inflammatory markers do not exclude axial spondyloarthritis. The diagnosis depends on the overall pattern of symptoms, examination findings, HLA-B27 status and imaging where needed.

HLA-B27 is a genetic marker associated with axial spondyloarthritis. A positive result can support the diagnosis if the symptom pattern fits.

However, HLA-B27 does not prove the diagnosis by itself. Many people who are HLA-B27 positive never develop axial spondyloarthritis, and some people with axial spondyloarthritis are HLA-B27 negative.

Not everyone needs an MRI, but MRI can be helpful when axial spondyloarthritis is suspected and X-rays are normal or unclear.

MRI of the sacroiliac joints or spine may show inflammation where clinically appropriate. The decision to arrange MRI depends on your symptoms, examination findings, previous imaging and overall likelihood of inflammatory disease.

Yes. X-rays can be normal in earlier disease or in non-radiographic axial spondyloarthritis.

This is one reason why MRI may sometimes be useful when symptoms suggest inflammatory back pain but X-rays do not show definite changes.

Mechanical back pain is often linked to strain, posture, disc problems, injury or degenerative change. It may worsen with activity and improve with rest.

Inflammatory back pain is more likely to cause prolonged stiffness, night pain, improvement with movement and symptoms that do not settle with rest. The distinction is not always clear without specialist assessment.

Yes. Axial spondyloarthritis can be associated with heel pain, tendon inflammation, swollen peripheral joints, uveitis, psoriasis and inflammatory bowel disease.

These associated features can be important when deciding whether back pain is inflammatory and what treatment options may be suitable.

Yes. Axial spondyloarthritis is treatable. Treatment aims to reduce inflammation, improve pain and stiffness, maintain spinal mobility and protect long-term function.

Management may include exercise, physiotherapy, anti-inflammatory medication and, in selected patients, biologic or targeted therapies.

Treatment depends on disease activity, symptom pattern, imaging findings, blood tests, medical history and associated conditions.

Options may include physiotherapy, structured exercise, anti-inflammatory medication, targeted injections in selected cases, and biologic or targeted therapies where clinically appropriate.

Biologic or targeted therapies may be considered if axial spondyloarthritis remains active despite standard treatment, or where there are specific reasons to consider these treatments.

The choice of treatment may need to take account of associated psoriasis, inflammatory bowel disease, uveitis, infection risk, blood test results, previous treatment response and other medical factors.

Yes. Dr Singh sees patients with established axial spondyloarthritis as well as patients with suspected axial spondyloarthritis.

A private review can help assess disease control, flares, treatment response, medication concerns, imaging findings, biologic or targeted therapy options, or whether a change in treatment may be needed.

Yes. Many patients seek a second opinion about diagnosis, HLA-B27 results, MRI findings, treatment options or ongoing symptoms.

A second opinion can be helpful if the diagnosis is uncertain, symptoms remain active, imaging findings are unclear or you would like an independent specialist review of your current management plan.

Where available, it is helpful to bring recent blood test results, previous X-ray or MRI reports, clinic letters, referral letters, a list of current medications and allergies, and details of previous treatments such as anti-inflammatory medication, steroid injections, physiotherapy, biologic therapies or targeted treatments.

If you have had an MRI, please bring the report and, where possible, access to the images rather than the report alone.

Please also bring details of any previous HLA-B27 result, CRP or ESR results, episodes of uveitis, psoriasis, inflammatory bowel disease, heel pain, tendon symptoms or family history of related inflammatory conditions.

A GP referral is not required for self-pay appointments. You can book directly by phone, email or online.

If you are using private medical insurance, please check your policy requirements before booking, as some insurers require a GP referral, pre-authorisation number or separate approval for investigations, imaging or procedures.

Yes. Dr Singh sees insured patients.

Please check your insurer’s requirements before booking and bring your membership number, pre-authorisation number and details of what has been approved.

Insurance policies vary, and Dr Singh’s team cannot advise on the details of your individual cover. Blood tests, imaging, injections, prescriptions and procedures may require separate authorisation depending on your policy.

Private appointments are usually available within a week. Short-notice appointment requests may also be considered where clinically appropriate and diary capacity allows.

Dr Singh sees private patients at clinics in Harley Street, Hampstead and Chiswick. Please contact Dr Singh’s team by phone, email or WhatsApp to ask about the earliest available appointment.

Reliable patient information can be helpful if you are newly diagnosed, waiting for assessment or trying to understand whether your back pain could be inflammatory.

Useful UK resources include the National Axial Spondyloarthritis Society (NASS), Arthritis UK, NICE patient information and the NHS ankylosing spondylitis overview.

These resources can support your understanding, but they should not replace personalised medical advice from your own rheumatologist or clinical team.