BACKGROUND: Axial spondyloarthritis (axSpA) is an inflammatory rheumatic disease primarily affecting the axial skeleton. OBJECTIVE: To evaluate the short-term effects of locoregional water-filtered infrared A radiation (sl-wIRAR) in the treatment of lower back pain in patients with axSpA. METHODS: Patients with active axSpA with non-steroidal anti-inflammatory drug (NSAID) therapy undergoing a 7-day multimodal rheumatologic complex treatment in an in-patient setting were eligible. Patients were randomly assigned to the intervention group (IG) receiving sl-wIRAR treatment of the back (2 treatments/day for 30 min each for 6 days) or to the control group (CG) receiving no treatment. Primary outcome was a between-group difference in pain after sl-wIRAR therapy measured on a numeric rating scale (NRS) (0 no pain, 10 worst pain). Secondary outcomes included an assessment of (i) the onset and development of analgesic effects and an evaluation of whether sl-wIRAR (ii) improved axSpA-specific well-being and (iii) influenced serum cytokine levels. RESULTS: Seventy-one patients were enrolled, completed the trial and were analyzed (IG 36 patients, CG 35 patients). In the IG, there was a statistically significant change (p < 0.0005) in pain level (NRS) (1.6 +/- 1.9) from baseline (4.1 +/- 2.4) to trial completion (2.6 +/- 2.0) and a significant difference to the CG (p = 0.006). In the IG there was a significant improvement in axSpA-specific well-being (BAS-G) (p = 0.006). A physiologically relevant change in serum cytokine levels could not be observed. CONCLUSION: Sl-wIRAR treatment can be useful in the treatment of patients with active axSpA as it leads to a rapid reduction of pain.

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