Definition
What is Ankylosing Spondylitis?
Ankylosing Spondylitis is a painful arthritis condition. The joints in the lower back can fuse, resulting in a hunched posture. The most commonly affected areas are the lower back, chest, and neck. Other joint parts include the hips, shoulders, knees, and ankles. This disease can also affect other organs of the body such as the eyes, heart, and lungs.
How common is ankylosing spondylitis?
Ankylosing spondylitis is common. This disease affects men 3 times more than women. Only 5% develop symptoms after the age of 45 years. This disease affects people throughout their lives.
Signs & Symptoms
What are the signs and symptoms of ankylosing spondylitis?
The most common symptom is back pain that comes on slowly. Morning stiffness and pain may go away with exercise. People can wake up at night because of pain. Usually the pain starts in the lower back and then spreads to the upper back. Lower back pain and muscle spasms are often relieved by bending over. Therefore, sufferers often bend over and eventually become a permanent hunchback. In others, the spine becomes straight and stiff. The spine becomes less flexible, stiff, and painful may affect large joints such as the hips, knees, and shoulders. Back pain can cause loss of appetite, mild fever, weight loss, excessive fatigue , andanemia. This disease also affects other organs such as the eyes, heart, and lungs. People with ankylosing spondylitis may experience swelling of the eye resulting in pain, redness, and loss of vision and acuity. There may be other symptoms not listed. If you have questions about signs of illness, consult a doctor.
When should I see a doctor?
If you have any of the signs or symptoms above or have any questions, please consult to the doctor. Each body acts differently from one another. Always discuss with your doctor to find the best method of diagnosis and treatment for you.
Reasons
What causes ankylosing spondylitis?
The cause of ankylosing spondylitis is unknown, but it is likely that it is genetic (from parent to child) and environment. The main gene associated with the risk of ankylosing spondylitis is named HLA‐B27. Having this gene does not mean you will have ankylosing spondylitis. Scientists recently discovered two additional genes (IL23R and ERAP1) that together with HLA‐B27 carry the genetic risk of ankylosing spondylitis.
Risk factors
What increases my risk for ankylosing spondylitis?
There are many factors that can increase your risk of ankylosing spondylitis, including:
- Gender: men are more at risk than women.
- Age: the disease usually starts from the early stages of adolescence.
- Genetics: people with HLA‐B27, IL23R and ERAP1 are at higher risk.
Treatment
The information provided is not a substitute for medical advice. ALWAYS consult your doctor.
What are my treatment options for ankylosing spondylitis?
No treatment can completely cure ankylosing spondylitis. Treatment focuses more on relieving pain and stiffness, including nonsteroidal anti-inflammatory drugs (NSAIDs) which may reduce swelling and pain. Some NSAIDs can be purchased without a prescription, such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn). You may also need stronger medications to control pain and swelling, including corticosteroid therapy (eg prednisone):
- Sulfasalazine
- Methotrexate
- TNF blockers (including etanercept, adalimumab, infliximab, golimumab).
Surgery may be needed if muscle pain or injury gets worse. Exercise can help improve posture and breathing, as well as reduce muscle swelling. Lying on your back at night can help maintain a normal posture.
What are the usual tests for ankylosing spondylitis?
The doctor checks the medication history, performs a physical examination and X-ray of the lower back (lumbar). X-ray shows swelling and jointing of the joints (sacroiliac joints) that connect the spine and hips. Your doctor may also order an MRI and suggest going to a rheumatologist. The medication history will involve questions such as the following:
- How long have you had pain?
- Which part of the body do you experience pain in, such as your back or neck?
- Are other joints affected?
- Does back pain subside with exercise and worsen after inactivity, such as when you wake up in the morning?
- Do you have other problems like eye problems or fatigue?
- Does anyone in your family have back problems or arthritis?
- Have you recently had a gastrointestinal disease?
- Do you have a rash including psoriasis?
Physical examination
During the physical exam, the doctor will look for signs and symptoms including pain along the spine and/or in the pelvis, sacroiliac joints, heels, and chest. The doctor may have you move and bend in different directions and breathe deeply to check for other problems.
Radiology Test
X-rays and magnetic resonance imaging (MRI) may be used, but these tests have limitations. X-rays may show changes in the spine and joints; however, it may take years to cause injury due to obvious swelling on X-ray. An MRI may make a faster diagnosis, as it can show damage to soft tissue and bone before it's visible on an X-ray.
Laboratory test
Blood tests primarily to check for the HLA‐B27 gene. However, this test also has limitations. The gene only serves as an indication for a higher risk. The gene is only found in many people who have not had ankylosing spondylitis, and never will.
Home Remedies
What are some lifestyle changes or home remedies that can be used to treat ankylosing spondylitis?
The lifestyle and home remedies below may help with ankylosing spondylitis:
- Take medicine according to doctor's prescription.
- Call your doctor if you fall and notice a sudden change in the structure of your neck or back.
- Call your doctor if you experience any side effects of the drug.
- Don't smoke or drink alcohol if your doctor tells you to stop. The drug may react with alcohol.
If you have any questions, consult a doctor for the best solution for your problem.
Video Credit: Osmosis