Information - Ankylosing Spondylitis
Ankylosing spondylitis (AS) is a chronic type of inflammatory arthritis that causes stiffness and back pain. Ankylosing spondylitis is a serious autoimmune condition that belongs to a family of diseases called the seronegative spondyloarthropathies, which includes arthritis, psoriatic arthritis and reactive arthritis.
It's caused by the body’s immune system attacking its own healthy cells and tissues, although the reason for this is not well understood. Ankylosing spondylitis is known as a systemic rheumatic disease, because it may also affect other parts of the body including the eyes, bowels and lungs.
Over time, ankylosing spondylitis leads to chronic inflammation, and the spine becomes stiffer and stiffer. The name for this condition comes from the term "ankylosing", which means the fusion of two bones into one, while "spondylitis" refers to inflammation of the spine.
Causes & Diagnosis of Ankylosing Spondylitis
As mentioned above, the exact cause of AS isn't known. As with many other diseases, it is thought that genetics has a role in who will develop ankylosing spondylitis.
Approximately 9 out of 10 people with AS have a gene called HLA-B27. While many people who have this gene never develop the disease, it does increase someone's chances of developing ankylosing spondylitis.
As the immune system attacks the body, it causes inflammation in the spine. As a result, the body tries to repair itself by growing new bone. However, in patients with ankylosing spondylitis, bones grow across joints, connecting two bones together.
Diagnosing Ankylosing Spondylitis
Ankylosing spondylitis causes different symptoms among patients. Some people have mild discomfort, while others experience reduced mobility. Most people with ankylosing spondylitis begin to notice signs and symptoms in their late teens to early 30s, but the onset can occur anytime.
Ankylosing spondylitis is best diagnosed by a rheumatologist, which is a type of doctor who specializes in autoimmune diseases and arthritis. To confirm the diagnosis of AS, the rheumatologist will ask about your medical history, perform a physical examination and order tests like blood tests, x-rays or an MRI.
Symptoms of Ankylosing Spondylitis
Back Pain and Stiffness
The most common AS symptoms are back pain and stiffness. Some patients believe they are dealing with a stiff back for years before being diagnosed with ankylosing spondylitis. The joints between the bones in your spine and/or the joints between the spine and pelvis are generally the first areas affected by AS.
Inflammation Throughout the Body
While back pain and stiffness are the most common symptoms, over time, ankylosing spondylitis can affect other areas of the body like the hips, shoulders knees.
In some patients, AS causes the Achilles tendons or plantar fasciitis in the foot to become inflamed. Others experience inflammation in one or both eyes (iritis).
Because ankylosing spondylitis is an autoimmune disease, it activates the body’s immune system into attacking the spine and joints. Many patients with AS often feel very tired.
For some people, bowel inflammation is a symptom of ankylosing spondylitis.
No matter what the symptoms are, it's essential for patients to go to regular rheumatologist appointments.
Treatment of Ankylosing Spondylitis
When it comes to treatment for ankylosing spondylitis, the earlier the better. Because any damage is permanent, even a few months can make a big difference. With early AS treatment, the spine and joints will remain more flexible.
Medications can reduce pain and improve mobility in some patients with ankylosing spondylitis. Medications for ankylosing spondylitis include those that control the symptoms and those that control the disease.
Medications that control the symptoms of AS include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Corticosteroids like prednisone
Types of medication that control the disease and prevent it from causing long-term damage include disease modifying anti-rheumatic drugs (DMARDs) and biologics.
Because certain medications can interact with other medications, supplements and alcohol, it's important that patients consult with their physician before starting any medications for ankylosing spondylitis.
A large part of effectively treating ankylosing spondylitis involves physical therapy. Seeing a physical therapist and doing daily stretches can greatly improve mobility and posture and reduce stiffness and pain. It can also strengthen the muscles around the joints, which helps protect them.
Finally, lifestyle improvements can make a big difference to the severity of ankylosing spondylitis symptoms. Smoking can worsen ankylosing spondylitis symptoms and make it more difficult to treat.
Because AS is linked to heart disease, people with this condition need to keep their cholesterol at healthy levels. Patients who have diabetes should keep their blood sugar at a healthy level.
Is Surgery Needed for Ankylosing Spondylitis?
In very severe cases of ankylosing spondylitis, the joints of the spine and/or the pelvis become so damaged that they fuse together and may require surgery to fix.
People with severe AS may become disfigured, developing a hunched posture and changes in how they walk.
Surgery may relieve pain and improve mobility in patients with advanced SA. During surgery, the doctor usually replaces the damaged joint with an artificial joint.
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Similarly to osteoarthritis, if you have ankylosing spondylitis the body attempts to repair your lower back by growing new bone, which often grows across the joint and may even become fused.
Ankylosing spondylitis symptoms include pain and stiffness in the joints in the lower back, spine, hips, knees, shoulders, ligaments and tendons.
Over time, the inflammation from ankylosing spondylitis can cause permanent damage to the joints.
Ankylosing spondylitis treatments include nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs and biologics.
Since having AS is linked to heart disease, it’s important to monitor and/or lower your cholesterol and blood pressure.