Ankylosing Spondylitis

Ankylosing spondylitis (ankylosing-fused, stiff, or rigid bone joints; spondylitis-inflammation of one or more vertebrae) is a type of arthritis that affects the spine. The cartilage, ligaments, and tendons that move the back become inflamed. Chronic inflammation can lead to shortening of tissue around the joint, resulting in loss of mobility. The vertebrae respond to the chronic inflammation by producing more bone. The extra bone can lead to fused vertebrae, locking the affected joints. Stiffness results, and occurs most commonly in the joints between the spinal bones, and the joints between the spine and the pelvis.

Causes

The cause of ankylosing spondylitis is unknown, but researchers believe that genetics play a key role. The disease occurs more often in males than females, and onset usually begins between the ages of 20-40, sometimes younger. Therefore, risk factors are family history and being male.

Symptoms

intermittent hip or low back pain (worse at night or morning)
back pain usually begins in sacroiliac joints (where the spine meets the pelvis)
experience low back pain for longer than three months
back pain relieved with exercise but not improved with rest
may involve all or part of spine
bending forward may temporarily relieve pain
may have difficulty fully expanding chest due to involvement of joints between the ribs

More Specific Symptoms

fatigue
hip pain and stiffness
joint swelling and pain in the ankles, knees, shoulders
loss of appetite
stooping to relieve pain
eye inflammation
heel pain
neck pain
slight fever
weight loss
limited range of motion, especially in spine and hips

Treatment

non-steroidal anti-inflammatory drugs (NSAIDs) to decrease inflammation and pain
corticosteroid therapy or medication to suppress the immune system
drugs called TNF-inhibitors, which block an inflammatory protein, have been shown to improve symptoms of the disease
drugs that block cell growth (cytotoxic drugs) in people who do not respond well to corticosteroids, or who are dependent on high doses of corticosteroids
exercise and stretching may help improve posture and breathing (lying flat on your back at night can help maintain normal posture)
water therapy programs
glucosamine supplements
surgery, as a last resort, if pain or joint damage is severe

The focus of treatment for ankylosing spondylitis is to relieve pain and stiffness, reduce inflammation, keep the condition from worsening, and enable you to continue daily activities. The key is early diagnosis and treatment to reduce pain, stiffness, inflammation, and deformity.

See a rheumatologist to confirm the diagnosis and begin a treatment plan.

Prognosis

The course of the disease is unpredictable. Symptoms may come and go at any time. Most people are able to function unless the hips are severely involved. In more severe cases, damage to cartilage and bone can lead to fusing of the joints in the spine or other areas, which can interfere with your ability to move. It can be extremely painful and crippling. The heart, lungs, and eyes may also become affected. An early diagnosis and treatment plan are essential for limiting pain and deformity.

surgery for ankylosing spondylitis

ankylosing spondylitis early diagnosis

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