Ankylosing Spondylitis(AS) is a type of arthritis that mainly affects the spine. It causes chronic inflammation in the joints and ligaments of the spine. This inflammation can lead to long-term pain and stiffness in the lower back Pain. Over time, this condition can cause the vertebrae(the small bones that make up the spine) to fuse together.
In addition to the spine, other joints like knees, hips, shoulders, ribs, etc, may also be affected, leading to loss of flexibility and mobility. It can also cause digestive symptoms, rashes, and weight loss. Early diagnosis and appropriate treatment are important in slowing down the growth of the disease.
Who is Most Affected by Ankylosing Spondylitis?
This condition usually starts in young adulthood usually between the age of 17 and 45.
Although it can affect anyone, AS is more common in men. One of the major factors in developing AS is genetics, meaning the condition usually runs in families.
In this comprehensive guide, we’ll dive deeper into the nuances and the available treatment of Ankylosing Spondylitis.
Symptoms & Causes of Ankylosing Spondylitis
Early signs of Ankylosing Spondylitis
The early signs of Ankylosing Spondylitis develop gradually over several weeks or months and can vary from person to person. AS symptoms can be mistaken for other types of back pain or arthritis as well. Some of the signs of Ankylosing Spondylitis include:
● Chronic lower back pain : Chronic lower back pain is the most common sign of AS. There is pain and stiffness in the lower back and hips, especially in the morning or after you have been resting in one position for a long time. AS related discomfort can last for months or even years.
● Fatigue : People with Ankylosing Spondylitis experience extreme tiredness. This tiredness isn’t just due to disturbance in sleep, it relates to the inflammation in the body. This can leave you feeling drained even after a good rest.
● Difficulty in movement: The inflammation in the spine due to AS, can reduce the flexibility and the movement of the person. The patient finds it difficult to bend or twist. In more severe cases the spine may become permanently hunched.
● Eye inflammation: AS can result in uveitis or inflammation of the eye. It can cause redness, pain, blurred vision, and sensitivity to light. About 40% of the people with AS may experience uveitis, an inflammation of the eye. If left untreated, it can lead to serious complications.
Ankylosing Spondylitis Symptoms
As the disease progresses, the symptoms of AS become more pronounced. Common symptoms include:
● Reduced spinal mobility: Ankylosing Spondylitis fuses the spine leading to a reduction in flexibility and a stooped posture. The spine can become permanently hunched. Though the spine is the most affected area, AS can also cause pain in other joints like knees, shoulders, and hips.
● Loss of appetite: AS can lead to loss of appetite and unexplained weight loss.
● Joint pain in other areas: Apart from affecting the spine, other joints like hips, shoulders, and knees can also be affected. As the disease progresses, joint swelling, pain, and discomfort become very common.
● Breathing difficulties: Ankylosing Spondylitis can also affect the ribs which can make breathing difficult and painful. It becomes difficult for the chest to expand fully which leads to shortness of breath.
Ankylosing Spondylitis Causes
The exact causes of Ankylosing Spondylitis are unknown but several genetic and environmental factors significantly contribute to its development.
● Genetics: One of the biggest factors linked to Ankylosing Spondylitis is genetics, meaning it can run in families. There is a gene called HLA-B27 that is associated with AS. It is commonly observed in 90% of the cases that people who have this disease, also carry this gene.
However, not everyone with this gene will develop AS. So, having this gene increases the chances of developing this disease but there is no guarantee that you will end up with this condition.
● Environmental factors: While genetics are the prime cause, some studies suggest that certain bacterial infections might kickstart AS in genetically susceptible individuals.
However, the specific environmental triggers are still not fully understood.
● Immune system dysfunction: AS is an autoimmune disorder. This means that the immune system whose function is to protect the body, mistakenly attacks the healthy tissues in the spine and other joints.
Ankylosing Spondylitis Diagnosis & Tests
How is Ankylosing Spondylitis Diagnosed?
Ankylosing spondylitis can be difficult to diagnose in its early stages as the symptoms of AS are very similar to other conditions. Various diagnostic tools and tests are often necessary to detect the presence of AS.
- Medical history and physical examination: The patient’s history and physical symptoms are thoroughly evaluated, focusing on back pain patterns, joint stiffness, and family history of similar conditions.
- Imaging Tests:
● X-rays: Useful for detecting damage to the sacroiliac joints and spinal vertebrae.
● MRI: Magnetic resonance imaging helps in detecting early inflammatory changes before bone damage becomes visible. - Blood Tests:
● Testing for the HLA-B27 gene.
● Inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), may be elevated in individuals with AS.
Additional diagnostic considerations
If the chronic back pain in an individual under the age of 45, lasts more than 3 months, it becomes a key diagnostic criterion. Moreover, if symptoms improve with NSAIDs, it can be an indication of AS.
Also Read : Top 10 Most Common Orthopedic Surgeries
Management and Treatment of Ankylosing Spondylitis
Treatment of Ankylosing Spondylitis
Treatment of AS involves a combination of medication, lifestyle changes, and sometimes surgery. Early detection is crucial to slowing down the progression of the disease and also reducing discomfort. The treatment plan depends upon the individual’s specific symptoms and disease progression. Managing AS aims to reduce pain, maintain mobility, and also prevent long-term complications.
Medications
● Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) : These are the first line of treatment to reduce pain and inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin) and naproxen (Aleve). Stronger prescription NSAIDs, such as celecoxib (Celebrex) and diclofenac, may be prescribed for more severe symptoms. NSAIDs are effective for many people with AS and help the patient to move more easily throughout the day.
● Disease-Modifying Antirheumatic Drugs (DMARDs): Medications like methotrexate may help manage symptoms, especially when peripheral joints are involved. Methotrexate and sulfasalazine are often used for treating AS, especially when peripheral joints are involved.
Methotrexate, for example, works by inhibiting the production of certain cells in the immune system that lead to inflammation. DMARDs help to preserve joint function and are important for long-term quality of life.
● Biologic Medications: Tumor Necrosis Factor (TNF) inhibitors and interleukin-17 (IL-17) inhibitors are biologic drugs that are used when NSAIDs alone are not effective. These medications target specific pathways in the immune system to reduce inflammation. They are highly effective at reducing pain, inflammation, and, stiffness.
Best Exercises for Ankylosing Spondylitis
Exercise plays an important role in managing AS. The best exercises for Ankylosing Spondylitis are those that focus on flexibility, strengthening, and posture correction. Regular physical therapy can reduce stiffness and stop AS from getting worse. Inactivity causes severe pain in many people. A physical therapist can suggest specific stretches and exercises to help the back muscles and spine. Some of these exercises are:
● Stretching: Regular stretching exercises, especially those that focus on the back and neck, can help to improve flexibility and prevent stiffness.
● Low-impact aerobic exercises: Swimming and cycling are excellent low-impact exercises. These activities tend to enhance cardiovascular health without putting stress on the spine and joints.
● Yoga and Pilates: Yoga and Pilates promote flexibility and core strength, which are essential for individuals with AS.
● Posture correction exercises: Posture correction exercises aim to improve posture and can help tackle the tendency of the spine to bend forward.
Ankylosing Spondylitis Diet
Certain dietary changes may help reduce inflammation and improve overall health.
● Anti-inflammatory foods: Including foods like fatty fish (rich in omega-3 fatty acids), nuts, seeds, and leafy green vegetables in your diet can help to reduce the inflammation levels in the body.
● Avoiding processed foods: The intake of processed foods, sugary drinks, and refined carbohydrates should be reduced as this can help reduce inflammation.
● Maintaining a healthy weight: Ankylosing Spondylitis mainly affects the spine and joints. So, maintaining a healthy weight is essential to reduce stress in these areas.
Management of AS in the long-term
Ankylosing Spondylitis is a chronic disease and hence requires lifelong management. Regular follow-ups with a healthcare provider are essential to oversee the progress of the disease and adjust the treatment plans accordingly.
In addition to medical treatment, lifestyle choices can help in managing Ankylosing spondylitis in the long run. The right kind of exercise helps to maintain flexibility. Good posture helps the spine to curve forward. Managing stress is also crucial for the management of this disease. Heat can also be applied to stiff joints and tight muscles. Ice packs can be used on inflamed joints.
People who smoke often have symptoms that can get worse. Hence, avoiding smoking can also help to manage the condition.
Possible complications of Ankylosing Spondylitis
Osteoporosis
Living with AS can be challenging and lead to potential complications. Understanding these complications is essential for effectively managing the disease. Patients diagnosed with AS are at a greater risk of developing osteoporosis. Osteoporosis is a condition where bones become thin and brittle. This can increase the risk of spinal fractures, which can severely affect mobility.
In case the disease progresses further, the inflammation can lead to new bone formation in the spine. This can cause the parts of the spine to fuse together leading to a condition known as ankylosis. This results in reducing mobility and making everyday work difficult. AS can also lead to psoriasis, and inflammation of the eye, aortic valve, and intestinal tract.
Postural Changes (Kyphosis)
Over time, people with AS may develop a forward bend in their spine. This can flatten the natural curve of the lower back and result in a bent-over posture known as kyphosis. This can make everyday activities more challenging, as the chest may not expand fully making it harder to breathe comfortably.
Surgery
Surgical intervention is needed only where there is significant joint damage or other treatments are not providing any relief. Surgical operations like joint replacement or spinal corrective surgery may be required. Joint replacement can help restore movement while spinal surgery can correct spinal deformities.
Conclusion
Ankylosing Spondylitis is a complex condition that requires a comprehensive approach to manage. While there is no cure, with medications and lifestyle changes it becomes easy to tackle this chronic disease. With proper diagnosis and treatment, individuals can manage their symptoms and maintain a good quality of life. Early diagnosis and intervention are important in preventing long-term complications and maintaining quality of life.
At Glyra Orthopedics, we specialize in providing comprehensive care for individuals with Ankylosing Spondylitis and other orthopedic conditions. With the help of advanced diagnostic tools and personalized treatment plans, we are committed to helping our patients manage their conditions effectively.
If you’re experiencing symptoms of AS or are looking for expert guidance on managing your condition, we encourage you to visit glyraorthopedic.com to learn more about our services.
Our team of specialists is experienced in treating Ankylosing Spondylitis and can provide you with the tools and strategies you need to lead a healthy, active life.
Get an Appointment at Glyra Orthopaedics Today for Treatment of Ankylosing Spondylitis
At Glyra Orthopaedics, our goal is to help you live an active life.
If you’re experiencing symptoms of Ankylosing Spondylitis or have been diagnosed with AS and are seeking expert care, we’d love to discuss further options. Here’s how you can get started:
- Call us: Reach us at +91 98731-65961 to schedule an appointment today.
- Online booking: You can also book your appointment through our website. Click on the appointment scheduling tab to choose a date and time that suits you.
Don’t wait—early intervention can make a significant difference in managing Ankylosing Spondylitis. Let our team of experts at Glyra Orthopedics guide you toward a healthier, more active future.
In addition to our specialized Ankylosing Spondylitis care, Glyra Orthopedic provides a range of orthopedic services, including:
● Comprehensive joint care
● Sports medicine
● Physical therapy and rehabilitation
● Minimally invasive surgical options
Whatever your orthopedic needs are, Glyra Orthopedics is here to support you every step of the way.