Ankylosing spondylitis (AS) is a long-term disease that involves inflammation of the joints in the spine. It’s a type of arthritis and main symptom is gradually developing lower back pain, usually in adolescence or young adults.
The inflammation can cause the vertebrae (individual bones that make up the spine) to fuse together, making the spine less flexible and resulting in a hunched-forward posture. While the spine is most commonly affected, other joints, such as the hips, knees, shoulders, and ribs, can also be involved.
The exact cause of AS is unknown, but genetics play a crucial role in the disease’s development. There is no cure for AS, but there are treatments that can reduce discomfort and improve function. These might include physical therapy, exercise, medication and in some severe cases, surgery.
Other symptoms can include early morning stiffness, poor posture, fatigue, loss of appetite and weight loss, eye inflammation and bowel inflammation. It is a chronic condition that usually lasts for a lifetime once it occurs. It’s important to get a diagnosis and begin treatment as soon as possible if AS is suspected.
Causes of Ankylosing spondylitis
Ankylosing spondylitis is a type of arthritis that affects the spine, causing chronic inflammation primarily in the spine and sacroiliac joints, which can lead to severe, chronic pain and discomfort. The exact cause of ankylosing spondylitis is unknown, but it may be due to a combination of both genetic factors and environmental triggers. Here are some key factors that may contribute to the disease:
1. Genetic Factors: A large number of people with ankylosing spondylitis carry a gene known as HLA-B27. Research has shown that more than 90% of individuals with ankylosing spondylitis are HLA-B27 positive. However, many people who have this gene never develop the disease.
2. Environmental Triggers: While the specific environment triggers are not well understood, they could potentially be traumatic injuries or infections that kickstart the immune response resulting in persistent inflammation.
3. Autoimmune Response: Some scientists believe that ankylosing spondylitis is an autoimmune disease. In an autoimmune reaction, the body’s immune system mistakenly attacks some of its own cells. In the case of ankylosing spondylitis, the immune system target is thought to be the entheses (where ligaments and tendons attach to bones).
4. Smoking: Some research has suggested that smoking could be a risk factor for ankylosing spondylitis.
Despite these potential factors, the exact cause is not fully understood and researchers are still exploring other possibilities. As of now, there is no known cure for this disease, but there are treatments available that can help to manage the symptoms and prevent the progression of the disease.
Risk Factors of Ankylosing spondylitis
Ankylosing Spondylitis is a type of arthritis that primarily affects the spine but can also damage other joints. Several factors can increase the risk of developing this condition:
1. Gender: Men are more likely than women to develop ankylosing spondylitis.
2. Age: The disease often starts in late adolescence or early adulthood.
3. Genetics: People who have a family member with the disease are at higher risk. It’s strongly related to a genetic marker called HLA-B27, most people with this gene don’t necessarily develop the condition but it is more common among those who do have it.
4. Certain Infectious Agents: This is a topic of research; some scientists believe that bacteria, specifically ones in the gut, might trigger the disease in people who are genetically predisposed.
5. Other Autoimmune Conditions: People with certain autoimmune conditions, such as psoriasis or inflammatory bowel disease, may have a higher risk of developing ankylosing spondylitis.
Remember that having risk factors does not mean you will definitely develop the disease. Some people with several risk factors might never get it, while others with no known risk factors might do. However, knowing your risk can help you and your doctor to monitor for signs and symptoms and manage the disease better if it develops.
Signs and Symptoms of Ankylosing spondylitis
Ankylosing spondylitis is a type of inflammatory arthritis that primarily affects your spine but can affect other joints as well. It leads to inflammation of the spinal joints (vertebrae) that can result in severe, chronic pain and discomfort.
Here are some of the common signs and symptoms:
1. Back Pain: Gradual pain and stiffness usually start in the lower back and buttock area. The pain is typically worse in the morning and at night.
2. Progressive Stiffness: Over time, the stiffness can progress up the spine and to other areas such as the hips, ribs, heels, and shoulder joints.
3. Bony Fusion: In severe cases, chronic inflammation can lead to the fusion of vertebrae, leading to decreased range of movement and a stooped-over posture.
4. Fatigue: Ankylosing spondylitis may also cause fatigue.
5. Neck pain and stiffness: The discomfort can also affect the neck.
6. Appetite loss or weight loss: Some people may experience a loss of appetite or weight loss.
7. Mild fever: This condition can sometimes be accompanied by a mild fever.
8. Inflammation in eye (uveitis): In some cases, ankylosing spondylitis also causes eye inflammation (uveitis), resulting in redness, pain, and blurred vision.
A point to note is that the symptoms can vary from person to person and they usually start gradually, most commonly around the late teenage or early adult years. It’s always advisable to consult a healthcare doctor or professional if you’re experiencing persistent discomfort or pain.
Diagnosis Ankylosing spondylitis
Ankylosing spondylitis is a type of inflammatory arthritis that primarily affects the spine, but it can also affect other parts of the body. It causes inflammation in the vertebrae and can lead to chronic pain, discomfort, and even disability in severe cases.
The exact cause of ankylosing spondylitis is unknown, but genetics play a significant role. The condition is more common in people who have a specific gene known as HLA-B27.
The symptoms of ankylosing spondylitis often start with lower back pain and stiffness, especially in the morning or after periods of inactivity. Over time, these symptoms could progress up to the spine and neck. In severe cases, chronic inflammation may lead to new bone formation causing sections of the spine to fuse in a fixed position.
Other symptoms may include pain and swelling in other parts of the body, fatigue, poor posture, loss of appetite, and eye inflammation.
Diagnosis of ankylosing spondylitis usually involves medical history evaluation, physical examination, imaging tests like X-rays or MRI, and sometimes blood tests.
Treatment is typically focused on managing symptoms, slowing the progression of the disease, and maintaining a normal lifestyle. This can involve medication for pain and inflammation, physical therapy, and in severe cases, surgery. Regular exercise and good posture practice can also help manage symptoms.
Keep in mind that it is a chronic condition, meaning symptoms may come and go over time. Each person with ankylosing spondylitis can experience it differently. Some may have mild symptoms and discomfort, while others may experience significant pain and stiffness.
Treatment of Ankylosing spondylitis
Ankylosing spondylitis (AS) is a type of arthritis that primarily affects the spine. Although there’s currently no cure for the condition, treatments can lessen your symptoms and potentially slow the progression of the disease.
1. Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are usually the first line of treatment. If NSAIDs are not effective, your doctor may suggest disease-modifying antirheumatic drugs (DMARDs) like sulfasalazine or biologic medications to target the immune response, including TNF-alpha blockers and Interleukin 17-A inhibitors.
2. Physical Therapy: A well-rounded physical therapy program can help maintain flexibility and posture, relieve pain, and improve your ability to function. It often includes exercises to improve strength, flexibility, and pain management strategies.
3. Exercise: Regular physical activity is encouraged as part of a management plan for AS. Exercises like swimming, walking, cycling, or tai chi can help to reduce stiffness, maintain posture, and promote flexibility.
4. Surgery: In severe cases where there is severe pain or joint damage, surgical intervention may be necessary. This can involve joint replacement or, in rare cases, surgery to straighten the spine.
5. Lifestyle modifications: Adopting a healthy lifestyle is important for managing AS. This may include quitting smoking, maintaining good posture, taking breaks from long periods of sitting, using ergonomic devices at work, and a balanced diet.
6. Pain Management: In some cases, simple pain management strategies like applying heat or cold, massage, or over-the-counter pain relievers can help.
Please consult your healthcare provider for the best treatment plan for you, as the choice of treatment should depends on your specific symptoms and disease progression.
Medications commonly used for Ankylosing spondylitis
Ankylosing Spondylitis is a type of arthritis that affects the spine. It involves inflammation of the spinal joints that can lead to severe, chronic pain and discomfort. In more advanced cases, it can cause sections of the spine to grow together, resulting in a rigid, inflexible spine. Here are some common medications used in the treatment of ankylosing spondylitis:
1. NSAIDs (Nonsteroidal Anti-inflammatory Drugs): The first line of treatment usually involves over-the-counter or prescription NSAIDs, such as ibuprofen (Advil, Motrin) or naproxen (Aleve) which can help to reduce inflammation, pain and stiffness.
2. TNF Blockers: Also known as TNF inhibitors, medications such as infliximab (Remicade), etanercept (Enbrel), adalimumab (Humira), golimumab (Simponi), and certolizumab pegol (Cimzia) decrease inflammation by blocking a protein known as TNF.
3. IL-17 Inhibitors: Secukinumab (Cosentyx) and ixekizumab (Taltz) are medicines that inhibit a protein known as IL-17, which contributes to inflammation.
4. Disease-modifying Antirheumatic Drugs (DMARDs): Sulfasalazine (Azulfidine) and methotrexate (Trexall) may help control the disease and prevent further progression. However, these are typically used if the disease involves other joints besides the spine.
5. Corticosteroids: These can reduce inflammation and are usually used for quick relief of acute symptoms, often for short periods. Prednisone is commonly used corticosteroid.
6. Physical Therapy: Although not a medication, physical therapy can improve strength and flexibility and alleviate some of the pain associated with ankylosing spondylitis.
Remember, all medication must be prescribed by a healthcare provider, who can take into consideration your medical history, other medications you may be on, and your overall health status.
Prevention of Ankylosing spondylitis
Ankylosing spondylitis (AS) is a long-term disease that affects the spine and large joints. While a cure for the disease does not exist, there are several ways to prevent, better manage, and reduce symptoms of ankylosing spondylitis:
Healthy Lifestyle: Maintain a healthy weight and balanced diet as being overweight can add stress to the joints. Regular physical activity can also help manage symptoms and keep bones and muscles strong.
Physiotherapy: Regular exercise can be very beneficial. Certain forms of exercise like stretching, yoga, and swimming may be particularly beneficial for people with AS. A physiotherapist can help design an exercise program suited for your condition.
Quitting Smoking: People with AS who smoke generally experience more severe symptoms. Smoking can also increase your AS complications, so it’s crucial to quit if you smoke.
Regular Check-ups: Regular visits to your doctor can help monitor your disease’s progression, adjust your treatment plan as needed, and prevent complications.
Medication: While not necessarily a prevention, taking prescribed medication regularly can slow the disease’s progression and help manage the symptoms.
Posture: Practising good posture can help reduce some of the pain and stiffness in your spine.
While there is no known way to ‘prevent’ Ankylosing Spondylitis, as most healthcare professionals believe it can be caused genetically, the above-mentioned steps can help manage the disease better.
Remember, each case of ankylosing spondylitis is unique; what works for someone else may not work for you and it is essential to work closely with your healthcare provider to create a comprehensive treatment plan.
FAQ’s about Ankylosing spondylitis
1. What is Ankylosing Spondylitis (AS)?
Ankylosing spondylitis (AS) is a type of inflammatory arthritis that primarily affects the spine, causing inflammation in the spinal joints that can lead to severe, chronic pain and discomfort.
2. What are the symptoms of AS?
The main symptom is back pain which is usually persistent and worse in the morning. Other symptoms can include fatigue, neck pain, pain and swelling in joints like hips, knees, and ankles, and in some cases, problems related to the heart and eyes.
3. Who gets AS?
Anyone can get AS, but it typically affects young men and women and usually starts before the age of 45. It’s also genetically linked, meaning that you’re more likely to have it if a member of your family does.
4. How is AS diagnosed?
AS can be difficult to diagnose because its symptoms are similar to more common back problems. However, a combination of medical history, physical examination, blood tests, and imaging tests like X-rays or MRI can help in diagnosis.
5. What is the cause of AS?
The exact cause of AS is unknown, but it’s believed to be linked to genetics. People with a particular gene known as HLA-B27 are much more likely to develop ankylosing spondylitis.
6. Can AS be cured?
There’s no cure for AS, but treatments can help manage symptoms and potentially slow disease progression. Treatments can involve medication, physiotherapy, and in some severe cases, surgery.
7. Is exercise beneficial for people with AS?
Yes, regular exercise is recommended because it can help to relieve pain, improve posture and flexibility, and maintain strong bones. It’s optimal to engage in exercises designed to stretch the back and neck to maintain maximum movement and flexibility.
8. Is AS a form of disability?
People with AS can often lead full, active lives with the right treatment. But in severe cases, the inflammation can cause the vertebrae in the spine to fuse together, causing permanent damage, which may be considered a disability.
Remember, these are general guidelines and your specific situation may be different. Always consult a healthcare professional for accurate information.
Useful links
Ankylosing Spondylitis (AS) is a type of arthritis that primarily affects the spine, although other joints can become involved. It causes inflammation of the spinal joints (vertebrae) that can lead to severe, chronic pain and discomfort. In advanced cases, this inflammation can lead to new bone formation on the spine, causing the spine to fuse in a fixed, immobile position, sometimes in a forward-stooped posture. This condition is a systemic disease, which besides musculoskeletal symptoms, can also affect the eyes, heart, lungs and kidneys.
Here are some useful links from journals about Ankylosing Spondylitis:
If you need Scholarly Articles, use Google Scholar or PubMed and search for “Ankylosing Spondylitis.”
Complications of Ankylosing spondylitis
Ankylosing spondylitis is a type of inflammatory arthritis that mainly affects the spine. It can lead to severe, chronic pain and discomfort, and in the most serious cases, it can cause the spine to fuse in a fixed, immobile position. Here are some of the complications associated with ankylosing spondylitis:
1. Chronic Pain: Most people with ankylosing spondylitis experience long-term pain, which can be moderate to severe. This is often most noticeable in the back and hips.
2. Spinal Fusion: The inflammation can cause the vertebrae in the spine to fuse together, leading to a less flexible spine and potentially resulting in a hunched-forward posture.
3. Eye Inflammation (Uveitis): Ankylosing spondylitis can sometimes cause inflammation of the uvea, leading to redness, pain and blurred vision in the eyes.
4. Heart Problems: Ankylosing spondylitis can cause problems with the heart, including aortic inflammation and scarring, which can affect the heart’s ability to function normally.
5. Lung issues: The disease can cause the upper part of the rib cage to be less flexible, making deep breathing difficult. Additionally, it may cause scarring or fibrosis in the lungs.
6. Reduced mobility: The combination of chronic pain, spinal fusion, and joint inflammation can severely limit physical mobility.
7. Osteoporosis: People with ankylosing spondylitis have an increased risk of developing osteoporosis–a condition that weakens bones and makes them brittle and susceptible to fracture.
8. Mental health complications: Like many chronic illnesses, ankylosing spondylitis can lead to mental health issues like depression and anxiety due to factors such as dealing with long-term pain, having to manage a long-term illness, and the impact the condition can have on work, social, and family life.
The severity of these complications varies greatly from person to person. It’s also important to note that timely treatment can help manage the symptoms and possibly slow the progression of the disease.
Home remedies of Ankylosing spondylitis
Ankylosing spondylitis is a chronic inflammatory disease that primarily affects the spine. While there’s no cure yet for this condition, there are some home remedies that may help manage symptoms and improve quality of life. These should ideally be used in conjunction with medical treatments prescribed by a doctor.
1. Exercising Regularly: Regular physical activity can help reduce stiffness, strengthen the muscles around the joints and maintain flexibility. Tailored workouts like a balance of stretching, strength, and cardio exercises can be helpful.
2. Heat and Cold Therapy: Applying warm or cold packs to stiff joints and muscles might help reduce pain and inflammation.
3. Posture Practices: Regular practice of good posture can help manage symptoms. It can be beneficial to use supportive devices such as ergonomic chairs and using pillows to support your body while seated or sleeping.
4. Stress Management: Techniques like deep-breathing, meditation, yoga, and other methods can help manage stress, which can worsen inflammation and pain.
5. Healthy Diet: A balanced diet can promote overall health and wellness. Some patients find an anti-inflammatory diet (which includes lots of fruits, vegetables, nuts, and whole grains) helpful.
6. Rest: Ensure sufficient rest and sleep as it’s important for managing symptoms. It helps in body repair and can reduce inflammation.
7. Avoid Smoking: Smoking can make ankylosing spondylitis symptoms worse and increase the risk of complications.
8. Aquatic Exercises: These are often recommended to people with this disease as the buoyancy of the water takes stress off painful and stiff joints, allowing for easier movement.
Always discuss any home remedies with your doctor before trying them and remember, these remedies are designed to help manage symptoms, but they do not replace the ankylosing spondylitis treatment prescribed by your healthcare team.