Adeeming Ankylosing Spondylitis

You wake up from a long night’s rest with a stiff back. The pain has traveled to your neck. You have a hunched posture. You could have ankylosing spondylitis.

Ankylosing spondylitis is a type of arthritis. It can occur at any age, to either sex. But it usually victimizes young men between age 20 to 30. The disease usually runs in families. There is a genetic link. Beyond that its origins are a mystery.

Back arthritis is only part of the picture. There’s eye inflammation which can destroy vision unless it’s properly treated. The aorta, the body’s largest artery, can suffer from inflammation and can leak blood back into the heart. With rib involvement, taking a deep breath can be an impossible task.

Ankylosing spondylitis can take an unpredictable course. Some patients are hardly affected. Meanwhile, others at the other end of the spectrum may have debilitating arthritis. In extreme cases, the patient may be bent over at the waist, seemingly immobile.

The disease is a particular type of arthritis that affects the spine and sacroiliac joints. The latter joints are those connecting the lowermost portion of the spine—sacrum—to the ilium, a pelvic bone.

At first, the pain starts in the lower back or buttocks. The lower back becomes stiff. As time passes, the pain becomes persistent and awakens the patient from sleep. The arthritic process makes an upward ascent in the spine and can reach as high as the neck. In time, the spine can become as stiff as a rod, freezing the patient with rigidity beyond measure and causing a forward bend of the neck.

Shoulder and hip joints can be involved in the same process. Some patients develop a leaky heart valve. This might prompt your doctor to order a HLA-B27 gene blood test, which is a genetic marker found on the white blood cells of many with this type of arthritis. It is important to remember that not everyone who tests positive for the gene will go on to develop ankylosing spondylitis.

Your doctor will also suggest an exercise regimen to keep the spine mobile and maintain normal posture. Swimming is an excellent form of exercise for this condition. A firm mattress and a small pillow will maintain spine alignment during the night.

The key to this condition is early diagnosis and timely treatment in order to avoid progression of the disease. Diagnosis of ankylosing spondylitis is based on clinical symptoms and signs. Based on the history, your doctor will test for stiffness of the spine, hips or restricted chest movements. Tests like X-rays or MRI may be advised to check for inflammation in the spine and pelvic joints. Blood tests may be ordered to check for inflammation in the body and the HLA-B27 gene.

There is no cure for ankylosing spondylitis. Treatment is directed towards controlling the disease, its symptoms and controlling the progression. Exercises and physiotherapy play a crucial role in treatment. They help preserve strength and flexibility of the spine and affected joints. Your doctor may prescribe pain killers and nonsteroidal anti-inflammatory drugs (NSAIDs) to take care of the pain. Drugs such as steroids and disease-modifying anti-rheumatic drugs (DMARDs) may be suggested to control and prevent progression of the disease. In severe cases, where the patient isn’t responding to conventional treatments, biological agents like anti-TNF alpha may be suggested. Fused spine or hips may require surgical treatment.

Timely detection of the disease and shrewd treatment are essential in controlling the disease and preventing its progression to advanced stage of deformity and disability. Regular follow-up and strict adherence to medical advice are important for effective treatment of this condition.