Ankylosing Spondylitis
Ankylosing spondylitis (AS) is a form of arthritis that mainly affects the spine, especially the lower back and the joints connecting the spine to the hips. The resulting inflammation causes pain and stiffness in the back and may eventually cause some of the bones in the spine, which are called the vertebrae, to fuse together.
Symptoms
Pain and stiffness of the lower back is the most common symptom. This tends to worsen with inactivity. Patients who find that movement and exercise help to relieve discomfort. Pain might also occur in the hips and neck. Pain and stiffness in the ribs can become intense enough to make breathing difficult. Other common symptoms include:
- Joint pain
- Fatigue
- Loss of appetite and unexplained weight loss
- Diarrhea and abdominal pain
- Rashes
Causes
The underlying cause of AS is unknown. Genetics and family history likely play a large part. One particular gene, called HLA-B27, is associated with the disease. About 95% of the people with ankylosing spondylitis have this gene. However, most people with the gene do not develop AS. Having Crohn’s disease, ulcerative colitis, or psoriasis may also raise the risk of getting AS.
Complications
Having ankylosing spondylitis can contribute to other serious health problems, including:
- Fusion of vertebrae and a forward curving of the spine.
- Uveitis (eye inflammation). Chronic eye inflammation results in pain, dryness, and light sensitivity, and may cause vision loss.
- Compression fractures. Bones tend to weaken and osteoporosis may develop. AS sufferers are more prone to lumbar spine fractures.
- Heart problems. The inflammation from AS may affect the heart and the aorta, the body’s largest artery, which sends blood from the heart to the rest of the body.
Diagnosing Ankylosing Spondylitis
There is no definitive test for AS. Your healthcare provider will review your family history and do a physical exam. MRIs, CT scans, or X-rays are sometimes used to look for signs of the disease. Blood tests and genetic testing can check for HLA-B27 gene issues.
Treatment
There’s no cure for ankylosing spondylitis. But there are standard treatments to address symptoms, manage pain, and reduce joint damage and future complications. Common practices include:
Lifestyle choices
Regular exercise and stretching are critical. They reduce stiffness and preserve the range of motion. Other recommendations: maintain good posture, make sure your diet includes calcium and vitamin D, and don’t smoke.
Medication
- Nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen and naproxen are used to ease inflammation and pain.
- Biologics may be used to disrupt specific immune system pathways and reduce inflammation.
- Corticosteroids may be used to reduce inflammation and relieve pain
Therapy
A physical therapist can create a useful exercise plan to fit your lifestyle and to strengthen and stretch muscles. They also can help you find the best position for sleeping and walking.
Surgery
Most people afflicted with AS do not need surgery, but those saddled with severe pain or joint damage may choose joint replacement. People with a severely bent spine may choose to have surgical straightening.
Help from Specialists
Ankylosing spondylitis can make life miserable for its victims. The rheumatologists at Florida Medical Clinic are here to help ease your symptoms and provide relief so you can get back to doing the things you love. Click here to schedule an appointment with our rheumatology team.
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