Ankylosing Spondylitis

Ankylosing spondylitis is a form of arthritis that primarily affects your spine. It causes severe inflammation of the vertebrae that might eventually lead to chronic pain and disability. In more advanced cases, the inflammation can cause new bone to form on the spine, which may lead to deformity.

Ankylosing spondylitis can also cause pain and stiffness in other parts of your body. Other large joints such as the shoulders, hips, and knees can be involved as well.

The cause of ankylosing spondylitis is unknown. The disorder does tend to run in families, so genetics probably play a role. If your parents or siblings have ankylosing spondylitis, you are 10 to 20 times more likely to be diagnosed with the disease than someone with no family history.

The symptoms of ankylosing spondylitis vary. It is often characterized by mild to moderate flare-ups of inflammation that alternate with periods of almost no symptoms. The most common symptom is back pain in the morning and at night. You may also experience pain in the large joints such as the hips and shoulders. Other symptoms may include:

• early morning stiffness
• loss of appetite
• low grade fever
• weight loss
• fatigue
• anemia or low iron

Because ankylosing spondylitis involves inflammation, other parts of your body can be affected as well. Patients may also experience:

• inflammation of the bowels
• mild eye inflammation
• heart valve inflammation
• Achilles tendonitis

A rheumatologist, a doctor who specializes in arthritis, is often consulted to help diagnose ankylosing spondylitis. The first step will be a thorough physical exam. A doctor will ask you for details about the pain and the history of your symptoms.

An X-ray of your spine and any painful joints will show erosion. The erosion may not be detected if the disease is in the early stages. An MRI study may also be done, but the results are often difficult to interpret.

A blood test called an erythrocyte sedimentation rate may be done to gauge the presence of any inflammation. A blood test for a protein HLA-B27 may be done. However, the HLA-B27 test does not mean that you have ankylosing spondylitis, only that you have the gene that produces this protein.

Because there is no cure for ankylosing spondylitis, your treatment will be focused on managing pain and preventing disability.

Medications

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are often used to help manage your pain and inflammation. When they don’t provide enough relief, stronger medications may be prescribed.

Activity

Daily exercise is encouraged to help you maintain flexibility and range of motion. Physical therapy may be prescribed for treatment.

Posture

Practicing good posture is promoted in order to prevent the deformity of the spine that can occur in later stages.

Heat/Cold

Applying heat to stiff joints can help reduce pain and soreness. Applying cold helps to reduce swelling.

Surgery

If you have severe damage or deformity to your knee or hip joints, surgery may be necessary.

Family History

A family history of ankylosing spondylitis is a risk factor, along with the presence of the HLA-B27 protein.

Age

Unlike other arthritic and rheumatic disorders, initial symptoms of ankylosing spondylitis often appear between the ages of 20 and 40.

Gender

Ankylosing spondylitis is more common in men, but is seen in women as well.

It is not known how you can prevent ankylosing spondylitis because no one knows what causes it in the first place. However, if you have the disease, you can focus on preventing disability by staying active, eating healthy, and maintaining a normal body weight.

Ankylosing spondylitis is a chronic, progressive disease that often leads to disability. With aggressive treatment and daily exercise, you can slow the progression and lead a normal life.