Ankylosing Spondylitis

Ankylosing Spondylitis is a relatively uncommon form of Arthritis. It is a rheumatic disease that causes degeneration in the spine and sacroiliac joints that attaches the spine to the pelvis. During the auto-immune response the body believes it is attacking foreign cells between the vertebrae causing inflammation, swelling, pain and loss of mobility. The disease can also cause inflammation to the eyes, lungs and heart valves.

The name of this condition is derived from  Ankylosing (which means stiff or rigid) and Spondylitis  (which means inflammation in the spine). 

Ankylosing Spondylitis can vary from an intermittent episodic condition that causes back pain throughout life to a severe chronic disease that attacks the spine, peripheral joints and other body organs. 

Ankylosing Spondylitis is a member of spondylarthropathies, a group of arthritic conditions with similar patterns. The cause of Ankylosing Spondylitis isn’t known but the group of spondylarthropathies share a common genetic marker, HLA-B27. In some cases Ankylosing Spondylitis will occur after the patient has had a bowel or urinary tract infection, potentially triggering the auto-immune response.

Ankylosing Spondylitis Symptoms

The main symptoms of Ankylosing Spondylitis include one or more of the following:

• chronic back pain

• stiffness in the back (especially in the morning)

• pain in other joints including the neck, knees, ankles and hips

• pain around tendons

• pain in the heel

• inflammation of the eyes

• various rashes 

Ankylosing Spondylitis Risk Factors

The main risk factors for Ankylosing Spondylitis include:

• Gender

• Age

• Race  

Ankylosing Spondylitis affects approximately 130 out of 100,000 people in the United States. These are typically young adolescents and young adult males.

Ankylosing Spondylitis occurs in twice as many men as women, and in women, the symptoms of the disease are usually much milder. Ankylosing Spondylitis usually has its onset between the ages of 16 to 35. There is a cultural link as it is prevalent in Native Americans. 

Ankylosing Spondylitis Causes

The precise cause for Ankylosing Spondylitis is unknown at the current time, but there does appear to be a strong genetic link. Most (but not all) people with Ankylosing Spondylitis carry a gene known as HLA-B27. Only a small percentage of people carrying this gene will go on to develop Ankylosing Spondylitis so, a range of genes, or alternate genes, may be involved. 

Ankylosing Spondylitis Diagnosis 

Delay of the initial diagnosis is common because the symptoms often mimic those of other more common back problems. In other more severe cases people show up at the doctor’s office with progression to the inflammation of the eye, fever, fatigue, weight loss or anemia.

With early diagnosis and treatment people are able to decrease the amount of functional loss and pain caused by Ankylosing Spondylitis. With the use of Magnetic Resonance Imaging (MRI) to visualize the inflammatory changes in the sacroiliac joint. The MRI gives a much better view of the earlier changes that happen in the sacroiliac joint early in the progression of Ankylosing Spondylitis. This gives physicians a better chance to begin therapies and treatments to slow the loss of function and mobility.

To obtain a diagnosis for Ankylosing Spondylitis, a doctor may perform one or more of the following tests:

• Physical examination,

• Medical history check,

• Blood test to measure the level of uric acid in the blood which, is usually raised during an attack but can sometimes be at normal levels in people experiencing an attack of Gout.

• Urine collection and testing to measure the amount of uric acid being expelled by the body.

• X-Rays of the affected joints, and/or,

• A fluid sample from the affected joint. 

These tests will help to confirm a diagnosis, or help rule out other types of arthritis.

Ankylosing Spondylitis Treatment

Another development is the use of tumor necrosis factor blockers. These treatments, usually reserved for patients with tumors, show a high effectiveness in reducing the spinal inflammation and slowing the progression of the disease as shown in x-ray. Unfortunately research has also shown that once the treatment has stopped most patient’s relapse. The study used this treatment over four years with little problems with toxicity for patients.

Patients and physicians have found that the simplest treatments for Ankylosing Spondylitis, such as exercise and non-steroidal anti-inflammatory drug therapies still give good relief from the degenerative response. The non-steroidal anti-inflammatory medications used are often Indomethacin and sulfasalazine. Patients with problems in their peripheral joints, arms and legs, may respond well to methotrexate.

Even with optimal therapy patients may develop a stiff back but if fusion happens in the upright position they are more functional for the remainder of their life. The objective of therapy is to increase joint flexibility and enhance lung capacity.

Ankylosing Spondylitis is a lifelong problem. Unfortunately there are those who fail to continue therapies and experience permanent posture and mobility loss.

Although it can be debilitating and painful with early diagnosis and treatment patients are able to delay onset of loss of function and can continue to enjoy the activities they have always enjoyed.

Ankylosing Spondylitis - complications and issues

Like all forms of Arthritis, if left untreated, the sufferer may experience severe pain and discomfort, which will impact on all facets of their life. 

Ankylosing Spondylitis is a long-lasting (or chronic) disease, however, much can be done to control and reduce its effects.

An individual Ankylosing Spondylitis management and treatment program is usually discussed and planned by the doctor and person involved. Such treatment plans usually include a combination of medication, exercise, and education to help the patient understand the condition and know as much about it as possible.

Ankylosing Spondylitis Prevention

There is no way to prevent the onset of Ankylosing Spondylitis, however, the symptoms of this condition can be managed and treated to reduce pain, discomfort, and damage to joints and bones.

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