Do you Know?
Ankylosing Spondylitis(AS) is affecting nearly 0.9% of the general population.
Ankylosing Spondylitis is a kind of arthritis which mainly affects your spine or the backbone. It is an inflammatory disease which is progressive and over time causes some of your small bones in the spine (vertebrae) to fuse.
Not only your spine, it even affects other joints like your neck, hip, lower limbs that it more likely effects men in the 20’s or 30’s of their life. If the condition left untreated, it might lead to an irreversible fusion of your bones over time.
The word Ankylosing Spondylitis itself indicates – ‘Ankylose’ means Fusion or to fuse, and ‘Spondylitis’ means inflammation of the backbone. Most often, it affects your sacroiliac joints located at the base of the spine, that meets the pelvis. Due to the inflammation, your body produces more calcium around the spinal bones. Sometimes this leads to extra bone growth and stiffens your back and neck and fuse together due to extra calcium. In severe conditions, your spine may even curve forward.
The Fusion of your spinal bones in this condition cannot be seen or felt during physical examination but can be diagnosed during imaging tests.
Everything You Need To Know About Ankylosing Spondylitis
- 1 out of every 4 patients with Ankylosing Spondylitis shows the signs of damage to the spinal bone within 3 years after diagnosis.
- This condition even impacts your movement and the ability to perform your daily tasks within the first 10 years of this condition.
- Fused spine condition can be seen in 7 out of 10 patients within 10 to 15 years of onset.
- Some studies say that nearly 70% of patients with Ankylosing Spondylitis progress to spinal Fusion over 10 to 15 years.
Symptoms Of Ankylosing SpondylitisAnkylosing Spondylitis progresses gradually and can be a chronic illness if it is neglected during the early stages. Stiffness and pain in your lower back and hip are the early signs of this condition, particularly in the morning and after a period of inactivity.
Progression can be easily identified if you notice the subtle symptoms below:
- Daily back pain
- Restricted movement
- Inability to perform everyday tasks with ease
- Increasing dependency
- Decreasing mobility
The most commonly affected areas are:
- The joints located between the spine and your pelvis
- The vertebrae located in the lower back
- The area where the tendons and ligaments connect to bones, mainly in your spine
- The cartilage located between your breastbone and ribs
- Other than spine your hip and shoulder joints can also get affected
Stages Of Ankylosing Spondylitis
Recent surveys on Ankylosing Spondylitis state that Fusion occurs in three stages i.e.
- Inflammation of the bone
- Repair of tissue formation
- New bone formation
Ankylosing Spondylitis is different from other arthritic diseases like rheumatoid arthritis that result in bone destruction. This condition involves both bone destruction and formation of new bone that results in Fusion. There is no specific cause for this condition. Experts say that some specific genetic factors are involved, particularly people with called HLA-B27 gene are at great risk of developing ankylosing spondylitis but not all. However, here are the few risk factors includes:
- Men are more prone to develop AS condition than women.
- Generally, this condition occurs in late adolescence or early adulthood.
Treatment For Ankylosing Spondylitis
Experts are working hard to find a permanent cure for this condition. The treatment goal is to relieve you from pain, stiffness and prevent or delay complications and to save you from the spinal deformity. Treatment for this condition is most successful before it causes irreversible damage to your joints.
Doctors most commonly prefer using NSAIDs like naproxen (Naprosyn) and indomethacin (Indocin, Tivorbex) to treat ankylosing spondylitis. They help you to get relief from inflammation, pain and stiffness. Using these medications may lead to gastrointestinal bleeding.
If NSAIDs doesn’t help you, your doctor suggests starting a biologic medication, like TNF blocker or an interleukin-17 inhibitor. TNF blockers help to reduce the inflammation that eventually reduces pain, stiffness, and swelling of joints. interleukin-17(IL-17) inhibitor helps to improve the body’s defence against infection.
The Food and Drug Administration (FDA) approved five TNF blockers to treat ankylosing spondylitis, which include:
- Golimumab (Simponi)
- Infliximab (Remicade)
- Adalimumab (Humira)
- Certolizumab pegol (Cimzia)
- Etanercept (Enbrel)
If your health doesn’t support to take TNF blockers or IL-17 inhibitors, your doctor may recommend taking another drug, Janus kinase inhibitor tofacitinib (Xeljanz) that has been approved for psoriatic arthritis and rheumatoid arthritis.
These medications are expensive and not many patients can afford them.
Physical therapy plays a dominant role in the treatment of ankylosing spondylitis with several benefits. It helps to relieve you from pain and improves your strength and flexibility. A physical therapist suggests you some specific exercises to improve mobility.
The flexibility of your joints and proper posture can be improved by:
- Range-of-motion exercises
- Stretching exercises
- Correct sleeping positions
- Walking positions
Abdominal and back exercises can also help you to maintain your upright posture.
Most people with the condition of ankylosing spondylitis may not require surgery. Doctor recommend for surgery unless if you are facing severe pain or vertebrae damage, or if the hip joint is damaged badly, it needs to be replaced.
Many patients present with fixed deformities of the spine and these patients can help with corrective osteotomies of the spine and it is possible to improve the quality of life in these patients.
If facing any problems with your back like a bent spine, it may or may not require surgery. So you need to consult an expert and experienced spine surgeon like Dr Surya Prakash, one of the best spine surgeons in Hyderabad for better suggestions. For more information or facing any other spinal problems, book an appointment and consult Dr Surya Prakash right away.