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Ankylosing spondylitis is an inflammatory illness that can cause parts of the vertebrae in the spine to fuse over time. The spine becomes less flexible as a result of this fusing, which might result in a hunched posture. Breathing deeply can be difficult if the ribs are impacted.
Men are more likely than women to develop ankylosing spondylitis. Signs and symptoms usually appear in early adulthood. Inflammation can develop in other regions of the body as well, most notably the eyes.
There is no cure for ankylosing spondylitis, however therapies can alleviate symptoms and possibly delay disease progression.
WHAT ARE THE SYMPTOMS OF ANKYLOSING SPONDYLITIS?
Pain and stiffness in the lower back and hips, especially in the morning and after periods of inactivity, may be early signs and symptoms of ankylosing spondylitis. Neck discomfort and exhaustion are also prevalent. Symptoms may intensify, improve, or stop at unpredictable periods over time.
The most typically affected places are:
- The joint that connects the base of the spine to the pelvis
- The lower back's vertebrae
- Tendons and ligaments attach to bones primarily in the spine, but also occasionally down the back of the heel
- The cartilage that connects the breastbone to the ribs
- Hip and shoulder joints
WHAT ARE THE CAUSES OF ANKYLOSING SPONDYLITIS?
Ankylosing spondylitis has no recognized etiology, though hereditary factors appear to play a role. People who carry the HLA-B27 gene, in particular, are at a much higher risk of developing ankylosing spondylitis. However, only a subset of persons who carry the gene acquire the illness.
WHAT ARE THE RISK FACTORS FOR ANKYLOSING SPONDYLITIS?
Men are more prone than women to acquire ankylosing spondylitis. Onset is usually in late adolescence or early adulthood. The HLA-B27 gene is found in the majority of patients with ankylosing spondylitis. However, many people who carry this gene do not develop ankylosing spondylitis.
WHAT ARE THE COMPLICATIONS OF ANKYLOSING SPONDYLITIS?
New bone occurs as part of the body's attempt to mend in severe ankylosing spondylitis. This new bone gradually covers the gap between vertebrae, eventually fusing vertebral portions. Those areas of the spine stiffen and become rigid. Fusion can also cause the rib cage to harden, limiting lung capacity and function.
Other issues that may arise include:
- Uveitis (inflammation of the eyes): Uveitis, one of the most prevalent consequences of ankylosing spondylitis, causes sudden eye pain, sensitivity to light, and blurred vision. If you experience any of these symptoms, contact your doctor straight once.
- Compression fractures: During the early phases of ankylosing spondylitis, some people's bones deteriorate. Weakened vertebrae might crumple, exacerbating a stooping posture. Vertebral fractures can exert strain on the spinal cord and nerves that go through the spine, potentially injuring them.
- Heart issues: Ankylosing spondylitis can create difficulties with the aorta, the body's biggest artery. Inflammation of the aorta can cause it to deform the shape of the aortic valve in the heart, impairing its function. Ankylosing spondylitis-related inflammation raises the risk of heart disease in general.
HOW IS ANKYLOSING SPONDYLITIS DIAGNOSED?
During the physical exam, your doctor may ask you to bend in different directions to examine your spine's range of motion. Your provider may attempt to replicate your pain by pressing on specific areas of your pelvis or putting your legs into a specific position. You may also be asked to take a deep breath to test if your chest expands easily.
Imaging tests
Although obvious indications of ankylosing spondylitis may not be visible early in the disease, X-rays allow clinicians to examine for abnormalities in joints and bones.
An MRI provides more detailed images of bones and soft tissues by using radio waves and a strong magnetic field. MRI scans, which are far more expensive, can detect ankylosing spondylitis early in the disease process.
Lab tests
There are no particular lab tests available to diagnose ankylosing spondylitis. Certain blood tests can detect inflammation indicators, however inflammation can be caused by a variety of health issues.
The HLA-B27 gene can be detected in blood. However, many people who have that gene do not have ankylosing spondylitis, and the condition can occur in persons who do not have the gene.
WHAT ARE THE TREATMENTS FOR ANKYLOSING SPONDYLITIS?
The goal of treatment is to alleviate pain and stiffness while also preventing or postponing consequences including spinal deformity. Treatment for ankylosing spondylitis is most effective before the disease causes irreversible damage.
Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs) including naproxen (Aleve, Naprosyn, and others) and ibuprofen (Advil, Motrin IB, and others) are the most often used medications to treat ankylosing spondylitis. These drugs can help with inflammation, discomfort, and stiffness, but they can also induce gastrointestinal bleeding.
If NSAIDs do not relieve your symptoms, your doctor may prescribe a tumor necrosis factor (TNF) blocker or an interleukin-17 (IL-17) inhibitor. These medications are administered through injection under the skin or through an intravenous line. These drugs can reactivate untreated tuberculosis and make you more susceptible to infections.
TNF inhibitors include the following:
- Adalimumab (Humira)
- Pegol Certolizumab (Cimzia)
- Etanercept (Enbrel)
- The drug golimumab (Simponi)
- Infliximab (Remicade)
Secukinumab (Cosentyx) and ixekizumab are two IL-17 inhibitors used to treat ankylosing spondylitis (Taltz).
Therapy
Physical therapy is a crucial element of treatment that can provide a variety of advantages ranging from pain relief to increased strength and flexibility. A physical therapist can create exercises tailored to your individual needs. To assist you maintain proper posture, you may be taught:
- Stretching and range-of-motion activities
- Abdominal and back muscle strengthening exercises
- Sleeping and walking positions that are appropriate
Surgery
The majority of persons with ankylosing spondylitis do not require surgery. If you have significant discomfort or a hip joint that is so damaged that it needs to be replaced, surgery may be indicated.
HOME REMEDIES FOR ANKYLOSING SPONDYLITIS
Lifestyle changes can also aid in the management of ankylosing spondylitis.
- Stay active: Exercise can help you relieve discomfort, stay flexible, and improve your posture.
- Avoid smoking: Quit smoking if you smoke. Smoking is harmful for your health in general, but it causes additional issues for those with ankylosing spondylitis, such as making breathing more difficult.
- Maintain proper posture: Standing straight in front of a mirror can help you prevent some of the complications of ankylosing spondylitis.