Know the basics
What is ankylosing spondylitis?
Ankylosing spondylitis is a painful, arthritic condition. Joints of the lower back can fuse, resulting in stooped posture.
Most often affected are the lower back, chest, and neck. Other affected joints can include hips, shoulders, knees, and ankles. The illness can also affect other organs, such as eyes, heart and lungs.
How common is ankylosing spondylitis?
Ankylosing spondylitis is common. It affects 3 times more males than females. Only five percent get symptoms after age 45. It affects people for the rest of their lives.
It can be managed by reducing your risk factors. Please discuss with your doctor for further information.
Know the symptoms
What are the symptoms of ankylosing spondylitis?
The common signs and symptoms of ankylosing spondylitis are back pain that starts gradually. Early morning stiffness and pain may go away during the day with exercise. People can be awakened during the night from the pain.
Usually the pain starts from the lower back, and then spreads upward to the entire spine.
Pain in the lower back and the associated muscle spasms are often relieved by bending forward. Therefore, people often assume a stooped posture, which can lead to a permanent bent-over position. In others, the spine becomes noticeably straight and stiff.
The spine becomes less flexible, stiff and the pain may affects large joints, such as the hips, knees, and shoulders.
Loss of appetite, low-grade fever, weight loss, excessive tiredness (fatigue), and anemia can accompany the back pain.
The illness also affects other organs, such as eyes, heart and lungs. People with ankylosing spondylitis may have inflammation in the eyes, leads to eye pain, redness and loss of visual and sharpness.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
Know the causes
What causes ankylosing spondylitis?
The cause of ankylosing spondylitis is unknown. It is likely that genes (passed from parents to children) and the environment both play a role. The main gene associated with the risk for ankylosing spondylitis is called HLA-B27. Having the gene doesn’t mean you will get ankylosing spondylitis. Scientists recently discovered two more genes (IL23R and ERAP1) that, along with HLA-B27, carry a genetic risk for ankylosing spondylitis.
Know the risk factors
What increases my risk for ankylosing spondylitis?
There are many risk factors for ankylosing spondylitis, such as:
- Sex: Men have higher risk than women.
- Age: Disease usually begins in early stage of adolescence.
- Hereditary: People with HLA-B27, IL23R and ERAP1 have higher risk.
Understand the diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is ankylosing spondylitis diagnosed?
The doctor takes a medical history, does a physical examination, and gets x-rays of the lower (lumbar) spine. X-rays show inflammation and fusion of the joint (sacroiliac joint) connecting lumbar spine and hip. The doctor may also order MRI. The doctor may recommend going to a specialist called a rheumatologist.
The medical history involves answering questions, such as the following:
- How long have you had pain?
- Where specifically is the pain in your back or neck? Are other joints affected?
- Is back pain better with exercise and worse after inactivity, such as when you first get up in the morning?
- Do you have other problems, such as eye problems or fatigue?
- Does anyone in your family have back problems or arthritis?
- Have you recently suffered from a gastrointestinal illness?
- Do you have any skin rashes such as psoriasis?
During the physical exam, the doctor will look for signs and symptoms include pain along the spine and/or in the pelvis, sacroiliac joints, heels, and chest. Your doctor may ask you to move and bend in different directions and to breathe deeply to check for any problems
X-ray and magnetic resonance imaging (MRI) may be used, but these tests have limitations. X-rays may show changes in the spine and joints; however, it may take years of inflammation to cause damage that is visible on x-rays. MRI may allow for earlier diagnosis, because it can show damage to soft tissues and bone before it can be seen on an x ray.
The main blood test checks for the HLA-B27 gene. However, this test also has limitations. The gene is only indication for higher risk. The gene can be found in many people who do not have ankylosing spondylitis, and will never get it.
How is ankylosing spondylitis treated?
There is no treatment known that will completely cure ankylosing spondylitis. Treatments are more focused on relieving the pain and stiffness, including:
Medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce swelling and pain.
Some NSAIDs can be bought over-the-counter (OTC), such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn).
You may also need stronger medicines to control pain and swelling, such as: Corticosteroid therapy (such as prednisone):
- TNF-inhibitors (such as etanercept, adalimumab, infliximab, golimumab).
Surgery may be done if pain or joint damage is severe.
Exercises can help improve posture and breathing, as well as reduce joint inflammation. Lying flat on your back at night can help you keep a normal posture.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage ankylosing spondylitis?
The following lifestyles and home remedies might help you cope with ankylosing spondylitis:
- Take medicines that your physician prescribes.
- Call your doctor if you fall and notice a sudden change in alignment of your neck or back.
- Call your doctor if you have drug side effects.
- Do not smoke or drink alcohol if your doctor tells you to stop. Your medicine may react with alcohol.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: May 30, 2016 | Last Modified: January 4, 2017
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Ankylosing spondylitis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Ankylosing_Spondylitis. Accessed July 13, 2016.
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