Ankylosing Spondylitis

Ankylosing Spondylitis

What is ankylosing spondylitis?

Ankylosing spondylitis is a rare, chronic, inflammatory autoimmune arthritis of the joints and ligaments in the low back (the axial spine). It affects the spine, and large joints like the sacroiliac joints. Ankylosing spondylitis manifests slowly as low back pain and progresses to chronic low back pain and stiffness. Over time it can cause the vertebrae to fuse decreasing flexibility and can lead to a hunched posture, loss of height and if the ribs are involved, it can cause difficulty breathing.

Sometimes organs can also be affected. The most common related conditions are inflammatory bowel disease, eye inflammation, and psoriasis. Ankylosing spondylitis is also associated with cardiovascular disease. It can also predispose patients to increased risk of vertebral fractures. Severe disability is uncommon. With treatment, most patients remain fully functional, can work, and lead productive lives.

What causes ankylosing spondylitis?

Ankylosing spondylitis symptoms typically begin in people younger than their thirties and is typically diagnosed in people younger than forty. Men are affected more often than women. The cause is unknown, but ankylosing spondylitis is genetic and runs in families. The condition can be painful and disabling, but treatments can help relieve pain and stiffness and improve joint function. 

What are the symptoms?

The type of back pain seen in ankylosing spondylitis comes on slowly as the disease manifests. Pain improves with exercise, but not rest, and pain at night does improve when arising. Some people have mild back pain and stiffness that comes and goes, while others have severe ongoing back pain and loss of spinal flexibility. The rate of progression varies from one patient to another. Symptoms can develop in other areas of the body including the hips, ribs, shoulders, knees, ankles, and feet. Because ankylosing spondylitis can affect other areas of the body, symptoms may include fatigue, weight loss, abdominal pain, and vision changes.

How is ankylosing spondylitis diagnosed?

You Ortho Illinois orthopedic surgeon will conduct a comprehensive, full body evaluation and a review of your medical history. Lab tests may help in the diagnosis.  Imaging studies including x-rays, and MRI scans are useful to assess the large joints and vertebrae.

Your expert must rule out other diseases like mechanical low back pain, lumbar spinal stenosis, rheumatoid arthritis, and other degenerative diseases. Patients may need a team of specialists including a rheumatologist, gastroenterologist, cardiologist, neurologists, and other experts to address the various organ systems involved.

How is Ankylosing spondylitis treated?

There is no one-size-fits-all treatment for ankylosing spondylitis, but there are many options that can help relieve symptoms and improve quality of life. The goals of treatment are to relieve pain and stiffness, maintain good range of motion and function in the spine and large joints, prevent spinal complications, and slow or stop the progression of ankylosing spondylitis.

Common treatments may include:

  • First line therapy is over the counter Nonsteroidal Anti-inflammatory drugs (NSAIDS) cha help to relieve pain and inflammation.
  • Prescription medications like Celebrex
  • Disease modifying antirheumatic drugs called DMARDS can slow progression of the disease. These include methotrexate, and sulfasalazine.
  • Biologics like Humira, Enbrel and Remicade target the immune system.
  • Physical therapy is important to improve range of motion and relieve pain. It may involve the use of heat, cold, massage and stretching to help relieve symptoms.
  • Exercise is a vital component of treatment because it helps improve range of motion, relieve pian and increase strength. Yoga, swimming, and biking are good exercises for people with ankylosing spondylitis.
  • Local steroid injections may be offered to treat pain and enable physical therapy.
  • In cases where joint damage is severe and the patient is unable to perform the basic daily activities of life, surgery may be offered.

What is the prognosis for ankylosing spondylitis?

There is no cure for ankylosing spondylitis, however, the condition can go into remission. The prognosis is good for people who receive early diagnosis and treatment. People with Ankylosing Spondylitis usually have a normal life expectancy. However, the disease can progress and lead to disability in some cases.

Research shows that patients can maintain function and fitness and improve sleep and keep a positive attitude when they follow a proper exercise program including exercise, water therapy, swimming, and physical therapy.

Contact Ortho Illinois to schedule a consultation to receive the correct diagnosis and learn about all available treatment options.