Ankylosing spondylitis (AS)

Dr.Nagesh Chandra, 4 mins read

Ankylosing Spondylitis (AS) is a type of arthritis that affects the spine and lower back. AS is an inflammation condition. AS is characterized by joint pain, stiffness, and loss of mobility in the spine, lower back, and other symptoms.
This condition is caused by inflammation at the joints where the ligaments and tendons attach to the bone of the spine and bones of the peripheral joint, also known as the "entheses." The inflammation causes bone fusion by increasing bone formation in the spine. This can lead to spinal deformity in advanced cases.
The symptoms can be relieved by physical therapy and drug treatments. This article will examine AS in detail, including its symptoms, causes, and treatments.

What is Ankylosing Spondylitis (AS)?

Ankylosing Spondylitis is arthritis that causes long-term (chronic) spine inflammation. Ankylosing Spondylitis (AS) causes inflammation of the sacroiliac joint between the base and pelvis. Assistive Spondylitis (also known as sacroiliitis) is the first sign of AS. Inflammation can often spread to the joints between vertebrae.

Signs

Ankylosing Spondylitis symptoms vary. It is similar to other forms of arthritis and can cause mild to moderate flare-ups or periods of almost no symptoms.

It is important to recognize warning signs. Most people experience back pain at night and in the morning. Other symptoms include pain in large joints such as the hips or shoulders. Some symptoms include:

• Poor posture or stooped shoulders
• Early morning stiffness
• Low-grade fever
• Appetite loss
• Fatigue
• Weight loss
• Reduced lung function
• Low iron or anemia

Ankylosing Spondylitis can cause inflammation and other symptoms. Ankylosing Spondylitis can also cause:

• Eye inflammation
• Inflammation of the bowels
• Plantar fasciitis, Achilles tendinitis
• Heart valve inflammation

Causes

Although the exact cause of AS is unknown, the initial symptoms are caused by inflammation of the lower spine. Ankylosing Spondylitis is more common in those who have the gene HLA-B27.

Due to inflammation, permanent damage and fusion may occur when new bone growth occurs. Doctors are still not able to explain why AS patients experience chronic inflammation. The exact cause of Ankylosing Spondylitis is unknown at this time.

This disorder is more common in families than in individuals. Genetics may play a part. Ankylosing Spondylitis is more common in those with a family history, such as siblings or parents.

Diagnosis

Your health care provider may ask you to bend in various directions during a physical exam to check your spine's range of motion. Your provider might ask you to press on specific areas of your pelvis or move your legs in a particular way. You may also be asked to take deep breaths to determine if your chest is expanding.

A thorough physical exam will be the first step. This will focus on joint function, range of motion, and the spine. Your doctor will ask about your symptoms and pain history.

The doctor will then examine your spine to look for any signs of damage or pain. If the disease is still in its early stages, damage or joint erosion might not be noticed. The doctor may recommend an MRI scan.

Imaging tests

Although X-rays can detect changes in bones and joints, the signs of ankylosing Spondylitis may not be apparent immediately.

MRI scans use radio waves and a strong magnetic field to produce more detailed images of bones and soft tissue.

Treatment

The treatment goal is to reduce pain and stiffness and prevent or delay spinal deformity and complications. Treatment for ankylosing Spondylitis is more successful if the disease does not cause irreversible damage.

Ankylosing Spondylitis is not curable. However, treatment can manage the pain and prevent future disability. The timely treatment of potential complications such as bone deformity may slow down or even stop them from happening. There are some ways to manage the condition and help with the progression. These include:

• Surgery, in rare cases
• Certain drugs
• Exercises and physical therapy

As patients will need to visit a specialist known as a physician who specializes in rheumatology. As the condition progresses slowly, they may require multiple visits. Consistent medical care allows for better monitoring and treatment. As can be managed with two standard methods: drugs to reduce inflammation and pain, and physical therapy or exercise to maintain movement. Drs will not recommend surgery for severe deformities, such as ankylosing or excessive posture changes caused by inflammation or ankylosing of a spine. To help manage AS symptoms, doctors may recommend specific foods or nutrients.

Medications

Doctors may treat Ankylosing Spondylitis with a variety of medications. The severity and progress of the condition will determine which medications are prescribed.

• Corticosteroids- Corticosteroids are potent inflammation-fighters that can ease symptoms and slow damage around the spine but cannot be used long-term.
• NSAIDs- NSAIDs (nonsteroidal anti-inflammatory drugs) are used to manage pain and inflammation.
• DMARDs- Your doctor might also recommend disease-modifying antirheumatic medications (DMARDs). These drugs slow down the progression of the disease and prevent it from getting worse.
• Biologics- Drugs that block inflammation can be blocked by drugs such as IL-17 inhibitors and tumor necrosis factor (TNF). These drugs prevent inflammation and may reduce joint stiffness and pain.

Surgery

Joint replacement surgery may be required if you severely damage your hip or knee joints. An osteotomy may also be necessary for people with poor posture due to fusions. A surgeon will perform this procedure by removing and realigning the spine bones.

The severity of the condition and the symptoms will determine the treatment.

Conclusion

AS is a form of arthritis that affects the spine, lower back, and hips. AS is more common in men and usually appears in late adolescence or early adulthood.

There is currently no cure for AS. However, there are many ways to slow down or stop its progression. People can manage them AS symptoms by exercising daily.

Talk to your doctor if you have been suffering from chronic back pain. Your doctor can help you determine the cause of your pain, such as ankylosing Spondylitis. They will also help you create a treatment plan to ease discomfort and alleviate your symptoms.

You can prevent long-term side effects by starting treatment as soon as possible.

Also Read: Spondylitis Types What You Need to Know Revised