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Ankylosing Spondylitis

Ankylosing Spondylitis – General Information

Ankylosing Spondylitis is considered a condition of severe inflammation of the spine and the sacroiliac joints. These types of joints are found in the low back where the sacrum, the bone above the tail, saturates with the iliac bones, the bones on each side of the upper buttocks. Severe inflammations in these areas provoke big pain and stiffness in or around the spine. Over the time, severe spinal inflammation, called spondylitis, can progress to a complete fusion of the vertebrae, a process known as ankylosis. This kind of process leads to loss of flexibility of the spine. Ankylosing Spondylitis is also considered a systemic rheumatic disorder, which can affect some of the tissues from the whole body. Due to this, it can provoke inflammation or injuries to some joints located elsewhere from the spine, such as other organs, here including the eyes, heart, lungs, and kidneys. This type of spondylitis have many characteristics with several arthritis disorders, like psoriatic arthritis, reactive arthritis, and arthritis combined with Crohn's disease, or ulcerative colitis. Every arthritic condition enumerated can lead to a disease or inflammation in the spine, joints, eyes, skin, mouth, and other organs. Because they have the same characteristics and tend to cause inflammations in the spine, these diseases are all called to as spondyloarthropathies. Ankylosing Spondylitis is more encountered in males than in females. In womens cases, the joints elsewhere from the spine are more affected than in men cases. This type of spondylitis affects all age patients, including children. The most common age in appearing of symptoms is over 40 years.

Ankylosing Spondylitis – Symptoms

The main symptoms of Ankylosing Spondylitis are correlated to the inflammations of the spine, joints, and several organs. Fatigue is the most encountered symptom associated with the active inflammation. This inflammation of the spine often provokes pain and stiffness in the low back area, upper buttock area, neck area, and the terminal area of the spine. The symptoms of pain and stiffness are usually gradual and the progress gets painful over time. In some cases, the symptoms are quick and intense. The symptoms of pain and stiffness are usually more discomforting in the beginning of the day, or after long periods of inactivity. The symptoms of pain and stiffness are usually relieved by movement, heat and a warm shower, especially in the beginning of the day. Patients who have chronic and severe inflammation in the spine area can lead to a complete bone fusion of the spine vertebrae, developing ankylosis. Ankylosing Spondylitis can provoke inflammation and hurting of the lungs, leading to the apparition of symptoms like coughing and shortness of the breath, particularly with exercise and infections. That’s why breathing difficulties can be considered a serious complication of this type of spondylitis. Patients suffering with Ankylosing Spondylitis can also present a form of arthritis in joints elsewhere than in the spine, that’s why patients can develop symptoms like pain, stiffness, heat, swelling, warmth, or redness in joints located in the hips, knees, and ankles. There are many areas of the body affected by this type of spondylitis including the eyes, heart, and kidneys.

Ankylosing Spondylitis – Treatment

There is no cure for Ankylosing Spondylitis, but there exists a trial of treatments and medications that have the effect of reducing the symptoms and relieve the pain. There are many ways to treat the disease, and includes physical therapy and exercise, in combination with medication, are the main participants of therapy for Ankylosing Spondylitis. The physiotherapy and the physical exercises are usually preceded by drug treatment to reduce any inflammations and pain, and are supervised by a physician. Doing this type of therapy, using the movements and medications, will help to improve the pain and stiffness, but these exercises in an active inflammatory form will make the pain worse. After the disease prognosis the doctor should prescribe a treatment trial including some medications like nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, corticosteroidsand tumor necrosis factors, which will help in curing the disease. The nonsteroidal anti-inflammatory drugs are prescribed as naproxen, or Naprosyn, and indomethacin, or Indocin, and are used only to relive the pain and cure the inflammation. The disease modifying antirheumatic drugs are prescribes as sulfasalazine, or Azulfidine, and methothrexate, or Rheumatrex, and are used to treat the inflammations in the affected joints in all tissues, and helps limit the joint damage production. Corticosteroids prescribed as prednisone, and are used to treat also inflammations and the joint damage in the severe cases of the disease, but can be taken orally, in limited trial because of the side effects, and intravenously, injected into the affected joint. The tumor necrosis factor blockers are prescribed as adalimumab, or Humira, etanercept, or Enbrel and are used to treat the pain and to decrease the inflammation. These blockers block the tumor necrosis factor, which is a protein, which acts as an inflammatory agent.

Another participant in the treatment of Ankylosing Spondylitis is physical therapy, which can add several benefits, such as pain relief, physical strength and flexibility. Usually, the doctor recommends a physician to help the patient to the exact exercises needed. The physical therapy consists in stretching exercises which have the goal to maintain the joint flexibility, leading to a good posture. These exercises, in combination with breathing exercises, help to maintain a perfect lung capacity. Depending on the severity of the Ankylosing Spondylitis, the body begins to stoop forward, and the improvement of the body posture can be obtain by having a proper sleep, walking positions, in combination with abdominal and back exercises. But, doing this treatment, the bodies spine can become stiff, which can be fixed by fusing it in a good position, due to the good posture. Another treatment option in curing Ankylosing Spondylitits is considered the surgical treatment, which intervenes in the severe cases of the disease, by replacing the joints, especially in the knees and hips areas. There can be done a surgical correction, if the spine presents a severe downward curvature, especially in the neck area, and this procedure is considered a very risky one, because there can appear many complex manifestations due to the anesthesia.




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