Informatoin On Ankylosing Spondylitis
Ankylosing spondylitis is a distinct disease entity characterized by inflammation of multiple articular and para-articular structures, frequently resulting in bony ankylosis. The term ankylosing is derived from the Greek word ankylos, meaning stiffening of a joint, while spondylos means vertebra. Spondylitis refers to inflammation of one or more vertebrae. Ankylosing spondylitis usually is classified as a chronic and progressive form of seronegative arthritis.
This inflammatory form of arthritis affects the spine and the sacroiliac joints. Since it often presents with low back pain, it is often misdiagnosed. AS is very treatable; accurate diagnosis and agressive therapy are advisable.
AS is three times more common in men than in women. It typically affects young people, beginning between the ages of 15 and 30. It may affect younger people also, although in very young people it may take a slightly different form, causing pain around the heels, knees, and hips rather than beginning with the spine. Onset after age 40 is uncommon.
Causes
The cause of AS is not known, but all of the spondylarthropathies share a common genetic marker, called HLA-B27, in most affected individuals. In some cases, the disease occurs in these predisposed people after exposure to bowel or urinary tract infections.
Some people may just experience episodes of transient back pain. Others may experience long standing and severe back pain that leads to differing degrees of spinal stiffness. Almost always, the problem is characterized by acute painful episodes followed by periods when the pain settles.
Symptoms
The typical patient is young, of 15 to 30 years of age, with chronic pain and stiffness in the lower part of the spine. Men are affected more than women by a ratio in excess of 2:1. In 40% of cases, ankylosing spondylitis is associated with iridocyclitis causing eye pain and photophobia (increased sensitivity to light). Other common symptoms are recurring mouth ulcers (aphthae) and fatigue. Pain can fluctuate from one side to the other.
Early symptoms include back pain and stiffness. These problems often start in late adolescence or early adulthood. Over time, ankylosing spondylitis can fuse your vertebrae together, limiting movement. Symptoms can worsen or improve or stop altogether. The disease has no cure, but medicines can relieve the pain, swelling and other symptoms. Exercise can also help.
Diagnosis
Ankylosing spondylitis is mainly diagnosed by the history of symptoms you provide your physician. When the diagnosis of AS is suspected, your doctor may investigate by obtaining blood work and imaging studies such as X-rays of the back and pelvis. The presence of X-Ray specific changes of the joints between the pelvis and the sacrum, or sacroiliac joints and vertebral bodies are signs of AS. Changes in the sacroiliac joint space may be detected earlier than changes in the spine by joint space narrowing, erosion and possibly fusion.
Treatment
The treatment of ankylosing spondylitis involves the use of medications to reduce inflammation and/or suppress immunity, physical therapy, and exercise. Medications decrease inflammation in the spine and other joints and organs. Physical therapy and exercise help improve posture, spine mobility, and lung capacity.
Your rheumatologist will tailor your treatment to your symptoms and the severity of your condition. There is no way of predicting exactly which treatment will work best for you. Each treatment has its own benefits and risks. Your doctor may need to trial several different treatments before finding the one that is right for you.
Treatment for ankylosing spondylitis focuses on relieving pain and stiffness, reducing inflammation, keeping the condition from getting worse, and enabling you to continue daily activities. Early diagnosis and treatment may reduce pain, stiffness, inflammation, and deformity.
