Ankylosing spondylitis is a chronic inflammation that can cause the closing of the gap between the vertebrae. This disorder can make people with ankylosing spondylitis become hunchy.
The spine consists of several vertebrae connected by soft bones bearings. In people with ankylosing spondylitis, the slit of the bearing fuse into the bone, so that the spine loses its suppleness. This condition will change the posture of the sufferer.
Symptoms of ankylosing spondylitis develop gradually in a matter of months to years, as well as more frequently attacking men than women.
Ankylosing Spondylitis Definition
Ankylosing spondylitis is an inflammatory disease of the joints that mainly hits the spinal joints. The disorder has several other names, such as Bechterew’s disease and Marie-Strumpell’s disease. Ankylosing spondylitis is chronic and generally affects adolescents or young older persons. This disease is important to treat as early as possible, as it can cause a decrease in quality of life due to possible complications, such as osteoporosis, fractures, pulmonary infections, heart disease, and kidney disorders.
Ankylosing Spondylitis Symptoms
Ankylosing spondylitis is initially characterized by pain or stiffness in the neck, lower back, chest, as well as pelvis. The pain is more pronounced when waking up or after the sufferer is silent for a long time.
Symptoms of this pain can disappear and appear in certain periods for several months to several years. If left unhandled, ankylosing spondylitis can change the patient’s posture to become more hunchy.
In addition to pain and changes in posture, people with ankylosing spondylitis can also feel the following symptoms:
- Fever.
- Feeling tired easily.
- Knee pain.
- Inflammation of the fingers.
- Diarrhea and abdominal pain.
- The skin is reddish and scaly, as well as itchy.
- Visual impairment.
- Difficulty breathing.
Ankylosing Spondylitis Causes
The exact cause of the disease is not yet known for certain, but it appears that ankylosing spondylitis is genetically related. Most people with this disorder have a gene called HLA-B27. The HLA-B gene provides instructions for making proteins associated with the immune system to distinguish proteins coming from the body itself and foreign / outer proteins, such as viruses or bacteria.
Ankylosing Spondylitis Risk Factors
Although the main cause is not yet known, several factors are said to increase a person’s risk of developing ankylosing spondilitis. The various risk factors that cause ankylosing spondylitis are:
Gender
The disease is more commonly found in men compared to women. Men are therefore more at risk of developing AS disease.
Specific age range
The disease usually occurs between the ages of 20-40 years. However, the AS may also start at under 10 years of age.
Family and genetic history
If you have a relative or family member with ankylosing spondilitis, you are more at risk of developing the same disease. Because, the HLA-B27 gene can be passed from parent to child. Five to twenty percent of children with this gene is also expected to develop the AS at some point.
Certain medical conditions
You are also at risk of developing AS disease if you have certain medical conditions, such as Crohn’s disease, ulcerative colitis (inflammation of the intestines), or psoriasis.
Ankylosing Spondylitis Diagnosis
To diagnose ankylosing spondylitis, the doctor will ask about the symptoms the patient is experiencing and his medical history. Next, the doctor will perform a physical examination to check for inflammation in the joints or a decrease in the flexibility of back movements.
Next, the doctor will run supporting examinations, such as:
- Scan with X-ray, CT scan, or MRI, to check the condition of the spine or other bones.
- Genetic examination, to check whether the patient has abnormalities in the HLA-B27 gene.
- Blood examination, to see the signs of inflammation that occurs in certain parts of the body.
Ankylosing Spondylitis Treatment
There is no cure for the AS, and the damage is irreversible. However, some options can help alleviate symptoms and manage development.
These include:
- Physical therapy and exercise
- Medical advice
- Drugs
- Surgery, in rare cases
The person needs to see a specialist, known as a rheumatologist. They may require a number of visits, as the disease develops slowly. Medical treatment enables better monitoring and treatment.
Two approaches commonly used to manage the AS are:
- Medicine to reduce pain and inflammation
- Physical therapy and exercises to maintain movement and posture
Surgery is only rarely used, in severe cases, to correct severe deformities, such as excessive bending of the spine, or to replace the pelvis or other joints.
Treatment of drugs
The main drug used to relieve AS pain and inflammation is a nonsteroidal anti-inflammatory drugs (NSAIDs). Examples include ibuprofen, naproxen, and diclofenac. Acetaminophen and codeine are also options if NSAIDs are not suitable or insufficient.
Some NSAIDs harm bone health by reducing the formation of new bones, and NSAIDs are not usually recommended after surgery for people with bone fusion problems.
Other drug options include:
- Locally injected corticosteroids
- Disease-modifying anti-rheumatic drugs (DMARDs), such as sulfasalazine (brand name: Azulfidine or Sulfazine) and methotrexate (Otrexup, Rheumatrex, or Trexall)
- Tumor necrosis factor (TNF) antagonists, such as adalimumab (Humira), certolizumab (Cimzia), etanercept (Enbrel), golimumab (Simponi), or infliximab (Remicade)
- Other biological treatments, such as secukinumab (Cosentyx).
TNF treatment seems effective, but it is expensive and can have side effects.
The AS can affect the whole body, and patients can meet with a variety of specialists, including physical therapists, ophthalmologists, and gastroenterologists.
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Exercises
Physical therapy and exercise can help prevent symptoms.
A physical therapist will design a program that can help patients maintain good posture and movement in the joints.
This may include:
- Daily exercises
- Special training
- Exercise therapy
Physical therapy exercises are referred to as strengthening exercises and range of motion exercises.
Here are two exercises, suggested by the UK charity, Versus Arthritis:
- Stand with your back and heels attached to the wall, and push your head back to touch the wall. Don’t tilt your head back. Hold for 5 seconds, relax, and repeat up to 10 times.
- Stand with your feet open and hands on your hips. Turn to one side, hold for 5 seconds, and relax. Repeat on the other side. Do this five times on each side.
There are a variety of ways to exercise, including water fitness. A doctor can recommend a suitable plan.