Overview

Ankylosing spondylitis (AS) is a type of inflammatory arthritis that primarily affects the spine or back. In AS, the joints and ligaments along the spine become inflamed. Over time, the joints and bones (vertebrae) may grow together (fuse), causing the spine to become rigid and inflexible.

Symptoms

Inflammation usually starts at the base of the spine, often in the sacroiliac joints and pain can be felt on one side or alternate side, Slow or gradual onset of back pain and stiffness over weeks or months, rather than hours or days,

• Early-morning stiffness and pain, wearing off or reducing during the day with exercise,
• Persistence for more than 3 months (as opposed to coming on in short attacks),
• Feeling better after exercise and worse after rest,
• Weight loss, especially in the early stages,
• Fatigue or tiredness,
• Feeling feverish and experiencing night sweats,

Causes

The cause of ankylosing spondylitis is unknown, but genes and heredity play an important role. Scientists have discovered a gene called HLA-B27 that is found in about 90 percent of Caucasians with AS

Diagnosis

There is no specific test to diagnose ankylosing spondylitis, but medical history, physical examination of joints and spine, imaging tests X-ray and MRI may show evidence of inflammation of the sacroiliac joint between the sacrum (the triangular bone at the lowest part of the back) and the ilium (the bone felt on the upper part of the hip). and also blood tests to check for the HLA-B27 gene.

Prevention

Be Active. Exercise can help prevent some of the stiffness.Stretching and weight-bearing activities can protect against joint damage.There is no cure for ankylosing spondylitis but a rheumatologist will tailor treatment to your symptoms and the severity of your condition.

Treatment

1)Analgesics : acetaminophen, Tramadol 2) NSAIDs like ibuprofen, ketoprofen and naproxen sodium, 3)Corticosteroids, 3) DMARDs include methotrexate, hydroxycholorquine, sulfasalazine, leflunomide, cyclophosphamide and azathioprine 4) Biologics like Adalimumab, Infliximab, Rituximab, Etanercept

Everyday Life

AS affects quality of life in terms of reduced ability to work, Anxiety, Depression, Social isolation. If left untreated, chronic inflammation can ultimately cause the vertebrae in your spine to fuse together. You may have decreased range of motion when bending, twisting, or turning. You may also have greater, more frequent back pain. Spine and vertebrae inflammation can spread to other joints, including your hips, shoulders, and ribs. The inflammation may affect the tendons and ligaments that connect to your bones. In some cases, the inflammation can spread to organs, such as your bowel or even your lungs.

Resources

https://www.spondylitis.org/Ankylosing-Spondylitis

https://www.arthritis.org/about-arthritis/types/ankylosing-spondylitis

https://www.healthline.com/health/progression-of-ankylosing-spondylitis

https://nass.co.uk/managing-my-as/