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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. There is a slow or gradual onset of back pain and stiffness over weeks or months, rather than over hours or days.
Early-morning stiffness and pain, wearing off or reduction 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 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
4) DMARDs including methotrexate, hydroxychloroquine, sulfasalazine, leflunomide, cyclophosphamide, and azathioprine.
4) Biologics like Adalimumab, Infliximab, Rituximab, and Etanercept.
Everyday Life
AS affects the quality of life in terms of reduced ability to work. It also leads to anxiety, depression, and social isolation. If left untreated, chronic inflammation can ultimately cause the vertebrae in your spine to fuse. You may have decreased range of motion while bending, twisting, or turning. You may also have greater or 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.
