Ankylosing Spondylitis
Ankylosing Spondylitis is an arthritis
of the spine and the joint between the spine and pelvis
(the sacroiliac joint) that can eventually cause fusing
of the spine. This condition causes inflammation of
the spine which then results in pain and stiffness
in the back (it usually improves with movement or
“working out the stiffness”), pain that
radiates from the back down to the buttocks, fatigue,
and eventually the person may develop a “stooped
over” posture.
The type of inflammation associated with Ankylosing
Spondylitis involves a specific point in the joint
where a connective tissue, such as a tendon, ligament,
or muscle, inserts into the bone (enthesis). Ankylosing
Spondylitis is grouped with other conditions with
the same type of inflammation, called Seronegative
Spondyloarthropathies. Other conditions grouped with
Seronegative Spondyloarthropathies. include Ulcerative
Colitis, Crohn's Disease, Psoriasis and Reiter's Syndrome.
Ankylosing Spondylitis usually affects men more than
women, and the typical patient is a young male between
the ages of 18 t0 30. In addition to the back problems
caused by the condition, Ankylosing Spondylitis can
cause inflammation of the eye, eye pain and sensitivity
to light (photophobia).
There is no cure for this condition, but there are
treatment options for symptoms & to improve the
quality of life for sufferers. Untreated, Ankylosing
Spondylitis can become a very painful and disabling
disease.
Symptoms:
Back pain that is relieved by movement and exercise
Bent-over posture
Difficulty bending
Difficulty walking
Fatigue
Lifting of the nails from the nail bed
Loss of appetite
Pain in buttocks
Pain in heels
Pain in hips
Pain in the sole of foot
Pain radiating from back to buttocks
Pain when moving eyes
Red eyes
Stiffness and pain in lower spine
Swollen eyes
Eyes sensitive to light
Diagnosis:
Diagnosing Ankylosing Spondylitis usually involves
a physical examination, X-rays of the spine and pelvis,
and a specific test called the Schober's Test that
may help physicians to determine the flexibility of
the spine. X-ray's of the spine may show characteristics
of Ankylosing Spondylitis. Blood tests may be non-specific,
but can be useful in helping to diagnose as well.
Blood tests may show:
Negative Antinuclear Antibody (ANA)
Elevated C-Reactive Protein (CRP)
Elevated Erythrocyte Sedimentation Rate (ESR)
Negative Rheumatoid Factor (RF) (one of the very few
cases where an RF would be negative in an AI condition)
Low Rheumatoid Factor Quantity (RFQnt)
Low Total Serum Iron
Treatment:
In most cases, Nonsteroidal Anti-Inflammatory Drugs
(NSAID's) are used to reduce the inflammation around
the spine and joints. Corticosteroid injections may
also be used in specific joints. Short-term oral Corticosteroids
are an option for patients that do not respond to
NSAID's or cannot take NSAID's for health reasons.
Severe cases of Ankylosing Spondylitis may require
immunosuppressive therapy medication such as Methotrexate
or Sulfasalazine to help tame the immune response
that is causing the arthritis in the spine. TNfa blockers
have also been used in the treatment of Ankylosing
Spondylitis,
Physical therapy, posture training, water therapy
and swimming are beneficial therapies for people suffering
from Ankylosing Spondylitis and can help improve and
maintain flexibility of the spine.
Prognosis:
If Ankylosing Spondylitis is caught and treated early
on, the prognosis is better, with most patients responding
well to therapy and are able to live mostly normal
lives. Some may need help walking while others are
able to maintain flexibility. Severe cases where flexibility
is greatly reduced may be more disabling to the quality
of life, but Ankylosing Spondylitis is not a fatal
disease.
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