Ankylosing spondylitis: Symptoms, Causes and Treatment

Millions of people across the globe are suffering from another kind of arthritis, the Ankylosing Spondylitis. It is commonly referred to as Bamboo Spine or Rheumatoid Spondylitis, a chronic inflammatory disease affecting the sacroiliac joints and spine which eventually merge together. The merging will then result to solidification of the spine making it less flexible resulting to curved-forward posture. Raising the head up to look forward is a struggle or impossible for acute cases of rheumatoid spondylitis. Studies show that men are greatly affected by this chronic auto-immune disease than women between 20 and 40 years of age. Yet, reported cases of rheumatoid spondylitis in children have also been documented. Although there is no known cure yet for this type of arthritis, still, treatments are available to relieve the pain and improve the symptoms. Here’s a brief review of the symptoms, causes and treatment of ankylosing spondylitis.

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Symptoms of  Ankylosing Spondylitis

Early symptoms usually include sporadic lower back pain which worsens at night as well as when getting out of bed in the morning; fever, fatigue, depressed appetite and weight loss; stiffness and pain on the hips, heel and joint; inflammation on the knees, ankles and shoulders; difficulty when breathing deeply due to the solidification of the rib cage. These symptoms may eventually aggravate, get better or totally disappear at erratic intervals. However, you may have to visit your physician if the stiffness and pain is recurring along with sharp chest pain when breathing. More so, when these symptoms are associated with vision problems such as eye pain, blurry vision and light sensitivity, seek immediate medical advice. Manifestations of symptoms can be noticed even on the first decade of life but becomes more pronounced within 20-40 years of age.

Causes of Ankylosing Spondylitis

The cause remains unclear until now but since it is a form of auto-immune disease, genetic factor has something to do with it. HLA-B27 gene was known to significantly increase your chances of developing this type of arthritis although not everyone with this gene has developed rheumatoid spondylitis. Another risk factor of developing ankylosing spondylitis is gender. Men have higher chances of developing this type of inflammation disease compared to women. While age is also another factor, it normally occurs either during early adulthood or later in the adolescent stage.

Ankylosing Spondylitis Diagnosis

In some cases where symptoms are placid, diagnosis is delayed or misdiagnosed as the symptoms may resemble typical back problems. However, comprehensive examinations may confirm if it is ankylosing spondylitis. These include imaging tests like CT scan, X-rays and MRI, as well as laboratory tests. Let’s closely consider them one by one.

CT Scan – this stands for Computerized Tomography which is usually combined with X-ray imaging to provide a more detailed image of the internal structures in your bones and joints by giving cross-sectional images taken from different angles.

X-ray – this enables the doctor to examine any changes on your bones and joints although the distinctive effects of the disease may not be noticed at an early stage.

MRI – this stands for Magnetic Resonance Imaging which is a type of imaging examination that uses intense magnetic field and radio waves which provides better illustration of the soft tissues like the cartilage.

Laboratory Tests – the disease can never be diagnosed with a particular laboratory test alone, but blood tests like CBC or ESR help uncover any indication of inflammation. Also, the blood can also be tested for HLA-B27 gene to examine if it could be the cause.

Treatment

Ankylosing spondylitis has no known cure but treatments can help relieve the pain and stiffness, prevent complications as well as delay its progression and vertebrae deformity. However, treatment is more successful when the ankylosing spondylitis has not yet caused any permanent joint damage. Available treatments include medications, therapies and surgery.

Medications – Doctors usually prescribe NSAIDs to their patients in treating rheumatoid spondylitis to ease pain, stiffness and inflammation.  But NSAIDs may cause gastro-intestinal bleeding. Aside from NSAIDs, TNF blockers may also be used to help ease pain, stiffness and tender, inflamed joints and administered either by intravenous line or injected underneath the skin. However, it can reactivate dormant tuberculosis and may even cause some neurological problems.

Therapy – This also helps in relieving the pain as well as improve mobility and bodily strength. Therapists may recommend you with some form of exercise to cater to your specific needs. Stretching and range-of-motion exercises are very effective in keeping the elasticity of the joints and good posture. Moreover, certain breathing exercises also help in improving lung capacity and endurance. Even if the condition gets worse and you may start bending forward, back and abdominal exercises coupled with proper walking and sleeping positions can be of great help in maintaining upright posture. Although part of your vertebrae may have merged, you will still perform well and more easily with merged spine in upright position.

Surgery – Most sufferers of rheumatoid spondylitis do not require surgery. But it is recommended if you’ve been experiencing intense pain and damaged joint or require total joint replacement.

Complications

Ankylosing spondylitis will eventually complicate to other health problems including heart problems wherein the aorta gets inflamed and enlarge further that warp aortic valve shape of the heart and later on paralyze its function. Besides, you may experience breathing difficulty because the lungs cannot fully pump up because the merged bones cannot move during breathing. In some cases, even if the disease is yet at the early stage, thinning of bones are already noticed causing it to easily crumble and increases the chances of severe hunched posture. Spine fractures could even cause damage to the spinal cord as well as the nerves passing through it. Lastly, the common complication is swollen eye or uveitis which entails immediate doctor’s attention.

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Recommendation

The fact that genetics play a vital role in the development of ankylosing spondylitis, prevention is hardly possible. But, learning the risk associated of having the disease effectively helps in early diagnosis and treatment. The main goal of treatment, however, is to delay its progression and prevent complications to emerge.

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