Ankylosing Spondylitis is a type of arthritis that affects the spine. Pain and symptoms in the neck and lower back and fusing of the lower vertebrae may lead to a stooped-over posture. An early diagnosis is important to help control pain and reduce or prevent deformity. Ankylosing spondylitis affects less than one percent of the adult population and can occur at any age. However, it most often strikes in men who are in their teens and twenties. It is less frequent and milder in women and more common in some Native American tribes.
Causes of Ankylosing Spondylitis
The cause of ankylosing spondylitis is unknown, but there is a strong genetic or family link. People who carry the gene called HLA-B27 are more likely to develop spondylitis. Spondylitis is also found in up to 10% of individuals who have no gene linked to the condition.
Symptoms of Ankylosing Spondylitis
Constant pain and stiffness in the lower back, buttocks, and hips, continuing for more than three months. Often this disease starts with the lowest major part of the spine, where the sacrum meets the pelvis. An overgrowth of bones and the abnormal joining of bones may affect bones of the neck back or hips. These debilitating fusions can even occur in the bones of the ribs to the spine or breastbone, limiting the ability expand the chest when breathing deeply. Ligaments and tendons that attach to bones may also be affected. Tendonitis may add pain and stiffness. Ankylosing spondylitis is a systemic disease, which means symptoms are not limited to the joints. Fever, fatigue, loss of appetite and eye inflammation occurs in some people with spondylitis. In rare cases, lung and heart problems can also develop.
Diagnosis and Treatment of Ankylosing Spondylitis
A doctor diagnoses spondylitis based on symptoms, a physical exam, X-rays of the back and pelvis, chest measurements while breathing, and lab tests.
There is no permanent remedy to cure ankylosing spondylitis, but there are methods and treatments that can improve function and reduce discomfort. Goals o treatment are to lessen pain and prevent deformity and disability. Leading a normal life with spondylitis is possible with proper treatment. Ideally a team including a patient, doctor, physical therapist, and occupational therapist
Intervention with physical and occupational therapy is necessary to keep up function and minimize deformity. A daily exercise program helps reduce stiffness, strengthen muscles around the joints and decreases the risk of disability. Deep breathing may keep the chest cage flexible. Certain drugs help provide relief from pain and stiffness. NSAIDS are the most commonly used. Disease-modifying-antirheumatic drugs (DMARDS) and biologics are sometimes prescribed. Steroid injections into the joint or tendon may help in some cases, and the antidepressant Cymbalta has also been approved for chronic back pain. Artificial joint replacement surgery may be a treatment option for an advanced joint disease affecting the hips or knees. Smoking aggravates the condition. People with spondylitis should sleep on a firm mattress with their back straight. Propping the legs up on pillows or placing large pillows under the head is discouraged because it may promote fusion in the neck and knees. Choosing work surfaces that help avoid slumping will contribute to preventing fusion, in addition to selecting armchairs over chairs with no arms.
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