Ankylosing spondylitis
Definition:
Ankylosing spondylitis is an inflammatory disease that can cause some of the vertebrae in your spine to fuse together. This fusing makes the spine less flexible and can result in a hunched-forward posture. A severe case of ankylosing spondylitis can make it impossible for you to lift your head high enough to see forward.
Ankylosing spondylitis affects men more often than women. Signs and symptoms of ankylosing spondylitis typically begin in early adulthood. Inflammation also can occur in other parts of your body — such as your eyes and bowels.
There is no cure for ankylosing spondylitis, but treatments can decrease your pain and lessen your symptoms.
Symptoms:
Early signs and symptoms of ankylosing spondylitis may include pain and stiffness in your lower back and hips, especially in the morning and after periods of inactivity.
These symptoms may come on so gradually that you don't notice them at first. Over time, symptoms may worsen, improve or stop completely at irregular intervals.
The areas most commonly affected are:
See your doctor if you have chronic pain and stiffness in your lower back and hips, or if deep breathing makes your chest hurt. Seek immediate medical advice if you develop eye pain, light sensitivity or blurred vision.
Causes:
Ankylosing spondylitis has no known specific cause, though genetic factors seem to be involved. In particular, people who have a gene called HLA-B27 are at significantly increased risk of developing ankylosing spondylitis.
As ankylosing spondylitis worsens and the inflammation persists, new bone forms as part of the body's attempt to heal. This new bone gradually bridges the gap between vertebrae and eventually fuses sections of vertebrae together. Those parts of your spine become stiff and inflexible. Fusion can also stiffen your rib cage, restricting your lung capacity and function.
Complications:
Ankylosing spondylitis doesn't follow a set course. The severity of symptoms and development of complications vary widely from person to person. Complications may include:
Treatments and drugs:
The goal of treatment is to relieve your pain and stiffness, and prevent or delay complications and spinal deformity. Ankylosing spondylitis treatment is most successful before the disease causes irreversible damage to your joints.
Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs) — such as naproxen (Aleve, Naprosyn) and indomethacin (Indocin) — are the medications doctors most commonly use to treat ankylosing spondylitis. They can relieve your inflammation, pain and stiffness. However, these medications also can cause gastrointestinal bleeding.
If NSAIDs aren't helpful, your doctor may suggest tumor necrosis factor (TNF) blockers. TNF is a cell protein that acts as an inflammatory agent in rheumatoid arthritis. TNF blockers target this protein to help reduce pain, stiffness, and tender or swollen joints. They are administered by injecting the medication under the skin or through an intravenous line.
Examples of TNF blockers include:
Therapy
Physical therapy can provide a number of benefits, from pain relief to improved physical strength and flexibility. Your doctor may recommend that you meet with a physical therapist to provide you with specific exercises designed for your needs.
Range-of-motion and stretching exercises can help maintain flexibility in your joints and preserve good posture. In addition, specific breathing exercises can help to sustain and enhance your lung capacity.
As your condition worsens, your upper body may begin to stoop forward. Proper sleep and walking positions and abdominal and back exercises can help maintain your upright posture. Even if portions of your spine eventually fuse, you'll be able to get around and perform daily functions more easily if your spine fuses in an upright position.
Surgery
Most people with ankylosing spondylitis don't need surgery. However, your doctor may recommend surgery if you have severe pain or joint damage, or if a hip joint is so damaged that it needs to be replaced.
Definition:
Ankylosing spondylitis is an inflammatory disease that can cause some of the vertebrae in your spine to fuse together. This fusing makes the spine less flexible and can result in a hunched-forward posture. A severe case of ankylosing spondylitis can make it impossible for you to lift your head high enough to see forward.
Ankylosing spondylitis affects men more often than women. Signs and symptoms of ankylosing spondylitis typically begin in early adulthood. Inflammation also can occur in other parts of your body — such as your eyes and bowels.
There is no cure for ankylosing spondylitis, but treatments can decrease your pain and lessen your symptoms.
Symptoms:
Early signs and symptoms of ankylosing spondylitis may include pain and stiffness in your lower back and hips, especially in the morning and after periods of inactivity.
These symptoms may come on so gradually that you don't notice them at first. Over time, symptoms may worsen, improve or stop completely at irregular intervals.
The areas most commonly affected are:
- The joint between the base of your spine and your pelvis
- The vertebrae in your lower back
- The places where your tendons and ligaments attach to bones, mainly in your spine, but sometimes along the back of your heel
- The cartilage between your breastbone and ribs
- Your hip and shoulder joints
See your doctor if you have chronic pain and stiffness in your lower back and hips, or if deep breathing makes your chest hurt. Seek immediate medical advice if you develop eye pain, light sensitivity or blurred vision.
Causes:
Ankylosing spondylitis has no known specific cause, though genetic factors seem to be involved. In particular, people who have a gene called HLA-B27 are at significantly increased risk of developing ankylosing spondylitis.
As ankylosing spondylitis worsens and the inflammation persists, new bone forms as part of the body's attempt to heal. This new bone gradually bridges the gap between vertebrae and eventually fuses sections of vertebrae together. Those parts of your spine become stiff and inflexible. Fusion can also stiffen your rib cage, restricting your lung capacity and function.
Complications:
Ankylosing spondylitis doesn't follow a set course. The severity of symptoms and development of complications vary widely from person to person. Complications may include:
- Eye inflammation (uveitis). One of the most common
complications of ankylosing spondylitis, uveitis can cause rapid-onset
eye pain, sensitivity to light and blurred vision. See your doctor right
away if you develop these symptoms.
- Compression fractures. Some people experience a
thinning of their bones during the early stages of ankylosing
spondylitis. Weakened vertebrae may crumble, increasing the severity of
your stooped posture. Vertebral fractures sometimes can damage the
spinal cord and the nerves that pass through the spine.
- Difficulty breathing. If ankylosing spondylitis
affects your ribs, the fused bones can't move when you breathe — making
it difficult to fully inflate your lungs.
- Heart problems. Ankylosing spondylitis can cause problems with your aorta, the largest artery in your body. The inflamed aorta can enlarge to the point that it distorts the shape of the aortic valve in the heart, which impairs its function.
Treatments and drugs:
The goal of treatment is to relieve your pain and stiffness, and prevent or delay complications and spinal deformity. Ankylosing spondylitis treatment is most successful before the disease causes irreversible damage to your joints.
Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs) — such as naproxen (Aleve, Naprosyn) and indomethacin (Indocin) — are the medications doctors most commonly use to treat ankylosing spondylitis. They can relieve your inflammation, pain and stiffness. However, these medications also can cause gastrointestinal bleeding.
If NSAIDs aren't helpful, your doctor may suggest tumor necrosis factor (TNF) blockers. TNF is a cell protein that acts as an inflammatory agent in rheumatoid arthritis. TNF blockers target this protein to help reduce pain, stiffness, and tender or swollen joints. They are administered by injecting the medication under the skin or through an intravenous line.
Examples of TNF blockers include:
- Adalimumab (Humira)
- Etanercept (Enbrel)
- Infliximab (Remicade)
- Golimumab (Simponi)
Therapy
Physical therapy can provide a number of benefits, from pain relief to improved physical strength and flexibility. Your doctor may recommend that you meet with a physical therapist to provide you with specific exercises designed for your needs.
Range-of-motion and stretching exercises can help maintain flexibility in your joints and preserve good posture. In addition, specific breathing exercises can help to sustain and enhance your lung capacity.
As your condition worsens, your upper body may begin to stoop forward. Proper sleep and walking positions and abdominal and back exercises can help maintain your upright posture. Even if portions of your spine eventually fuse, you'll be able to get around and perform daily functions more easily if your spine fuses in an upright position.
Surgery
Most people with ankylosing spondylitis don't need surgery. However, your doctor may recommend surgery if you have severe pain or joint damage, or if a hip joint is so damaged that it needs to be replaced.
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