Table of Contents
What is Ankylosing Spondylitis
A form of chronic, degenerative arthritis (INFLAMMATION of the joints) that primarily affects the spine. The inflammation permanently damages the vertebrae (bones of the spine), causing outgrowths of bony tissue that fuse vertebrae to one another such that their mobility and range of motion can become extremely limited. Ankylosing spondylitis, sometimes called Marie-Strümpell disease, is one of the AUTOIMMUNE DISORDERS related to RHEUMATOID ARTHRITIS. In most people who develop the condition, symptoms remain confined to the spine. However, in some people inflammation also involves structures of the EYE (IRITIS and UVEITIS), the HEART valves, the LUNGS, and other joints such as the shoulders and hips.
Symptoms of Ankylosing Spondylitis and Diagnostic Path
Early symptoms of ankylosing spondylitis are general and include low BACK PAIN and stiffness, especially upon awakening. The PAIN often becomes intense at night, which is the primary reason any people seek medical evaluation. Over time the stiffness and pain may spread to the entire back, shoulders, and hips. As the condition progresses, additional symptoms may include loss of spine FLEXIBILITY and range of motion, constricted movement of the chest (from inflammation of the joints connecting the ribs to the spine), fatigue, and hunched or stooped posture.
The diagnostic path typically includes a comprehensive medical examination and PERSONAL HEALTH HISTORY, X-rays of the spine, and BLOOD tests to look for signs of inflammation within the body. Because symptoms are fairly general until the condition is well advanced, early diagnostic efforts look for more common causes such as OSTEOARTHRITIS.
Ankylosing Spondylitis Treatment Options and Outlook
Treatment typically combines prescription medications such as ANTI-INFLAMMATORY DRUGS (NSAIDS) and PHYSICAL THERAPY with lifestyle measures such as daily physical exercise, stretching and flexibility activities, and techniques to support upright posture. Some people experience symptom relief and delayed progression of the condition with medications used to treat rheumatoid arthritis, such as DISEASE-MODIFYING ANTIRHEUMATIC DRUGS (DMARDS). Though treatment cannot prevent the vertebrae from fusing, lifestyle measures can help retain maximum functional capacity of the spine. Many doctors aim for a goal of shaping the fusion so the spine remains erect, which allows better mobility than when the spine fuses into a hunched posture. Ankylosing spondylitis is a lifelong condition.
Ankylosing Spondylitis – Risk Factors and Preventive Measures
Ankylosing spondylitis typically begins before age 40 and is more common in men. It is also more common in people who have INFLAMMATORY BOWEL DISEASE (IBD) and in people of Native American heritage. Researchers have identified a GENE, HLAB27, associated with ankylosing spondylitis. The HUMAN LEUKOCYTE ANTIGENS (HLAS) are proteins on the surfaces of cell membranes that identify the cells to the IMMUNE SYSTEM. HLA-B27 is one of the numerous genes that encodes for HLAs. Researchers believe this variant of the gene predisposes an individual for ankylosing spondylitis though does not inevitably result in the condition. Remaining as active as possible helps extend the spine’s flexibility and range of motion.