Ankylosing Spondylitis Explained
Ankylosing spondylitis is a type of arthritis that causes damage to your spinal joints. As an inflammatory condition, it can reduce the flexibility of your spine by causing calcium deposits to build up in the ligaments. Over time, this leads to vertebrae fusing together, causing the spine to become twisted and stiff. Ankylosing spondylitis often starts in the lower back, but it can spread up to your neck. Here's an overview of the causes, symptoms, diagnosis and treatment approach for this condition:
Causes And Symptoms
It's not fully understood why some people develop ankylosing spondylitis, but genetics and environmental triggers, such as certain bacteria that can alter immune response, are believed to play a role. The condition often develops in young people, and those prone to gastrointestinal infections may be at a greater risk of developing ankylosing spondylitis.
Early symptoms of ankylosing spondylitis include spinal pain in your lower back and stiffness that's most prominent when you wake up and tends to ease off as the day progresses. You may also experience sharp pains down the back of your thighs. As the condition progresses, you may experience pain radiating from your spine that's either constant or comes and goes throughout the day. Simple movements, such as turning and bending, will be painful, and pelvic tenderness may leave you feeling uncomfortable when sitting. Severe or untreated ankylosing spondylitis can also cause inflammation to develop in other parts of the body where bone and tendons join together, such as the heels, fingers or elbows.
Diagnosis And Treatment Approach
Ankylosing spondylitis is diagnosed by a rheumatologist. They will use a combination of your family medical history, a physical exam, blood tests and diagnostic imaging to make their diagnosis. Blood tests will confirm if you have raised inflammatory markers in your blood, which simply indicate the presence of inflammation somewhere in your body. Diagnostic imaging, such as X-rays and MRI scans, can be used to narrow down the site of the inflammation and show changes to the joints of the spine.
Once diagnosed, your doctor will develop a treatment plan with you based on the severity of your symptoms. Treatment can include painkillers and anti-inflammatory drugs or steroids to reduce inflammation. Anti-TNF medications have been found to be effective at reducing symptoms and preventing further damage to your spine. Tumour necrosis factor (TNF) is a chemical produced by your body when inflammation is present. Anti-TNF medications reduce inflammation by blocking the effects of TNF.
Physiotherapy can also be used to help your spine remain flexible and keep you mobile. Your physiotherapist will teach you how to do targeted exercises, but these must be done daily to prevent stiffness and loss of muscle strength in your back. In severe cases of ankylosing spondylitis, you may require surgery to correct a bend or twist in your spine, which can reduce pain and improve mobility. However, if the condition is diagnosed early and inflammation is managed well with medication, surgery tends not to be required.
If you have a family history of ankylosing spondylitis, don't be tempted to dismiss back pain as a common ache or muscle strain. You should be seen by a rheumatologist as soon as you develop back pain to allow for prompt diagnosis and treatment.