Ankylosing Spondylitis
What is Ankylosing Spondylitis?
Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the spine and sacroiliac joints, leading to pain and progressive stiffness in the back.
- Can result in fusion of the spine over time
- Frequently begins in early adulthood
Overview of the Condition
AS is an autoimmune condition associated with the HLA-B27 gene. Inflammation can spread to other joints, potentially causing systemic symptoms like fatigue or eye inflammation.
Symptoms
- Chronic low back and hip pain, often worse in the morning or after inactivity
- Stiffness that improves with movement
- Reduced spinal mobility and chest expansion
Causes
Though the exact cause is unclear, a combination of genetic predisposition (HLA-B27) and immune system dysregulation contributes to spinal and joint inflammation.
Diagnosis
Diagnosis involves clinical evaluation, imaging (X-ray or MRI of the sacroiliac joints), and blood tests for inflammatory markers and HLA-B27.
Treatment Options
- NSAIDs for pain and inflammation
- Biologic medications (TNF inhibitors, IL-17 inhibitors)
- Physical therapy and exercise
- Lifestyle modifications to preserve spinal mobility
Conservative Management
Long-term management relies on exercise, anti-inflammatory medications, and close monitoring of disease progression. Biologic therapies may be introduced early to control inflammation.
Rehabilitation Exercises
- Daily stretching to maintain spinal flexibility
- Postural exercises to prevent excessive forward bending
- Breathing exercises to support chest expansion
When is Surgery Needed?
Surgery is less common for AS but may be considered in cases of severe spinal deformity, instability, or significant joint damage requiring replacement.
Surgical Procedures
- Spinal osteotomy to correct severe deformities
- Hip or other joint replacement for advanced arthritis
Anatomy Overview
The inflammation in AS commonly starts at the sacroiliac joints and can progress up the spine, leading to bony fusion (ankylosis). Over time, this reduces mobility significantly.
Affected Areas
- Sacroiliac joints
- Lumbar, thoracic, and cervical spine segments
- Other joints (hips, shoulders, knees) in some cases
Frequently Asked Questions
| Question | Answer |
|---|---|
| Can exercise worsen ankylosing spondylitis? | No. A regular, gentle exercise program is encouraged to maintain flexibility, although high-impact sports may need caution. |
| Is ankylosing spondylitis curable? | There is no cure. However, early diagnosis and treatment can significantly slow progression and reduce symptoms. |
Prevention Strategies
- Early diagnosis and treatment to slow disease progression
- Consistent exercise to maintain spine mobility
- Healthy posture habits and ergonomic adjustments