Ankylosing Spondylitis, Treatment, Symptom, Causes 2024

Nowadays it is being seen that spondylitis is seen very fast in people, many people are victims of this disease. Many do not even know about it. Ankylosing spondylitis is one type of spondylitis and today we are going to give complete information about it in detail.

Because of this information, you can get strength to fight this disease in the coming time. It is often seen that information is the only protection. The more information you have about this disease, the more easily you can get rid of this disease. So we are going to tell about Ankylosing Spondylitis Types, Symptom, Causes, Diagnosis, Treatment.

What is Ankylosing spondylitis ?

Ankylosing spondylitis is a type of Arthritis. Ankylosing spondylitis, sometimes referred to as ‘spondyloarthritis’, is a form of arthritis that most commonly occurs in the spine, although it can affect other joints of the body. In fact, the term ‘spondylitis’ is associated with a group of related diseases, which have similar progression and symptoms, but these diseases affect different areas of the body.

Ankylosing spondylitis (pronounced ankle-oh-sing spon-dill-eye-tiss). Ankylosing spondylitis is a type of spinal arthritis, in which our spine or bone becomes completely attached and over time there is complete tilt in the patient. Some times it affected other joints such as the shoulders or hips, eye and bowel problems may occur as well as heavy back pain. Its symptoms are stiffness.

Stiffness in the morning after waking up. Bone fever persists. Its pain is very mild in the beginning and gradually increases and with time there is a complete tilt in the waist. With early treatment, pain and disease can be prevented and the disease can be brought under control completely.

Ankylosing spondylitis (AS) inflames the sacroiliac joints located between the base of the spine and pelvis from there the disease starts and gradually captures the entire spinal cord and there is complete tilt in the body. Some of the bones in the spine fuse, this fusing makes the spine less flexible. If ribs are affected, it can be difficult to breathe deeply.

Ankylosing Spondylitis Patient

Who can get Ankylosing Spondylitis ?

How common is Ankylosing Spondylitis (AS)?

Ankylosing spondylitis (AS) can occur in 0.5% to 1.5% of the adult population. Mostly it occurs in males and its male to female ratio is 3 : 1. Ankylosing spondylitis in women are less compared to male.

How many types of Spondylitis?

According to the Spondylitis Association of America, there two main types of Spondylitis.

• First is  the older, traditional system, there are six different types.
• Second is a newer system breaks all spondylitis diagnoses into one of two categories.

Traditional types of spondylitis

• Ankylosing spondylitis
• Enteropathic arthritis (EnA)
• Psoriatic arthritis (PsA)
• Reactive arthritis/Reiter’s syndrome (ReA)
• Juvenile spondylitis (JSpA)
• Undifferentiated spondylitis

New way to spondylitis

• Peripheral spondylitis

• Axial spondylitis

Axial spondylarthritis mainly consists of two diseases.

• Nonradiographic axial spondyloarthritis (nr-axSpA)
• Radiographic axial spondyloarthritis This type is more commonly known as ankylosing spondylitis (AS).

What are ankylosing spondylitis symptom?

• Pain and stiffness in the body are its common symptoms.
• Joint pain.
• Neck pain.
• Ankylosing spondylitis patients have back pain or hip pain.
• Stiffness in the body when they wake up in the morning.
• Breathing Problem.
• Chest Pain.
• Bone fever in the body.
• Fatigue.
• Vision Problem
• Loss of appetite, irritability are all the symptoms of this disease.

If the pain in the back bone is more than 3 months and the stiffness is more on getting up in the morning, then we should see the rheumatologist as soon as possible.

In this disease, the bones of the spine are completely fused, ie, the bones joining in this disease become one bone in 8-10 years, due to which the patient can get up, sit, walk, bend, twist of the neck. shuts down and all day-to-day activities are affected.

What are ankylosing spondylitis causes?

The cause of ankylosing spondylitis is not known, generally it believed that environment plays a major role and genetic factors. More than 90% of those affected have a specific human leukocyte antigen known as the HLA-B27 antigen. The underlying mechanism is believed to be autoimmune or autoinflammatory. If  people who are HLA-B27 positive, the spread of AS is approximately 5% to 6% only some people with the gene develop the condition.

How ankylosing spondylitis diagnosis?

Generally the diagnose of  Ankylosing spondylitis (AS) in 80% patients when they are younger than 30 years. Less than 5% patients when they are older than 45 years. AS is more common in men than women. It can be treated only after showing it to a rheumatologist or rheumatologist.

Rheumatologist are doctors who specialize in  joints, bones and muscles problem.

• There are some blood tests or some tests, by which the disease can be detected. In the blood test, CBC, ESR, CRP and HLAB-27 are a type of genetic test, due to which if it comes positive then there is a possibility of getting this disease.

• In addition to blood tests, X-rays and Magnetic resonance imaging (MRI) scans can detect ankylosing spondylitis early.

• The Schober’s test is a useful clinical measure of flexion of the lumbar spine performed during the physical examination.

What are the complications of ankylosing spondylitis (AS)?

If some one had Ankylosing spondylitis (AS)  and survived for long time then the chances of back bone fused together. Fused bones may fracture and fractured spine bones can damage nerve. It has articular and extra-articular complications.

• Eye inflammation
• Chronic pain and disability
• Aortic regurgitation
• Pulmonary fibrosis
• Cauda equina syndrome
• Mood disorders
• Heart disease, including aortitis, arrhythmia and cardiomyopathy.
• Chest pain that affects breathing.

How ankylosing spondylitis treatment?

This disease is an autoimmune disease. It is related to our immunity. There is no complete cure for this, but it is possible to prevent the disease by getting it treated at the right time, so that patients can normalize their daily routine like other people.

Drug Treatments for ankylosing spondylitis.

In addition, rheumatologists use non-steroidal anti-inflammatory drugs (NSAIDs), which are given by a doctor for a short period of time. It completely reduces the inflammation caused by the disease. Apart from this, there are also disease modifying anti-inflammatory drugs. Such as sulfasalazine  and methotrexate, which are used by rheumatologists to inhibit disease activity.

Painkiller like paracetamol medications for temporary pain relief for ankylosing spondylitis.

non-steroidal anti-inflammatory drugs (NSAIDs) such as IBUPROFEN, NAPROXEN to help control inflammation and provide temporary pain relief and stiffness. Generally doctors first recommendation is Ibuprofen for the treatment for ankylosing spondylitis.

Biological Therapy Treatment for ankylosing spondylitis.

New methods such as biological therapy are also very effective. These drugs are more targeted to stop inflammation than the older DMARDs. If NSAIDs treatment are not make any relief to patient then, your doctor might recommend an interleukin-17 (IL-17) inhibitor or tumor necrosis factor (TNF) blocker. These drugs are injected under the skin or through an (IV) intravenous. They are not suitable for everyone and can only be prescribed by dr. if patient condition is not controllable with anti-inflammatory drugs and physiotherapy. This drugs reduce or slowing the process of inflammation.

There are some group of biological therapies called Tumor necrosis factor (TNF) blocker.

• Infliximab (Remicade)
• Adalimumab (Humira)
• Golimumab (Simponi)
• Etanercept (Enbrel)
• Certolizumab pegol (Cimzia)

Steroids Treatment for ankylosing spondylitis

Steroids is commonly used to relieve pain for a short period of time. Steroids is usually given as an injection into the area of inflammation of joints or into a muscle, which injected very slow through injection in to the body. They can also treat painful tendons. But it cannot be given repeatedly as it may make the tendons weak.

Physical Treatment for ankylosing spondylitis

Physical activity is very important for our body in the same way, a normal person should also include physical activities in his daily routine. If we talk about ankylosing spondylitis, physical activity exercise for spondylitis is like a boon. By continuing exercise, there is a lot of improvement in spondylitis, sometimes happens that a person gets cured of spondylitis disease.

A physiotherapist can tell you the right kind of exercises which will strengthen your muscles and you will also see improvement. Physiotherapist will prepare a program for you, due to which you will get relief in spondylitis to a great extent. Continuous exercise prescribed by the physiotherapist will not only relieve the pain in the spine and joints of the body, but will also improve their functionality.

In spondylitis, the back and neck become stiff, due to which there is difficulty in turning and bending them, so it becomes very important to exercise, only by exercising, we can move it easily.

A good physiotherapist can advise you on how to maintain good posture for your body, due to which you will have less pain due to spondylitis. The physiotherapist can also recommend Hydrotherapy to you.

Hydrotherapy is a therapy done in a hot water pool, in which some special exercises are done in the hot water pool, which is for the lower back, hips and shoulders, due to which the pain of spondylitis is relieved.

Surgery is the last option for spondylitis if you have severe pain or if a hip joint is so damaged that it needs to be replaced. But most people with ankylosing spondylitis don’t need surgery.

History of Ankylosing Spondylitis (AS) according to wikipedia

Ankylosing spondylitis has a long history, having been distinguished from rheumatoid arthritis by Galen as early as the 2nd century AD. Skeletal evidence of the disease (ossification of joints and entheses primarily of the axial skeleton, known as “bamboo spine”) was thought to be found in the skeletal remains of a 5000-year-old Egyptian mummy with evidence of bamboo spine. However, a subsequent report found that this was not the case.

The anatomist and surgeon Realdo Colombo described what could have been the disease in 1559, and the first account of pathologic changes to a skeleton possibly associated with AS was published in 1691 by Bernard Connor. In 1818, Benjamin Brodie became the first physician to document a person believed to have active AS who also had accompanying iritis.

In 1858, David Tucker published a small booklet which clearly described the case of Leonard Trask, who had severe spinal deformity subsequent to AS. In 1833, Trask fell from a horse, exacerbating the condition and resulting in severe deformity. Tucker reported:

It was not until he [Trask] had exercised for some time that he could perform any labor … [H]is neck and back have continued to curve drawing his head downward on his breast.

The account of Trask became the first documented case of AS in the United States, owing to its indisputable description of inflammatory disease characteristics of AS and the hallmark of deforming injury in AS.

In the late nineteenth century, the neurophysiologist Vladimir Bekhterev of Russia in 1893, Adolph Strümpell of Germany in 1897, and Pierre Marie of France in 1898 were the first to give adequate descriptions which permitted an accurate diagnosis of AS prior to severe spinal deformity. For this reason, AS is also known as Bekhterev disease, Bechterew’s disease or Marie–Strümpell disease.

The word is from Greek ankylos meaning crooked, curved or rounded, spondylos meaning vertebra, and -itis meaning inflammation.

Conclusion 

In conclusion, effective management of ankylosing spondylitis involves a multifaceted approach tailored to individual needs. While there is currently no cure for the condition, various treatments are available to alleviate symptoms, slow disease progression, and improve quality of life. These treatments may include medication, physical therapy, exercise, lifestyle modifications, and in some cases, surgery.

Understanding the causes, symptoms, and triggers of ankylosing spondylitis is crucial for early diagnosis and intervention. With proper medical care and support, individuals with ankylosing spondylitis can lead fulfilling lives, managing their symptoms and optimizing their overall well-being. Ongoing research and advancements in treatment continue to offer hope for enhanced outcomes and improved quality of life for those affected by this chronic inflammatory condition.

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