Ankylosing Spondylitis in Adults
Arthritis is a disease that affects joints in your body. Ankylosing spondylitis (AS) is a type of arthritis that attacks the spine. The name comes from the Greek language. “Ankylosing” means stiffening of the joints. “Spondyl” refers to the spine, or vertebrae.
What causes Ankylosing spondylitis?
Healthcare providers don’t know exactly what causes AS. Genes may play a role. A significant percentage of people with AS patients have a gene called HLA-B27. But only a small percentage of people with this gene actually get AS.
Young and old people can develop AS. But it’s more common in people ages 17 to 35. Men are more likely than women to have AS. You are also more likely to have it if someone else in your family had it.
Like other types of arthritis, AS causes pain and stiffness. The spine and other nearby joints, such as the hip, become inflamed. In serious cases, the disease may break down the joints. Bones may even fuse together.
Symptoms of AS may come and go. They often include:
Back pain, especially in the morning when waking up from sleep
Body aches, such as in the legs, shoulders, buttocks, or heels
Stiffness in the morning
Stooped posture to ease pain
Problems breathing in deeply if AS affects the joints between the ribs and the spine
Lack of appetite
Extreme tiredness (fatigue)
Some people with AS also have skin rashes and stomach illnesses. They may have eye problems, too. These include pain, redness, and sensitivity to light. Severe cases of the disease may damage organs such as the heart and lungs. About 50% of people with AS develop weak and brittle bones (osteoporosis).
Diagnosing Ankylosing spondylitis
To diagnose AS, your healthcare provider will start with a physical exam. He or she will ask about your symptoms and health history. X-rays of your spine and other joints may show joint damage. MRI testing may be done as well. Genetic testing can find out if you have the HLA-B27 gene.
Your healthcare provider may also recommend a lab test that checks for inflammation. An erythrocyte sedimentation rate test measures how quickly red blood cells fall to the bottom of a test tube. If you have inflammation from arthritis, the red blood cells will clump together and fall faster.
Treating Ankylosing spondylitis
AS can’t be cured. But treatments can ease pain and stiffness. They can help you live a more active life. Your healthcare provider will choose the best treatment based on your overall health, the severity of your disease, and other factors.
Several types of medicine can reduce pain and inflammation. These medicines include:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen or ibuprofen
Corticosteroids, which can be injected into affected joints and areas.
Disease-modifying antirheumatic drugs (DMARDs)
Alternative treatments may also be helpful. Talk with your healthcare provider about the possible benefits of acupuncture, massage, yoga, and TENS units (transcutaneous electrical nerve stimulation).
Quitting smoking may help.
Your healthcare provider may also recommend surgery. For instance, you may need to have a joint replaced. Other procedures remove damaged bone or insert rods into the spine.
Exercising regularly can help relieve your symptoms. Be sure to include activities that strengthen the back and increase flexibility and range of motion. Your healthcare provider may also suggest physical therapy. Maintaining proper posture is important, too.
June 15, 2018
Assessment and treatment of ankylosing spondylitis in adults. UpToDate., Clinical manifestations of axial spondyloarthritis (ankylosing spondylitis and nonradiographic axial spondyloarthritis) in adults. UpToDate., Diagnosis and differential diagnosis of axial spondyloarthritis (ankylosing spondylitis and nonradiographic axial spondyloarthritis) in adults. UpToDate.
Freeborn, Donna, PhD, CNM, FNP,Hanrahan, John, MD,Horowitz, Diane, MD