Ankylosing Spondylitis

 What is Ankylosing Spondylitis?

Ankylosing spondylitis is a condition that affects the lower back. The term ankylosing spondylitis describes the nature of the disease- ‘ankylosing’ which refers to ‘fusing together’ and ‘spondylitis’ which refers to ‘inflammation of vertebral bone’.

The sacroiliac (SI) joint, which connects the bottom of the spine to the pelvis, is where ankylosing spondylitis usually begins. The middle and upper spine might be impacted as the condition advances.

Ankylosing spondylitis is a severe illness that begins in the early adolescent years and progresses into the late thirties as a result of a sedentary lifestyle, poor sitting posture, stress, and a stressful job environment. It can be minor or severe in certain people, resulting in severe abnormalities of the back and neck and occasionally leaving the neck and back with little or no mobility. In extreme circumstances, the patient may be severely leaned forward and unable to see in front. Ankylosing Spondylitis can be mistaken for mechanical back pain in young individuals in their 20s and 30s.

The vertebrae of one's back tend to fuse with this condition, resulting in a stooped posture and a loss of flexibility in the back. This condition frequently affects the ribs and creates breathing difficulties.

What causes ankylosing spondylitis?

The exact aetiology of ankylosing spondylitis is unknown. Ankylosing spondylitis tends to run in families, therefore physicians suspect genetics may play a role. Furthermore, the majority of persons with ankylosing spondylitis have the same gene (called HLA-B27).

Having one of these conditions may also increase your risk:

• Crohn’s disease
• Ulcerative colitis
• Psoriasis

What are the most commonly affected areas in the body?

The following bodily parts are the most typically affected:

• The joint that connects the base of the spine to the pelvis
• The lower back vertebrae
• The points on the bones where tendons and ligaments attach
• The cartilage that connects the breastbone to the ribs
• Joints in the hips and shoulders

What are symptoms of Ankylosing Spondylitis?

• The most common signs and symptoms are pain and stiffness. The pain might be felt in the lower back and hip joint.
• Another symptom of this disorder is bony fusion, which occurs when the vertebrae fuse together, resulting in a hunched back posture.
• It can also affect the neck, causing it to be unable to turn.
• It's also linked to other systemic symptoms including Iritis (eye inflammation and redness), Fever, Fatigue, and Weight Loss.
• It has been linked to heart and lung problems in certain rare cases.

How is a disease identified?

An X-ray of the spine is used to confirm the diagnosis of ankylosing spondylitis. The look is typically characterised as 'bamboo spine.' The spinal column is shaped like a bamboo stalk.

During a clinical examination, the clinician may try to elicit various spinal motions to evaluate the degree of ankylosing spondylitis-related flexibility loss. Other tests that may be performed include lung capacity testing. Although genetic studies have been undertaken to detect the presence or absence of the particular gene previously indicated, there are no specific laboratory tests that may assist diagnose ankylosing spondylitis. It's important to remember that having the HLA B27 gene doesn't always indicate you have ankylosing spondylitis.

In certain cases, an MRI of the spine can be useful in diagnosis of the condition.

How long is Ankylosing Spondylitis likely to last?

Ankylosing Spondylitis generally begins before the age of 40, and it can develop over time. Instead of other joint back pain, early morning back pain and stiffness in the joints can last up to 90 days even with medicine and worsen with rest. Physical activity helps with Ankylosing Spondylitis. Ankylosing spondylitis affects between 0.1% and 1.4 percent of the world's population. Although the number of sufferers is tiny globally, roughly one in every 100 persons suffers from this chronic illness.

Is It an Autoimmune Disease?

Whatever causes it, ankylosing spondylitis is a "immune-mediated" illness, meaning it is caused by aberrant immune system activity. Immunologists are confused on whether it is an autoimmune disorder.

In autoimmune disorders, the body erroneously assaults a material generated by the body called an antigen. Autoantibodies are blood proteins that attack the antigen and may be detected in a blood sample.

In recent years, scientists have begun to refer to hereditary disorders that induce recurring episodes of inflammation in the absence of autoantibodies as "auto-inflammatory." It indicates that the immune system is responding to something other than a self-antigen in these disorders.

However, because ankylosing spondylitis has both autoimmune and auto-inflammatory properties, many doctors feel it fits under both groups at the same time.

What is the treatment for Ankylosing Spondylitis?

Ankylosing spondylitis treatment should aim to relieve pain and stiffness, avoid abnormalities, and allow you to continue with your typical activities.

The following are the fundamentals of treatment:

• Exercise: Regular exercise is an important component of ankylosing spondylitis treatment. Your physical therapist with arthritis experience can create an exercise programme tailored to your specific requirements. Back and neck strengthening exercises can help you maintain or improve your posture. Deep breathing and cardiovascular workouts will help the chest and rib cage remain flexible. Swimming is a great approach to exercise since it develops spinal flexibility, neck, shoulder, and hip joint movement, and deep breathing.

• Attention to posture: Make every effort to maintain a straight spine. A firm mattress is recommended for sleeping. Without a pillow under your head, try sleeping on your stomach. You may also sleep on your back with a lightweight pillow or one that supports your neck hollow. Instead of sleeping in a curled posture, keep your legs straight. If sleeping in these postures is challenging for you, talk to a physical therapist about additional possibilities.

• Medications: Medication is frequently a continuous and necessary aspect of treatment. While drugs may not cure ankylosing spondylitis, they do reduce pain and stiffness, enabling you to exercise, keep excellent posture, and carry on with your daily routine.

What role does physiotherapy play?

As the condition advances, physiotherapy treatment seeks to reduce discomfort during flare-ups and preserve good posture. Your physiotherapist will evaluate your spinal mobility, posture, and strength. They will also give you particular exercises to assist preserve mobility and strength in those joints if your hands, feet, hips, or shoulders are impacted. Many studies have shown that exercise can help people with Ankylosing Spondylitis, such as increased rib cage expansion during breathing and improved upper back and neck posture.

What diet should you follow if you have Ankylosing Spondylitis?

You should eat a diet that includes Omega-3 fatty acids. You may also lower disease activity by eating flex seeds and walnuts. Vitamin D also plays important role in bone health. A balanced diet can help persons with Ankylosing Spondylitis manage their symptoms and slow down the progression of the condition.