Introduction to ankylosing spondylitis
Ankylosing spondylitis is a disorder of the spine. Basically, it is a form of arthritis that affects mainly the spine. It inflames the vertebrae, resulting in severe pain and disability. In extreme cases, this inflammation can trigger the formation of a new bone on the spine. The resulting effect is deformity. Apart from the spine, stiffness and pain can also occur in other parts of the body. The knees, shoulders, and hips can also be affected.
Symptoms of ankylosing spondylitis
Ankylosing spondylitis has a variety of symptoms. Symptoms could be mild or moderate, and at other times, the patient may not experience any symptoms at all.
The major symptoms are back pain occurring mainly in the morning and in the night. Pain may also occur in the shoulders, the hips, and other large joints. Other symptoms experienced by the patient include:
- Stiffness experienced early in the morning
- stooped shoulders & poor posture
- poor appetite
- weight loss
- low iron, known clinically as anemia
- reduced lung function
Ankylosing spondylitis is an inflammatory condition. Because of this, other parts of the body become affected as well. Patients may also experience the following conditions:
- abdominal inflammation
- mild inflammation of the eyes
- inflammation of the heart valves
- Achilles tendonitis
We have established that ankylosing spondylitis is basically a spinal condition. However, other parts of the body may also be affected.
The causes of ankylosing spondylitis
The primary cause of ankylosing spondylitis has not been fully established. It appears that genetics may play a role in the occurrence of the disorder. Clinical experience has shown that this disorder tends to run in families. If your family has a history of ankylosing spondylitis, then you are 10-20 times more likely to have the disorder compared to someone without a family history of the disorder.
Risk factors for ankylosing spondylitis
One of the major risk factors for the condition is a family history of the disease. Another would be the presence of the HLA-B27 protein. A 2002 study showed that no less than 90% of those who were diagnosed of this condition had a gene that expressed the protein.
Ankylosing spondylitis occurs in young adults. This is quite unlike the conventional rheumatic and arthritic disorders that occur in the elderly. Symptoms of ankylosing spondylitis occur between 20 and 40 years of age.
Males are three times more likely to have the disorder compared to females.
The disease is more common among the Caucasians than the Africans or other ethnicities.
Treatment for ankylosing spondylitis
Ankylosing spondylitis does not have a cure. However, pain can be treated with medications while disability can be prevented. Timely diagnosis and treatment can minimize the symptoms of the disease. In fact, if treatment is done at the right time, some possible complications may be prevented or totally stopped. Such include bone deformity.
Inflammation and pain is managed with Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen. These drugs are long-acting and have little to no complications.
When NSAIDs fail to provide the needed relief, then more potent medications may be prescribed by your physician. Corticosteroids are short-term medications. However, they are very potent anti-inflammatory agents, and so they can ease the symptoms and minimize damage in the spine and around it.
Inflammatory triggers can be blocked by Tumor necrosis factor (TNF). These drugs prevent inflammation, and eases stiffness and joint pain. Tumor necrosis factor inhibitors are used after the condition has progressed and NSAIDs are not as effective as they used to be.
When the case becomes severe, then disease-modifying anti-rheumatic drugs may be prescribed by your physician. These drugs impede the progress of the disease, thus preventing worsening of symptoms.
If your hip joints or knee joints are deformed or severely damaged, then you may have to undergo a knee replacement surgery. People with poor posture may undergo an osteotomy. This procedure involves cutting and realignment of bones in the spine.
Treatment depends on the severity of the condition and the nature of the symptoms.
Any natural treatments for ankylosing spondylitis?
The symptoms of this disorder can be alleviated by some natural remedies. These remedies can be applied on its own, or in some cases, may be combined with other treatments. It is best that you converse with your doctor on the safest remedy.
Symptoms of ankylosing spondylitis can be eased with range-of-motion exercises. Even strength training exercises can also relieve the symptoms. These exercises help to strengthen the joints and makes it more flexible. Your physician may refer you to a physical therapist who will teach you how to do these exercises the right way.
Stretching improves on the strength and flexibility of your joint. This causes less pain and increases the range of motion in your joints.
Bad posture is a function of spine stiffness. Over time, your spine bones can fuse in a slumping and slouching position. If you have a good posture or practice a good one, then your risk will reduce.
Because this may not come naturally after years of poor posture positions, you may need to encourage better posture with reminders to correct your posture regularly. You can also use support devices, such as chairs or seat cushions.
Heat and cold therapy
Spinal pain and stiffness can be reduced with the use of heating pads or a warm shower. Ice packs may be used to reduce inflammation in the joints.
Acupuncture reduces pain in ankylosing spondylitis. This it does by activating the release of natural analgesic hormones.
Massage is both invigorating and relaxing. In addition to this, it boosts flexibility and improves your range of motion. If you have ankylosing spondylitis, please inform your massage therapist. By so doing, they will feel around for the tender points in your spine.
The role of diet in the treatment of ankylosing spondylitis
There is no one diet that can offer total treatment for ankylosing spondylitis. However, you may start with a balanced diet, one that is rich in minerals and vitamins. Be sure to add the following to your diet:
- Foods loaded with omega-3 fatty acids. These include nuts, fish, oils, and nuts.
- Vegetables and fruits of all kinds.
- Whole grains like farro, quinoa, and whole grain foods.
- Yogurt and other foods with active cultures.
Reduce your intake of sugar, fat and sodium-rich foods. Such foods include those are heavily processed. Canned foods, and foods that are boxed or bagged are loaded with preservatives and trans fats. These worsen inflammation.
Cut down on the amount of alcohol that you take in daily. Alcohol interferes with the action of medications and worsens symptoms. Other supplements and foods may worsen or improve the symptoms of ankylosing spondylitis.
Is exercise beneficial to ankylosing spondylitis?
Engaging in regular exercise and posture practice helps you to maintain flexibility and a range of motion. The following exercise can help to improve the symptoms of ankylosing spondylitis:
- Deep breathing
- Posture practices
Physical therapy and medications may also be combined with these for a more holistic treatment plan.
Diagnosis for ankylosing spondylitis
Diagnosis of this disorder is usually done by a rheumatologist. A rheumatologist is a doctor who specializes in the treatment of arthritis.
Diagnosis begins with a thorough physical examination. Your physician will ask for your medical history and history of your symptoms.
Your spine will be examined for any erosion using an X-ray. If the disease is still in its early stages, then no erosion will be detected. MRI studies are also used for diagnosis, but they are usually difficult to interpret.
The presence of inflammation may be determined with a blood test known as erythrocyte sedimentation rate. Your physician may also order a HLA-B27 protein test. Test for this protein does not mean that you have the disorder. It only means that you have the gene that produces the HLA-B27 protein.
It does take some time to make a diagnosis for this kind of arthritis.
Complications of ankylosing
If the disease is not treated on time, then you may develop some complications. These include:
- Fusion of your vertebrae due to chronic inflammation
- Spread of inflammation to nearby joints. The inflammation may even spread to the shoulders and the hips.
- The tendon and ligaments may be inflamed. This worsens flexibility.
- Problems with breathing
- Irritation of the eyes
- Damage to your lungs, bowel or heart
- Compression and fracture of the spine.
You are advised to seek immediate treatment for chronic stiffness of the joint, and, lower back pain.
Prevention of ankylosing spondylitis
We do not know the right methods of prevention. This is because the primary cause of the disease is not yet known. However, if you are affected by the disease, then you can prevent disability by:
- Eating a balanced and healthy diet
- Maintaining the right body weight
- Living an active life
With these lifestyle modifications, combined with conventional medical treatments, you will surely delay the progression of this disorder.
The prognosis for ankylosing spondylitis
The disorder can rightly be described as a progressive condition. The implication is that it will worsen with time and may even result in disability. Ankylosing spondylitis is a chronic disorder, and so, no treatment has been discovered for it.
Damage and inflammation can be delayed by exercise, medication, and alternative therapies. However, these cannot put a total end to it. They can help with improvement of symptoms.
If you experience chronic back pain, be sure to disclose this to your physician. He or she will design a treatment plan that suits your condition.
Early treatment helps to prevent long-term damage.
Tonika Bruce, MSN, RN, MBA. is an accomplished nurse leader, published author, and personal development expert passionate about advancing healthcare management and quality patient outcomes.
She taps into the years of experience in healthcare management to produce credible and easy-to-understand health and leadership content. Her exceptional work has been featured in reputable publications, including Forbes, Recruiter, Inc, and the Color of Wellness magazine.