Ankylosing Spondilitis

July 23, 2015 | By | Reply READ MORE...

– Dr. Soma Jaldhari

Ankylosing Spondilitis (AS) is a kind of arthritis which is mainly caused because of inflammation of the spine. It’s a silent disease which is autoimmune in nature (body attacks its own cells)

  • Advance stages – complete fusion of the spine happens, also known as “bamboo spine”

Ankylosing Spondilitis

  • Fusion is a reaction to inflammation of muscles and ligaments where they attach to the bone
  • Most commonly seen in males between 20-40 years of age
  • Real cause still not understood though the commonest cause is genetic predisposition
  • Most of the AS are associated with HLA-B27 genotype

 

Symptoms

  • Gradual onset of symptoms
  • Initially, pain in buttock or low back followed by morning stiffness
  • Morning stiffness – improves with activity and returns with inactivity
  • Postural changes – in advance stages, the head moves forward, upper back curves (kyphosis), lower back becomes flat (reduced lumbar lordosis) and hips may become stiff not allowing to stand straight

Ankylosing Spondilitis

  • Sleep may be disturbed due to pain
  • Weight loss – usually because of an irritable bowel
  • Iritis – redness and pain in the eye
  • Breathing difficulty – in advance stages when there is fusion of ribs
  • Joint pain – mainly affecting the shoulder and knee

 

Major investigative findings

  • X-ray-Early stage – inflammation at the Sacroiliac(SI) joints (sacroilitis)
  • Later stage – fusion of bones of the spine
  • MRI or CT scan to reveal the inflammation in SI joint more clearly
  • Laboratory findings-HLA-B27 is found in about 90-95% of patients
  • 50-70% of patients show increased C-reactive protein (CRP) and raised erythrocyte sedimentation rate (ESR)

Ankylosing Spondilitis

Treatment

  • Goal of treatment is to reduce pain and stiffness, reducing inflammation, keeping the condition from progressing
  • It’s successful before the disease causes irreversible damage to the spine
  • The best formula for treatment is medicines, exercises and healthy diet
  • Education – it’s important to know what to expect from the course of AS, how can you manage your own symptoms
  • Anti-inflammatory drugs – they help to reduce inflammation, pain and swelling
  • Physical therapy – is important to maintain flexibility, strength, good posture, relieve pain and to have a good quality of life. It mainly constitutes of –
    – Stretching exercises
    – Postural correction exercises
    – Back & core muscles strengthening exercises
    – Breathing exercises to improve chest expansion
    – Low impact cardio exercises
    – Pain relieving modalities like ultrasound or hot-pack

Despite the challenges of Ankylosing Spondilitis (AS), our patients at PHYSIOREHAB have achieved their life goals through proper medical management, exercises and will power.

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