Information for Ankylosing Spondylitis Sufferers
What is Ankylosing Spondylitis?
Ankylosing spondylitis is a recurring, inflammatory, degenerative, and quite painful form of arthritis. It can cause pain, stiffness, swelling, and limited motion in the lower back, middle back, and neck, and sometimes areas such as the hips, chest wall, and heels.
- It can cause an eventual fusion of the spine, which can result in its complete rigidity. This condition is called “bamboo spine”.
- The main feature of ankylosing spondylitis is the involvement of the joints at the base of the spine where the spine joins the pelvis – the sacroiliac (S1) joints.
- Ankylosing Spondylitis (also called Bechterew's disease/Bechterew syndrome; Marie-Strümpell disease/Marie-Struempell disease, or Spondyloarthritis).
- It most commonly occurs in younger people (men more than women), from around age 15 up to age 40. Onset after age 40 is uncommon.
- It may affect younger people also, although in very young people it may take a slightly different form, causing pain around the heels, knees, and hips rather than beginning with the spine.
Do I have it?
There are some warning signs of ankylosing spondylitis.
If you experienced any of the following for more than a few weeks, you might be suffering from ankylosing spondylitis:
- Chronic back pain lasting for many months.
- Back pain occurring during the night.
- Back stiffness lasting for extended periods in the morning or after periods of rest.
- Pain and tenderness in the ribs, shoulder blades, hips, thighs, shins, heels and along the bony parts of the spine.
- Recurring inflammation in the eyes causing pain, redness, blurred vision, and sensitivity to bright light.
Establishing the correct diagnosis early is important because the sooner appropriate treatment is started the better the chance of avoiding disability or deformity. So, if you think you may have this disease, go see your doctor!
How is it diagnosed?
Diagnosis is determined through several different factors. The history of the onset of pain, the areas of involvement, and the times of the day when pain is worst, is key. In young people the presence of tender points at specific locations around the feet, heels, knees and hips can be indicative of ankylosing spondylitis.
Here are some tests your doctor may perform:
- An ESR (erythrocyte sedimentation rate) blood test shows whether or not inflammation is present in the body. This test can help determine if your pain is caused by inflammation or by something else.
- A test for the HLA-B27 blood group to help diagnose the disease early, however the presence of HLA-B27 does not directly indicate that you the disease.
- X-rays may be taken to determine if there is evidence of change to the joints at the bottom of the spine (sacroiliac joints). However, changes in these joints occur slowly over time and may not be present in early stages of the disease.
- Take precise measurements of the mobility of the spine and this can also contribute to the diagnosis. By the time spinal joints become markedly stiff, however, the disease has usually been present for some time.
If your doctor thinks you have ankylosing spondylitis, generally you are referred to a rheumatologist.
A rheumatologist is a doctor who has received special training in the diagnosis and treatment of problems with joints, muscles and bones.
If your eyes are affected too, you could also be referred to an ophthalmologist.
An ophthalmologist is a doctor who specializes in the medical and surgical care of the eyes and visual system and in the prevention of eye disease and injury.
If the inflammation associated with ankylosing spondylitis continues unchecked, it can produce changes within the spinal column. Small bony outgrowths extend from the edges of the vertebrae and can eventually bridge across from one vertebra to the next. Should this occur, over time it can result in stiffness and immobility between the vertebrae.
How did I get it?
There are no clear causes of ankylosing spondylitis, but a genetic factor is suspected to be involved. A parent with ankylosing spondylitis has about a 50% chance of passing the condition on to children. Current research suggests that both the environment and bacterial infections may also have roles in triggering ankylosing spondylitis.
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