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Ankylosing Spondylitis: Symptoms, Causes & Diagnosis

Post written by BFH Staff Writer on May 30, 2024
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Ankylosing Spondylitis (AS) is a long-term inflammatory arthritis that mainly targets the spine, causing ongoing pain and stiffness and possibly leading to the fusion of the spinal bones. This condition not only impacts physical well-being but also significantly affects daily functioning and quality of life. Gaining comprehensive knowledge about its symptoms, causes, and diagnosis is important for identifying and implementing tailored medical steps.

Causes of Ankylosing Spondylitis 

The specific reason behind ankylosing spondylitis (AS) remains uncertain, though experts believe genetics contribute to its development. A gene known as HLA-B27 is prevalent in a majority of white Americans diagnosed with AS, but its presence in African Americans with AS is around 50%. However, it’s noteworthy that not all individuals carrying the HLA-B27 gene develop AS; in fact, less than 5% of them do.

Ankylosing spondylitis is frequently observed in individuals between the ages of 17 and 35, although it can also manifest in both children and older adults. This condition predominantly affects young males, and there is often a familial predisposition to the disease.

Symptoms of Ankylosing Spondylitis

Symptoms of ankylosing spondylitis often come and go over time and can vary from person to person. These symptoms may include:

  • Back pain, typically worsening at night or during periods of rest
  • Early morning stiffness
  • Adopting a stooped posture to alleviate back pain
  • A rigid and unbending spine
  • Difficulty breathing deeply if the joints between the ribs and spine are affected
  • Loss of appetite and weight
  • Persistent fatigue
  • Occasional fever
  • Anemia
  • Joint discomfort
  • Mild inflammation of the eyes
  • Possible damage to organs like the heart, lungs, and eyes
  • Skin rashes
  • Digestive issues such as Crohn’s disease or ulcerative colitis

Since many of these symptoms can overlap with other conditions, it’s important to consult a healthcare professional for an accurate diagnosis.

Ankylosing Spondylitis Tests

Diagnosing ankylosing spondylitis begins with a review of your medical history and a physical examination. Additional tests may be necessary, including:

X-ray

This imaging test employs a minor dose of radiation to generate images of internal structures, bones, and organs, aiding in the detection of abnormalities in the spine or other affected regions.

Erythrocyte sedimentation rate (ESR or sed rate)

This test identifies how quickly red blood cells settle at the base of a test tube within a specified time frame. When inflammation and swelling occur, proteins in the blood, such as fibrinogen, cause the red blood cells to clump together, forming stacks known as rouleaux. These clumps are denser and settle more rapidly than individual red blood cells. As a result, a higher sedimentation rate can determine the presence and degree of inflammation within the body, helping in the diagnosis and monitoring of conditions such as infections, autoimmune diseases, and inflammatory disorders.

An elevated sedimentation rate suggests more intense inflammation, commonly found in individuals with ankylosing spondylitis. Approximately 70% of people with ankylosing spondylitis exhibit this condition.

Genetic testing

This test is conducted to determine if a person carries a mutated gene associated with a particular disease. The HLA-B27 gene, found in over 19 out of 20 people with ankylosing spondylitis, is often examined to support the diagnosis.

Ankylosing Spondylitis Medication

Treatment for ankylosing spondylitis varies based on individual symptoms, age, and overall health. The severity of the condition also influences the choice of treatment. The primary treatment objectives are reducing pain and stiffness, preventing deformities, and facilitating a normal lifestyle. Various treatment options may include:

  1. Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications help reduce pain and inflammation.
  2. Biologic medicines: These medications, such as tumor necrosis factor inhibitors, target specific molecules in the immune system to reduce inflammation and swelling.
  3. Interleukin-17A (IL-17A) inhibitors: These medications target a specific protein to reduce inflammation and swelling.
  4. Disease-modifying anti-rheumatic drugs (DMARDs): These drugs help control inflammation and manage ankylosing spondylitis. An example of a DMARD used in the treatment of ankylosing spondylitis is sulfasalazine.
  5. Short-term use of corticosteroids: These drugs are used temporarily to reduce inflammation.
  6. Short-term use of muscle relaxants: These medications are used to alleviate severe pain and muscle spasms.
  7. Surgery: In some cases, surgery may be necessary to replace a joint, insert rods in the spine, or remove parts of thickened and hardened bone.
  8. Maintaining proper posture and regular exercise: These lifestyle measures can help manage symptoms and improve mobility.

It’s necessary to discuss the potential risks, benefits, and adverse reactions of each treatment option with your healthcare provider to determine the most suitable approach for your condition.

Takeaways 

Understanding ankylosing spondylitis is crucial for individuals experiencing persistent discomfort, stiffness, and potential spinal fusion. This chronic inflammatory arthritis primarily affects the spine and major joints, significantly impacting daily functioning and quality of life. While symptoms may vary, seeking medical attention for accurate diagnosis through tests like X-rays, erythrocyte sedimentation rate (ESR), and genetic testing is essential. Treatment options range from medications like nonsteroidal anti-inflammatory drugs (NSAIDs) and biologic medicines to surgery and lifestyle modifications such as sustaining proper posture and regular exercise.

Frequently Asked Questions (FAQs)

Can Ankylosing Spondylitis be cured?

At present, there is no cure for ankylosing spondylitis. However, with proper management, including medication, physical therapy, and lifestyle adjustments, symptoms can be controlled, and the advancement of the condition can be slowed, enabling individuals to lead fulfilling lives. Timely detection and intervention are crucial for attaining improved outcomes.

Can diet play a role in managing Ankylosing Spondylitis?

While there is no specific diet for ankylosing spondylitis, maintaining a healthy, balanced diet can help support overall health and well-being. Certain foods, like those packed in omega-3 fatty acids and antioxidants, may help minimize inflammation and alleviate symptoms. Consult and discuss with a healthcare provider or dietitian for personalized dietary recommendations.

How does Ankylosing Spondylitis affect mental health?

Living with a chronic condition such as ankylosing spondylitis can significantly impact mental health, leading to feelings of frustration, anxiety, and depression. Coping with chronic pain, fatigue, and limited mobility can be quite challenging. It’s important for individuals diagnosed with the condition to seek support from healthcare professionals, family, and friends and to prioritize self-care and mental well-being.

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