Ankylosing Spondylitis

Ankylosing Spondylitis

Anklyosing Spondylitis (AS) is a form of arthritis that predominantly affects the spine (backbone). "Ankylosing" means stiff or rigid, "spondyl" means spine and "itis" means inflammation - a process that causes pain and stiffness.

Anklyosing Spondylitis is painful, progressive and rheumatic disease in which some or all of the joints and bones of the spine fuse together. In Anklyosing Spondylitis, the main site of inflammation is at the attachment of ligaments and capsules with bones. The condition starts at the base of the spine and spreads upward to the rest of the vertebral column, affecting joints between the ribs and backbone or breastbone, and causes chest pain. The shoulders, knees, ankles and heels may also be affected.

Occasional inflammation of the eye may occur when Anklyosing Spondylitis effects the iris and its attachment to the outer wall of the eye. The first indicator of such a condition is the slight blurring of vision in one eye, but the main symptom would be sharp pain with dramatically bloodshot eye. Seek treatment promptly to avoid permanent damage.

Anklyosing Spondylitis is a chronic disease that usually starts in the mid-twenties but may affect children or teenagers. Males are also more likely to suffer from Anklyosing Spondylitis than females. In children, Anklyosing Spondylitis tends to affect areas such as the knees, ankles, feet, hips and buttocks. Back pain is usually rare in youngsters. However, the condition may lead to persistent hip disease that can be carried into their adult lives, with severe conditions requiring hip replacements.

Symptoms of Anklyosing Spondylitis

- Slow or gradual back pain and stiffness over weeks or months.

- Stiffness and pain in the morning, wearing off or reducing (with exercise) as the day progresses.

- Persistent pain for more than three months

- Pain subsides with exercise but becomes worse with rest

- Weight loss

- Loss of appetite

- Fatigue

- Feeling feverish and night sweats

Management and Treatment of Anklyosing Spondylitis

While it is the doctor's responsibility to relieve pain, it is the patients job to manage their own condition. Treatment and management of Anklyosing Spondylitis is designed to reduce pain and stiffness so that regular activities can be continued.

1. Maintain a proper posture at all times - Whether sleeping, sitting or standing, the patient must make every effort to keep the spine straight, as Anklyosing Spondylitis tends to cause flexion of the spine, so that the joints do not fuse into undesirable positions.

2. Rest in prone position - While it is important to lie flat on their back, Anklyosing Spondylitis suffers should spend 20 minutes lying on the face (prone position) before getting up in the morning and before retiring to bed. This regular routine will prevent the patient's back and hips from becoming bent.

3. Sleep on firm bed mattresses - If the mattress is too yielding, an abnormal spinal curvature may develop in the Anklyosing Spondylitis patient. High chairs with a firm seat and an upright, firm back support are best for people with Anklyosing Spondylitis to keep their spine in a good posture.

4. Exercise regularly - The doctor or physiotherapist will suggest a programmed of exercise to be done daily. This will help people with Anklyosing Spondylitis to keep posture and activity as normal as possible.

5. Medications to help relieve pain and stiffness - Patients will probably be first prescribed a drug from the class of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs). These medications help to relive pain and stiffness. A new class of arthritis/ analgesic medications known as cyclooxygenase-2 (COX-2) specific inhibitor (coxib) is now available. Patients should check with their doctors on the most suitable medication and dosage.

6. Work smartly - It is important for Anklyosing Spondylitis sufferers to pay close attention to the position of their backs at work. When seated at a desk or bench, they should adjust their seat to the proper height and try to move from time to time.

7. Other treatments - Surgery is usually used to reduce pain and restore movement to joints that have been damaged by arthritis. Artificial joint replacement surgery of the hip and spinal surgery are sometimes performed on Anklyosing Spondylitis sufferers.

People with Anklyosing Spondylitis should stop smoking as the disease causes reduced chest expansion and can be complicated by lung involvement. Patients with eye problems such as pain, red eyes or reduced vision should seek immediate consultation with an ophthalmologist (eye doctor) for inflammation of the iris.

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