Read now everything you ever wanted to know about Ankylosing Spondylitis and its causes, symptoms, treatment, diagnosis, and care, natural remedies, myths & facts, Frequently asked questions about spondylitis disease.
All about to Ankylosing Spondylitis
- Ankylosing spondylitis is an inflammatory disease known for causing spinal pain and stiffness, particularly in young men.
- Ankylosing spondylitis is a form of chronic inflammatory arthritis that primarily affects the joints, ligaments, and tendons of the spine.
- In advanced cases, the disease can cause new bone to grow and the vertebrae of the spine to fuse together.
- This can lead to kyphosis, a type of spinal curvature that results in a forward-hunching posture.
- People with ankylosing spondylitis may also have inflammation in other parts of their body, including the eyes — leading to a condition called uveitis.
- Ankylosing spondylitis is also associated with enthesitis — inflammation where ligaments attach to bones.
- This can occur in the heel area as well as the knees, elbows, vertebrae, and pelvis.
What is Ankylosing Spondylitis?
Ankylosing spondylitis is a type of Arthritis that mainly affects the Spine or lower back and cause severe inflammation and damage at the joints. Finally, the inflamed joints can become fused and this fusion makes the joints less flexible. As a result, the affected person experience chronic pain and can’t move joints independently.
Initially, it affects the sacroiliac joints between the spine and the pelvis. While Ankylosing spondylitis is primarily a condition of the spine, but its symptoms may not be limited to the lower back, it can also impact other parts of the body as it is a systemic disease.
It may cause pain in the areas of other large joints such as shoulders, hips, and knees, although it usually affects no more than three or four joints in the arms and legs. In some advanced cases, a new bone on the spine can be formed due to the inflammation which may lead to deformity.
What Causes Ankylosing Spondylitis?
Although the cause of Ankylosing spondylitis is not understood, there are some of the possible reasons for occurring of Ankylosing spondylitis.
Ankylosing spondylitis is an inflammatory disease that can cause spine to fuse. This fusion makes the spine less flexible and can result in a hunched-forward posture and it can be difficult to breathe deeply if ribs are affected.
It may run in families. Not all, but most of the people with Ankylosing spondylitis carry a gene called HLA-B27. People carrying this gene are more likely to develop Ankylosing spondylitis and it is found that up to 10% of people have no signs of the condition.
As there is no particular cause of Ankylosing spondylitis, there is no cure for Ankylosing spondylitis and there is no way to prevent it, but treatments can lessen your symptoms and possibly slow progression of the disease.
Early warning signs of Ankylosing Spondylitis:
- Gradual onset of low back pain prior to age 35
- Morning stiffness of the spine.
- Pain and stiffness that worsens with immobility.
- Pain and stiffness that improves with physical activity.
- Symptoms which persist for more than three months
What are the Symptoms of Ankylosing Spondylitis?
Signs and symptoms of Ankylosing spondylitis usually begin in early adulthood. People with Ankylosing spondylitis can have symptoms like pain and tenderness in the thighs, hips and other joints of the upper body. Most commonly Knees, ankles, and eyes can be inflamed as well. Other symptoms may include:
- Pain and stiffness: People with Ankylosing Spondylitis can have constant pain and stiffness in the low back, buttocks, and hips especially in the early morning or after periods of inactivity.
- Bony fusion: Ankylosing spondylitis can cause an overgrowth of the bones which may lead to “bony fusion”, an abnormal joining of bones. This affects bones of the neck, back, or hips and may impair a person’s ability to perform routine activities. Fusion of the ribs to the spine may affect a person’s ability to take a deep breath.
- Pain in ligaments and tendons: Ankylosing Spondylitis also may affect some of the ligaments and tendons and may cause pain and stiffness in the area behind or beneath the heel, for instance, the Achilles tendon at the back of the ankle.
- Reduced lung function: In rare cases, lung problems also may develop.
- Weight loss: Weight loss is another most common symptom for Spondylitis.
- Anemia or low iron: People with Spondylitis may have Anemia as one of the symptoms.
- Low-grade fever: Person with Ankylosing spondylitis disorder can experience a Low-grade fever.
- Fatigue: Fatigue is a symptom of Ankylosing spondylitis which can be a major quality-of-life thief. People with fatigue will have more pain and were more likely to have inflammatory bowel symptoms.
Since Ankylosing spondylitis involves inflammation, other parts of the body can be affected as well. People with Ankylosing spondylitis may also experience:
- Eye inflammation: Eye inflammation (redness and pain) occurs in some people with Ankylosing spondylitis.
- Inflammation of the bowels: Inflammation of the bowels can be a symptom of Ankylosing spondylitis.
- Heart valve inflammation: In some rare cases, people with Ankylosing spondylitis can experience Heart valve inflammation
- Achilles tendonitis: Achilles tendonitis can occur in the people with Ankylosing spondylitis.
Risk factors of Ankylosing Spondylitis
- Family history: Another risk factor is a family history of Ankylosing spondylitis along with the presence of the HLA-B27 protein. According to some studies, more than 90 percent of people who receive a diagnosis of Ankylosing spondylitis have the gene that expresses this protein.
- Age: The initial symptoms of Ankylosing spondylitis often appear in younger adults unlike other arthritic and rheumatic disorders. Symptoms often appear between ages of 20 and 40 and rarely in children.
- Gender: Ankylosing spondylitis can affect both men and women but around three times more common in males than in females.
- Ethnicity: Ankylosing spondylitis can be seen mostly in people of Caucasian descent than those of African descent or other ethnicities.
- Stop Smoking: Smoking will worsen lung problems and rib cage which may make breathing more difficult and it is an important risk factor.
Complications of ankylosing spondylitis
The complications of Ankylosing spondylitis might include:
- Bone fusion: Bone fusion is a condition where a new bone forms as part of the body’s attempt to heal. Fusion can stiffen the rib cage restricting your lung from proper function.
- Eye inflammation (uveitis): It is one of the most common complications of Ankylosing spondylitis cause rapid-onset eye pain, sensitivity to light and blurred vision.
- Compression fractures: Some people’s bones become thin during the early stages of Ankylosing spondylitis. It weakens vertebrae and increases the severity of your stooped posture. Vertebral fractures can put pressure on that possibly injure the spinal cord and the nerves that pass through the spine.
- Heart problems: Ankylosing spondylitis can cause the problem to your aorta, the largest artery in your body. The inflammation of aorta can enlarge to the point that it damages the shape of the aortic valve in the heart which impairs its function.
Self-care for Ankylosing Spondylitis
People with Ankylosing spondylitis have to take a proactive role in their own treatment in a process called self-management. The following are some ways help you manage your disease along with your medication program.
- Regular exercises: Stiffness often improves with activity. People who have symptoms of Ankylosing spondylitis may get worse if they do not exercise regularly. Deep-breathing exercises, aerobic activities and swimming will help keep your spine, neck, shoulders and hips flexible and can improve overall health and function in individuals with Ankylosing spondylitis.
- Stop Smoking: People with Ankylosing spondylitis should avoid smoking because it can affect lungs and rib cage which may make breathing more difficult and is an important risk factor for osteoporosis (bone loss).
- Maintain Good Posture: It is important to maintain proper body position to prevent joints from fusing in undesirable positions. Practicing standing straight in front of a mirror can help you reduce some of the problems of Ankylosing spondylitis.
- Take Advantage of Self-help Devices: Self-help devices such as long-handled shoehorns and sock aids may make your daily tasks easier like bending your back or hips that doesn’t bend easily. Consult an occupational therapist who can advise you about special aids or assistive devices.
- Make Workplace Accommodations: Avoid things like lifting, stooping and remaining in cramped or bent positions for more time. Maintain a good posture by adjusting the height of the desk or computer monitor. It will be helpful to alternate between standing and sitting and using a cushion to support a painful back. If possible, finish your activities as soon as and try to take short rest periods throughout the day.
How common is ankylosing spondylitis?
Results from the survey revealed the following about Ankylosing spondylitis patients:
- 66 percent of respondents said ankylosing spondylitis caused them to have forward-stooped posture.
- 55 percent reported that their spine had fused, at least partially.
- 60 percent of respondents said ankylosing spondylitis limits their ability to walk, get into a car, sleep, and/or have a satisfying sex life.
- 25 percent had been forced to change their job/career because of ankylosing spondylitis.
- 44 percent of jobs/careers have stopped working due to ankylosing spondylitis
- 17 percent under age 65 said they are not working
- 54 percent were not diagnosed with ankylosing spondylitis until at least five years after their first symptoms appeared.
- 30 percent endured symptoms for more than 10 years before being diagnosed with ankylosing spondylitis.
- 24 percent saw five or more health professionals as they sought a diagnosis.
- 62 percent said they were diagnosed by a rheumatologist.
- 71 percent claimed that back pain/stiffness was one of the symptoms causing them to seek treatment at first.
- 29 percent reported that when ankylosing spondylitis pain was at its worst, they were unable to move and were incapacitated.
- 51 percent reported that their breathing had been painful or difficult at some point due to ankylosing spondylitis.
How it is diagnosed? Diagnosis of Ankylosing Spondylitis
The diagnosis of Ankylosing spondylitis is based on a number of factors. They are
- Symptoms: The symptoms are the primary source of diagnosis for identifying the cause of Ankylosing spondylitis.
- Findings of a physical exam: During the physical exam, you may be asked to bend in different directions to test the range of motion in your spine. Your doctor will try to reproduce pain by pressing on specific portions of your pelvis or by moving your legs into a particular position.
- X-rays of the back and pelvis: X-rays can help to check for changes in joints and bones, though the visible signs of Ankylosing spondylitis might not be evident early in the disease.
- Measurements of the chest when breathing: This test can be done to see if you have difficulty expanding your chest.
- Results of lab tests: There are no specific lab tests to identify Ankylosing spondylitis. Blood tests can be done to check for markers of inflammation, but inflammation can be caused by many different health problems. Blood can be tested for the HLA-B27 gene, but most people who have that gene don’t have Ankylosing spondylitis and fewer black people with Ankylosing spondylitis disorder have the gene than do white people.
Upon considering the above factors your physician may also consider your medical history and conduct a physical exam as a part of Diagnosis of Ankylosing spondylitis. The rheumatologist is a physician who conducts a medical history, physical exam, and another testing before ruling out or diagnosing a patient with Ankylosing spondylitis.
A patient with Ankylosing spondylitis will be asked to describe:
- When and how the joint pain or other symptoms first occurred
- If pain improves or worsens with exercise
- If joint pain has changed in severity or location
- If any treatment has provided pain relief
- If he or she has ever experienced symptoms other than joint pain, such as eye inflammation, skin rash, gastrointestinal problems, and fatigue
- His or her family history of back pain and joint diseases
Your physician may conduct the full examination by:
- Looking at the patient’s posture to see if the lumbar spine (lower back) is losing its normal curve and beginning to flatten out, a condition called lumbar lordosis
- Examining the whole spine to look for evidence of inflammation
- Evaluating other joints, particularly the hips and ankles, that may be affected (particularly in women and children)
- Checking for eye and skin abnormalities
- Assessing each joint’s range of motion and trying to identify tender points
Investigations for Ankylosing Spondylitis
- CT scan
- X –Ray
- Lab Tests
Treatment for Ankylosing Spondylitis
Ankylosing spondylitis is a disease that causes inflammation in joints and leads to pain and inflexibility. There is no cure for Ankylosing spondylitis, but there are some treatments that can reduce discomfort and improve the function of the joints.
The goals of treatment are to relieve pain and stiffness, maintain a good posture, prevent deformity, prevent or delay complications and preserve the ability to perform normal activities. People with Ankylosing spondylitis may lead fairly normal lives when it is properly treated.
It is important to treat Ankylosing spondylitis before the disease causes irreversible damage to your joints. Under ideal circumstances, a team approach to treat Ankylosing spondylitis is recommended.
The spondylitis treatment team typically includes the patient, doctor, physical therapist, and occupational therapist. osteotomy and fusion can be done if patients have severe deformities.
- Physical and occupational therapy: Early treatment with physical and occupational therapy is important to maintain proper functioning of joints and minimize deformity.
- Exercise: A daily exercise helps reduce stiffness, strengthen the muscles around the joints and prevent or minimize the risk of disability. Exercises like deep breathing may help keep the chest cage flexible. Swimming is another excellent exercise for people with Ankylosing spondylitis.
- Medications: There are certain drugs that help provide relief from pain and stiffness and allow patients to perform their exercises with minimal discomfort. Your Physiotherapist doctor may prescribe you Nonsteroidal anti-inflammatory drugs (NSAIDs) and antirheumatic drugs (DMARDs) in order to reduce the inflammation, stiffness, and pain.
- Surgery: Artificial joint replacement surgery may be an option to treat some people with advanced joint disease affecting the hips or knees. Surgery is preferred only if the disease has caused nerve damage in the spine or if joint damage is severe.
Preparing for your appointment
You have to bring your symptoms to the attention of your doctor, so that he may refer you to a doctor who specializes in inflammatory disorders (Rheumatologist).
Here some information is provided that can help you to get ready for your appointment.
What you can do?
Make a list of:
- Your symptoms, including any that may seem unrelated to the reason you made the appointment, and when they began
- Key personal information, including major stresses, recent life changes and family medical history
- All medications, vitamins and other supplements you take and their doses
Questions to ask your doctor
Take a family member or friend along with you who can help you remember the information you’re given. The following are the basic questions to ask your doctor:
- What’s likely causing my symptoms?
- Other than the most likely cause, what are other possible causes for my symptoms?
- What tests do I need?
- Is my condition likely temporary or chronic?
- What’s the best course of action?
- What are the alternatives to the primary approach you’re suggesting?
- Are there restrictions I need to follow?
- Should I see a specialist?
- Are there brochures or other printed material I can have?
- What websites do you recommend?
What to expect from your doctor?
Your doctor may ask you the questions regarding your signs and symptoms. So be prepared to answer the questions. The following are the few questions which you can expect from your doctor.
- Where is your pain?
- How severe is your pain?
- Have your symptoms been continuous or occasional?
- What, if anything, seems to worsen or improve your symptoms?
- Have you taken medications to relieve the pain? What helped most?
How to find the right rheumatologist?
Ankylosing Spondylitis is a chronic condition for which your rheumatologist is a lifelong associate and is important to find the right rheumatologist. Your primary care doctor may recommend or you may choose to go online and look for rheumatologists near you.
You have to ask few questions before choosing your Rheumatologist.
- Do they have a location near you?
- What days and hours are they available?
- Have they treated many patients with AS?
- Do they accept your insurance?
- What hospital do they send patients to?
- Are they available by telephone and email?
Yoga poses for Ankylosing spondylitis
Performing yoga probably won’t do much to relieve back pain but consistency is key. Choose a time of day when your muscles are more relaxed and probably break up your poses throughout the day. Try some easier poses in the morning and difficult ones at later hours.
The following are the yoga poses for Ankylosing spondylitis.
- Child’s pose which can stretch your lower back and hips
- Bridge pose which can stretches the spine, neck, and chest.
- Downward facing dog can stretch your back and promotes flexibility.
- Cobra pose can stretch your back, lungs, and chest by lifting your chest off the floor while straightening your arms.
- Locust pose strengthens lower back muscles.
- Mountain pose is a simple stretch with a big impact.
- Cat pose strengthens and elongates your spine and neck.
- Cow pose warms the spine and releases spine tension.
- Staff-pose strengthens your core, improves posture, and stretches your neck and shoulders.
Spondylitis Diet & Lifestyle Advice
- Avoid sleeping in the daytime.
- Try yoga asanas such as dhanurasana, vakrasana, pawana muktasana, paschimottanasana and bhujangasana in your daily routine.
- Include ghee in your diet.
- Practice pranayamas such as bhramari, nadi shodhana and chandrabhedi sheethali
- Include light foods and avoid oily food items along with curd in your diet.
- Ensuring proper evacuation of bowels. Constipation should be avoided at all cost.
- Applying heat on affected areas will help to relieve pain and stiffness.
- Avoid day sleeping.
Home Remedies for Spondylitis
- Chew 2-3 raw garlic buds on an empty stomach in the morning with water to alleviate lumbar pain in ankylosing spondylitis.
- Make a powdered preparation of dried ginger root, celery seeds and cumin seeds in equal quantities. Have 1 teaspoon of rock salt with water at bedtime as this can reduce the flatulence as well as lumbar stiffness.
- Drinking cider vinegar + honey three times a day to have a good result.
- Use juices like amla, aloe vera and another herbal one because all these strengthen the immunity.
- Castor oil + Milk are useful for Ankylosing spondylitis.
Myths of Ankylosing Spondylitis
The following are the various Myths about Ankylosing Spondylitis
- Ankylosing spondylitis is rare
- Ankylosing spondylitis is genetic
- If you have HLA-B27 you have Ankylosing spondylitis
- Ankylosing spondylitis is a man’s disease
- Ankylosing spondylitis will always cause spinal fusion
- Ankylosing spondylitis is just back pain
- White men have it the worst
- Diet and exercise will cure Ankylosing spondylitis
- Ankylosing spondylitis is an autoimmune disease
- Ankylosing spondylitis is a form of rheumatoid arthritis
- Ankylosing spondylitis affects everyone the same
Facts about Ankylosing Spondylitis
The following are the various Facts about Ankylosing Spondylitis
- Ankylosing spondylitis is a rheumatic disease.
- AS is more common in white males: it affects white males about four times as often as females.
- Regular daily exercise is a wonderful way to deal with symptoms of AS.
- Range of motion exercises helps you maintain how well your joints move—very important in AS.
- Iritis (eye inflammation) is sometimes associated with Ankylosing spondylitis.
- Surgery is rarely needed for AS patients.
- NSAIDs can help control the pain and inflammation of AS.
- There is a connection between the genetic marker HLA-B27 and Ankylosing spondylitis. Heredity does play a role in who develops AS.
- Ankylosing spondylitis symptoms usually first appear between the ages of 15 and 45.
- Pope John Paul II had Ankylosing spondylitis.
- Ed Sullivan had Ankylosing spondylitis
Natural Ways to Manage Ankylosing Spondylitis Self-Care
Natural approaches are the long-term management of ankylosing spondylitis. Self-care is essential in the effective and is a part of conventional treatment recommendations. The cornerstone to maintaining mobility and limiting pain is the self-care.
The following are the natural strategies to self-manage many symptoms of ankylosing spondylitis:
- Practice good posture
- Participate in physical therapy
- Use hot or cold packs
- Ask about transcutaneous electrical nerve stimulation (TENS)
- Consider acupuncture
- Get a therapeutic massage
- Take food to reduce pain, inflammation and other symptoms
- Ask about folate supplements or probiotics
- Avoid potentially harmful supplements and diets
- Maintain a healthy weight
- Don’t smoke
- Use task-related accommodations
Naturopathy treatment for Ankylosing Spondylitis
- Hydrotherapy: hot and cold compresses may alleviate severe pain.
- Avoid all animal fats, tea, coffee, and alcohol.
- Drink plenty of pure and fresh water.
- Drinking cider vinegar + honey three times a day to have a good result.
- Medicine like Celery seeds, yucca, bogbean, devil’s claw, black cohosh, wild yarm, willow bark, is effective at reducing inflammation, stiffness, and pain.
- Massage therapy, Aromatherapy, Acupressure, and Acupuncture are too suggested for Ankylosing Spondylitis
Ayurveda medicines for Ankylosing Spondylitis
- The extract of turmeric is effective in reducing the pain and inflammation of all types of arthritis and joint pains.
- Giloy is not only effective for ankylosing spondylitis but for osteoarthritis, rheumatoid arthritis too.
- Vitex negundo is extremely useful for ankylosing spondylitis.
- The resin product of Boswellia serrata is worldwide known for its anti-inflammatory nature.
- The analgesic and anti-inflammatory feature of Commiphora Mukul, is instant.
- Dry Ginger is used to reducing inflammation.
- Ashwagandha is a known product for ankylosing spondylitis.
- Methi reduces pain and inflammation in joints.
Homeopathy medicines for ankylosing spondylitis treatment
Homeopathic treatment is firmly suggested for the better and suitable result.
- Calcarea carbonicum reduces pain and inflammation to those patients who have Leucophlegmatic constitution, light complexion, blue eyes, fair skin etc.
- The stiffness of the neck and rheumatic pain can be minimized by Calcarea phosphorica.
- Phosphoric acid is helpful for neck muscles cramp and Spondylitis of cervical vertebrae.
- Rigidity and swelling of the neck, Shoulder pressure, softening of the spine etc. can be lessened by Phosphorus.
- Stiffness and Swelling of glands of the neck, Scabby elevation on the coccyx, inflammatory abscess in the lumbar region, Tearing and shootings in the back;
- Take the help of Silicea.
- Sulphur and Symphytum are too effective for Ankylosing Spondylitis.
- Homeopathic medicines will help in reducing ankylosing spondylitis.
- Non Steroidal Anti Inflammatory Drugs (NSAIDs) may help in treating ankylosing spondylitis
- Suppress inflammation and slow joint damage in severe cases of ankylosing spondylitis.
Ankylosing Spondylitis Prevention and Precautions
The disease ankylosing spondylitis cannot be prevented because is related to hereditary, but early detection with the proper and suitable treatment at the right time may help to prevent it.
- The disease is associated with the spine so aspects of examination are more important.
- Keep yourself away from cold and dampness.
- keep yourself warm
- prevent injuries
- Eat a balanced diet.
- Vitamin C & A, and consumption of pears, apples, berries, pawpaws etc. is recommended as these bolster the immune system.
- Essential supplements like omega-3 oils, calcium, magnesium, and sodium should be given to the patients.
Allopathy Treatment of Ankylosing Spondylitis
- Anti-inflammatory and Painkilling medication remains the mainstay in the management of Ankylosing Spondylitis. Disease-modifying drugs are useful in reducing inflammation of the joints but however are associated with side effects on long term use.
- Your Rheumatologist may suggest the injections that are administered every month and are very effective in controlling the inflammation but are to be used non-stop.
- Physiotherapy and leading an active lifestyle are recommended
- Swimming is very helpful to keep the muscle strength and to keep the lungs functional.
- Cessation of smoking is very important to protect lung function and prevent cardiac complications.
- In a case where deformities have developed surgery is advised.
FAQs of Ankylosing Spondylitis:
- When to seek medical advice for Ankylosing Spondylitis?
Contact your doctor if you have symptoms like back pain and stiffness in Spine that gets worse gradually over weeks and months. Early morning stiffness can be improved when you do light exercise or when you take a warm shower especially.
- Who is more likely to develop Ankylosing Spondylitis?
It most commonly affects young people. Some surveys states that men get this condition 10 times more often than women. This Ankylosing spondylitis disorder most often appears between the ages of 20 and 40, but it can develop in children also.
- Does Ankylosing spondylitis go away?
In some cases, Symptoms of Ankylosing spondylitis may get worse eventually. But in others, they may get better with time or go away completely.
- What triggers Ankylosing spondylitis?
Ankylosing spondylitis has no specific cause, though genetic factors seem to be involved. Particular people who have a gene called HLA-B27 are at a higher risk of developing Ankylosing spondylitis.
- Is Ankylosing spondylitis is curable?
There’s no cure for Ankylosing spondylitis but some treatments are available to help relieve the symptoms. These treatments can help delay or prevent the process of fusing) and stiffening.
- Can Ankylosing spondylitis be life threatening?
Ankylosing spondylitis is a serious disorder that can cause some many complications when left untreated. However, symptoms and complications for many people can be controlled or reduced by regular treatment plan.
- Can Ankylosing spondylitis lead to cancer?
Ankylosing spondylitis is a chronic inflammatory joint disease which may lead to extra-articular complications. The disease associated cancer risk has been poorly discovered but its long term risk is unknown.
- Is ankylosing spondylitis considered a disability?
It can be considered as a disability if you have a severe case of Ankylosing Spondylitis that keeps you from working. You may be eligible to receive monthly disability benefits from the Social Security Administration (SSA) because it is a lifelong chronic condition and there is no cure for it.
- Can home remedies help prevent Ankylosing spondylitis?
Besides seeing the doctor regularly and taking medications as prescribed, there are some things you can do to help your condition like avoid smoking, regular exercise and Stay active. These can help ease pain, maintain flexibility and improve your posture.
- Why is Ankylosing spondylitis so painful?
Ankylosing spondylitis is not caused by physical trauma to the spine unlike ordinary back pain. It is a chronic condition caused by swelling in the spine. Ankylosing spondylitis is a form of spinal arthritis.
- Will I have to take the drugs forever?
Most people need to continue some medication for the rest of their lives after they have been diagnosed with Ankylosing spondylitis. Without medication, their symptoms regress.
- How soon will it take to get better?
It takes about three to four weeks to provide relief from Ankylosing spondylitis disorder. Some patients will feel better only if they continue treatment for three months, but the chance of complete cure takes long. If it doesn’t work in three months, then you have to stop and seek for doctors.