Ankylosing spondylitis - (AS)
Ankylosing spondylitis (AS) is a rheumatic disease that causes arthritis of the spine and sacroiliac joints and can cause inflammation of the eyes, lungs, and heart valves. It varies from intermittent episodes of back pain that occur throughout life to a severe chronic disease that attacks the spine, peripheral joints and other body organs, resulting in severe joint and back stiffness, loss of motion and deformity as life progresses. Ankylosing spondylitis is one of many forms of inflammatory arthritis, the most common of which is rheumatoid arthritis. The condition primarily causes inflammation of the joints between the vertebrae of your spine and the joints between your spine and pelvis (sacroiliac joints). However, ankylosing spondylitis may also affect joints in your arms and legs, tendons and ligaments where they attach to your bones, and the joints in your ribs where they attach to your spine.
As the condition worsens, and the inflammation persists, new bone forms in the healing process. Your vertebrae begin to grow together, forming vertical bony outgrowths (syndesmophytes) and becoming stiff and inflexible. Fusion can also stiffen your rib cage, restricting lung capacity and function.
Ankylosing spondylitis is a chronic condition. However, treatments can decrease your pain and lessen your symptoms. Effective treatment may also help prevent complications and physical deformities. Also called spondylitis or rheumatoid spondylitis previously, ankylosing spondylitis.
Signs and symptoms
Your condition may change over time, with symptoms getting worse, improving or completely stopping at any point. Early signs and symptoms may include:
In advanced stages, the following signs and symptoms may develop:
Ankylosing spondylitis can lead to a stiff, inflexible spine....
Ankylosing spondylitis has no known specific cause, though genetic factors seem to be involved. The majority of people with ankylosing spondylitis have a gene called HLA-B27. This gene may make people more susceptible to developing ankylosing spondylitis.
Genetics may play a role in the development of ankylosing spondylitis. In fact, 90 percent of people with this condition have the HLA-B27 gene. Having this gene doesn't mean that you'll acquire ankylosing spondylitis — only about 2 percent of people with this gene develop the condition — but it may make you more susceptible to the disease.
If you test positive for the HLA-B27 gene, are younger than 40 and have a family member with ankylosing spondylitis, you have about a 20-percent chance of developing the condition. However, if you're older than 40, your chances of acquiring ankylosing spondylitis are low. If you have ankylosing spondylitis, you have about a 50-percent chance of passing the HLA-B27 gene on to your children if you have the gene.
Ankylosing spondylitis affects males more often than females.
When to seek medical advice
See your doctor if you have symptoms of ankylosing spondylitis. Also contact your doctor if you're being treated for the disease and new signs and symptoms develop.
Screening and diagnosis
In most cases, ankylosing spondylitis is mild, so it may go undiagnosed for decades. In addition, some people may mistakenly attribute many of the symptoms of ankylosing spondylitis for more common back problems.
To determine the cause of your discomfort, your doctor will conduct a medical history and complete a physical examination. Then, your doctor may use the following diagnostic procedures:
Ankylosing spondylitis doesn't follow a set course. The severity of symptoms and development of complications vary widely among individuals. Complications may include:
Typically, many of the complications involving the lungs and heart don't develop until after ankylosing spondylitis is no longer active in your spine. This can take up to 20 years.
Inflammation can also involve other parts of your body, resulting in conditions such as:
Treatment for ankylosing spondylitis exists, but the fusion of joints is irreversible. Instead, the goal of treatment is to relieve pain and stiffness, and prevent or delay complications and spinal deformity. Treatment of ankylosing spondylitis is most successful early, before it causes irreversible damage to your joints, such as fusion, especially in positions that limit your function.
Range-of-motion and stretching exercises can help maintain flexibility in your joints and preserve good posture. In addition, specific breathing exercises can help to sustain and enhance your lung capacity.
As your condition progresses, your upper body may begin to stoop forward. Proper sleep and walking positions and abdominal and back exercises can help maintain your upright posture. Though you may develop spine stiffness despite your treatment, proper posture can help to ensure that your spine is fused in a fixed upright position.
Because genetic factors appear to play a part in ankylosing spondylitis, it's not possible to prevent the disease. However, being aware of any personal risk factors for the disease can help in early detection and treatment. Proper and early treatment can relieve joint pain and help to prevent or delay the onset of physical deformities.
If you smoke, try to quit. Smoking is bad for your health, but creates additional problems for people with ankylosing spondylitis. It's also a risk factor for the development of cavitary lesions in your lungs, a complication of ankylosing spondylitis. And depending on the severity of your condition, ankylosing spondylitis can affect the mobility of your rib cage. Damaging your lungs by smoking can compromise your ability to breathe.
The course of your condition may change over time, and you may experience relapses and remissions throughout your life. But despite the potential complications, most people are able to live productive lives despite a diagnosis of ankylosing spondylitis.
You may want to join a support group of other people with this condition, in order to share experiences and support. Contact your local office of the Arthritis Foundation to see if there are any groups in your area or if you can start your own.