Ankylosing spondylitis (AS) is a type of arthritis that mainly affects the back. It’s one of a group of inflammatory conditions, referred to as spondyloarthritis.
Spondylitis simply means inflammation of the spine. As part of the body’s reaction to inflammation, calcinosis occurs in ligaments that attach to the vertebrae. This causes bone to grow from the sides of the vertebrae. Eventually the individual bones of the spine may fuse and loose flexibility. This is called ankylosis.
It often starts in your late teens or 20s.
- Non-radiographic axial spondyloarthritis
- Undifferentiatedspondyloarthritis (uSpA)
- Enteropathic arthritis
- Reactive arthritis
- Enthesitis-related arthritis
Reach out for a RHEUMATOLOGIST if you have any of these symptoms:
- Stiffness and pain in your lower back in the early morning that eases through the day or with activity
- Pain in the joints in the buttock where the base of your spine meets your pelvis, this makes sitting uncomfortable
- Some may have pain, stiffness and swelling in their knees or ankles.
- Inflammation can occur at any point where tendons attach to bone (enthesitis), for example at the elbow and heel. It causes tenderness.
Other possible symptoms include:
- Pain and swelling in a finger or toe /dactylitis.
- Chest pain
- Inflammation of the eye (uveitis or iritis)
- Tiredness (fatigue)
ANKYLOSING SPONDYLITIS ISN’T CONTAGIOUS
Most people with ankylosing spondylitis have a gene called HLA-B27, which can be detected by a blood test. However, this gene doesn’t mean you’ll definitely get ankylosing spondylitis. It is estimated that only 1 in 15 people with the gene will actually develop this condition.
No specific test will confirm you have ankylosing spondylitis, so diagnosis involves piecing together:
- the history of your condition
- a physical examination
- C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) which may show inflammation
- X-rays can sometimes help to confirm the diagnosis; however it used to be normal in the early stages
- MRI scans may show the typical changes at an earlier stage of the disease
- Blood test for HLA-B27 gene
- Exercise and close attention to your posture
- Drug treatments
- Painkillers and NSAIDs are usually the first choice of treatment, tablets/gels
- Disease-modifying anti-rheumatic drugs (DMARDs) like sulfasalazine
- They are slow-acting so you won’t notice an immediate impact on your condition, but they can make a big difference to your symptoms over a period of time.
- Biological therapies (anti-TNF drugs or anti IL 17) are effective treatments.Your rheumatologist would guide you if you need them.
- Steroids: used as a short-term treatment for flare-ups. They’re usually given as an injection into a swollen joint
- Physiotherapy is a very important part of the treatment
- It’s especially important to exercise your back and neck to avoid them stiffening into a bent position
- Bed rest is certainly not recommended, as this will speed up the stiffening of your spine
THINGS YOU CAN DO
- Hot or cold pads
- Use a medium-firm bed
- Try a hot bath before going to bed
- If your heels or feet are affected, orthotics inside your shoes
- Stop smoking
- Special attention to your posture.
- Try to keep the number of pillows to a minimum.
If you have ankylosing spondylitis, there’s A SMALL CHANCE that your children will also develop it (ONLY 15% )
If you think your child or another relative might have ankylosing spondylitis, ask them to see a rheumatologist as soon as possible as there’s a history of ankylosing spondylitis in the family.