|Ankylosing Spondylitis is a type of arthritis causing
inflammation of the spine. It is most common in teens and young
adults although it can also affect children and older people. Ankylosing
spondylitis affects about 1 out of every 200 adults. |
The inflammation mainly affects the joints between your spine and
the joints between the spine and pelvis (sacroiliac joints). However,
inflammation may also affect other areas of the body. There are
periods of flare-ups and remissions.
Though the exact cause of ankylosing spondylitis remains unknown,
genes that increase the chances of a person developing the disease
have been identified. Because there is more that one gene involved,
the chances of a person passing this disease to his or her children
are fairly low.
Ankylosing Spondylitis Diagnosis:
Diagnosis ankylosing spondylitis is often difficult in the early
stages or mild cases as back pain is very common and usually caused
by muscle strain. An x-ray of the spine and sacroiliac
joints is taken. Degenerative changes are usually
first seen in the sacroiliac joints. A rheumatologist
that specializes in ankylosing spondylitis can usually make an accurate
Ankylosing Spondylitis Symptoms:
The symptoms and severity of ankylosing spondylitis vary - from
mild back pain to severe back pain, from mild stiffness to loss
of mobility. In the early stages, the the inflammation of the sacroiliac
joints cause lower back pain and buttocks pain. Symptoms may come
If inflammation occurs in the middle area of the spine, pain may
be felt in the chest area.
Scarring of the tissues and extra bone overgrowth can develop as
a result of chronic inflammation. In some severe cases, the ligaments
of the spine eventually become fused together by bony overgrowth
– this is called ankylosis.
Not all cases of spondylitis reach this stage, but maintaining
good posture is essential so that even if the spine does fuse together
the spine will be in a fixed upright position rather than a fixed
hunched over position.
Remaining active is important. Strengthening and Stretching exercises
are helpful. A physical therapist can create a customized exercise
program for a patient to follow.
Medications Used to Treat Ankylosing Spondylitis:
Medications for Ankylosing spondylitis are geared at reducing inflammation.
Ankylosing Spondylitis is with NSAIDs -nonsteroidal
anti-inflammatory drugs. NSAIDs treat the pain and inflammation.
Ibuprofen (Advil, Motrin), naproxen (Aleve, Anaprox, ) and indomethacin
(Indocin) are NSAIDs.
When NSAIDs are not effective enough other medications are often
Sulfasalazine, often used for inflammatory bowel
disease, also can reduce pain and inflammation in the joints and
is somtiems used to treat ankylosing spondylitis.
Drugs that suppress the immune system, such as Azathiprine, or
Methotrexate are sometimes used to treat Ankylosing spondylitis.
Immunosuppressive agents are used to suppress the inflammatory response
by suppressing the immune system.
Unlike some inflammatory diseases, ankylosing spondylitis is not
considered to be an auto-immune disease (diseases where there are
antibodies that attack the bodies own tissues). However, the immune
system seems to be overly sensitive in people with ankylosis spondylitis
and certain cells of the immune system that initiate inflammation
may be triggered too easily.
Corticosteroids (such as prednisone) have extremely
powerful anti-inflammatory properties and also suppress the immune
system. The problem with corticosteroids is that the side effects
are severe in long-term use and the person taking them can develop
a host of other unwanted problems.
One class of drugs,TNF Inhibitors (such as Remicade), has shown
a lot of promise in treating ankylosing spondylitis along with other
chronic inflammatory diseases. Remicade suppresses inflammation
by binding to and neutralizing substances (TNFa) that act as an
alarm signal that triggers inflammation. New drugs in this class
are being developed.
Immunosuppressive agents, corticosteroids, and Remicade
all increase the risk of infection.
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