Ankylosing Spondylitis

Ankylosing spondylitis is a type of chronic inflammation of the spine and the sacroiliac joints (the joints between your pelvis and the spine). It can also cause inflammation and pain at other parts of the body, for example, at the junctions of ligament/tendon with bones, ribs, thighs, shoulders, knees, feet and even eyes.

When the condition is worsen or inflammation progresses, there will be new bone formation during the healing process. In another word, there is calcification taking place. This will lead to stiffening of the spine and will make bending difficult. The spine can fused together and it can then have a bamboo type of appearance. This condition can also lead to stiffening of the chest cage. Therefore, both lung capacity and lung function can become affected.

The symptoms of ankylosing spondylitis can change with time. It can worsen, improve or no symptoms at all. The early symptoms usually include pain and stiffness at lower back and buttock regions. It tends to get worse in the morning and at night time, also after a period of immobility. After a period of time, pain and stiffness can gradually affect the upper part of the spine and other joints, such as shoulders, knees and feet.

The cause of ankylosing spondylitis is unknown, but it is possibly genetic related. Most people with ankylosing spondilitis are born with HLA-B27 gene. So, this gene can cause human body more likely to have ankylosing spondylitis. According to researches, when there is HLA-B27 gene in the body, you will have 20% of chance to have ankylosing spondylitis if you are less than 40 years old and there is a family history of ankylosing spondylitis. If you are over 40 years old, the chance to get ankylosing spondylitis is very low. The symptom tends to initiate between 16 to 40 years old. Male is more than female.

When your symptoms are mild or similar to common lower back pain, diagnosing ankylosing spondylitis is more difficult. The Doctor usually needs to know your medical history and to perform detailed examination. There might be the need to have x-ray or other scans done. The Doctor will also do a blood test to check the sedimentation rate of red blood cells to evaluate the inflammation process. The chronic inflammation from ankylosing spondylitis can also lead to anemia. Blood test for HLA-B27 gene might be done as well. But, the existence of HLA-B27 gene does not mean a definite diagnosis of ankylosing spondylitis.

Every ankylosing spondylitis sufferer has different medical history. Typical symptom is pain starting from the lower back. The spine is gradually stiffen up and is then unable to bend. This will influence walking and standing. When it is affecting the chest cage, ribs will lose its normal movements during breathing. Lung capacity will become restricted. The inflammation from ankylosing spondylitis will also gradually affect other parts of body, such as heart valves, stomach and intestine, and eyes.

Treatment for ankylosing spondylitis is mainly reducing pain and stiffness, also for preventing or delaying other associated conditions and spinal deformity. Early intervention is the best in order to avoid reaching the stage of untreatable, such as fusion of spinal joints. Your Doctor will recommend the use of anti-inflammatory, cortisone or non-steroid medications. Physiotherapy can help to minimize pain and to improve body flexibility. Through assessment, your physiotherapist can provide you with personalized treatment and exercise program to maintain joint flexibility. Specific breathing exercise will assist to improve and maintain fair lung capacity. When condition is worsening, proper back exercises can minimize the formation of a hump back posture. It is better the spinal joint fused in a straight back position, instead a hump back posture. Majority of people with anklylosing spondilitis do not need surgical intervention, unless there is severe pain or joint damage.

Ankylosing spondylitis is possibly influence by genetic factor. Therefore, it is not preventable. But, with good understanding of the condition, early diagnosis and treatment can be achieved and will reduce ongoing pain and posture changes. If you have any question, please do not hesitate to ask your physiotherapist.