Ankylosing Spondylitis (AS) is a systemic inflammatory rheumatoid disease that can affect the joints between your spine and peLvis, the spine, muscLe and Ligaments that adhere to the bones, rib cage and most frequenfly shoulder and hip joints.
What Are The Symptoms of Ankylosing Spondylitis?
AS symptoms often start in later adoLescence or early adulthood. It rarely starts after 40. It may begin in childhood and is seen mostly in men. Since it's systemic disease, it can occur in other organs outside the musculoskeLetaL system too. Back, lower-back, neck pain and stiffness, pain that awakens you from sleep at night and morning stiffness that lasts more than 30 minutes might indicate AS.
What Are The Involvements Outside The Musculoskeletal System?
AS is a systemic disease. It may involve other organs outside the muscuLoskeletaL system.
Eye: It might cause recurring inflammatory attacks called anterior uveitis in the front part of the eye's uveal layer.
Heart: The main artery of the body, the aorta can be inflamed and widen. This deforms the aortic valve and may cause dysfunction. Less often, cardiac membrane inflammation and arrhythmia may occur.
Lung: In some AS patients, due to the involvement of the rib cage and the spine, the expansion of the lungs during inhaling may be limited. Moreover, hardening called fibrosis and loss of tissue in the upper parts of the lung itself may develop. This causes lung capacity reduction and breathing dysfunctions.
Kidneys: In advanced stages of AS, due to amyloid-a protein- accumulation in the kidneys, kidney dysfunction might develop.
Intestine: Occasionally, ulcers grow in the intestines. Most of the time there are no symptoms of these ulcers.
Nervous Systems: In AS patients, depending on the bone loss (osteoporosis) developing secondary to the spinal inflammation, theremay be compression fractures on the vertebra and hunching. In later periods, new bone formations and strictures may develop. Related to these, neurological complaints and finding may come up depending on the a rea of involvement because of the pressure on the spinal cord and on the nerves coming out of the spinal cord.
How Is It Diagnosed: AS diagnosis is made; evaluating together the patient complaints, family history, examination findings of the specialist, imaging methods (x-Ray, MR e.g.) and lab findings.
How Is It Treated: There is no definitive cure for AS. The aim of treatment is; eliminate the pain and the stiffness, prevent or slow down permanent impairments and related unwanted effects that may develop in the long run.
Medications: Non steroidal anti-inflammatory therapies are most frequently used. The most commonly used one is Indomethacin. Plus, others (Diclofenac, Naproxen, etc.) may also be used. These can be sufficient for early and mild patients. In patients with non spinal involvements, Sulphasalazine and Metorexate may be helpful.
On some occasions, topical corticosteroids can be administered. Anti-tumor necrosis factor therapies (anti-TNF therapies) are medications that patients notably benefit from on occasions where especially non steroid anti-inflammatory therapies and other therapies are insufficient or can not be applied. These drugs may be given by injection under the skin or by vein. They should be administered to suitable patients, with necessary cautions and close follow-up by a doctor. In secondary to inflammation osteoporosis treatment, Bisphosphonates and other medications may be considered.
Physiotherapy: Daily exercise, preservation of good posture, continuation of rib cage stretching are very important for minimizing possible injuries. Swimming must be a part of the exercise program. Smoking is not allowed due to the disease's potential risks on the rib cage and the lungs.
Is Surgery A part Of Ankylosing Spondylitis Treatment?
In serious pain and movement constraint, total hip prosthesis can be applied. For some advanced deformities, spinal surgery can be done. Also for spinal deformities, stricture related neurological damages can call for surgical interventions.
As a result, Ankylosing Spondylitis, even if it is a disease with flare up and remission periods; patients, with early diagnosis and appropriate treatment, can lead productive lives.
Although it's a chronic disease, Ankylosing Spondylatis patients; with early diagnosis and proper treatment, can lead productive lives
Group Florence Nightingale Hospital's Health Magazine - Number : 5