Understanding Ankylosing Spondylitis, Symptoms, Treatment and Awareness

Understanding Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a type of inflammatory arthritis that primarily affects the spine and sacroiliac joints. Ankylosing refers to the fusing together of the spine and other joints. Spondylitis refers to inflammation of the vertebrae and discs that make up the spine. AS causes pain and stiffness that typically begins in the low back and buttocks. Over time, the vertebrae can fuse together, resulting in a rigid spine. Other joints like the hips, shoulders, knees, ankles and jaw can also be affected.

AS is a chronic condition, meaning it is lifelong. Symptoms tend to develop gradually over several years. There is currently no cure, but with early diagnosis and proper treatment, symptoms can be managed. Medications, physical therapy, exercise and lifestyle modifications are key to managing AS effectively.

Prevalence

About 0.2-1.2% of the general population has AS. Men are about 2-3 times more likely to develop the condition compared to women. The average age of onset is typically in the late teens to mid 20s. However, onset can occur as early as 8 years old and as late as 45 years old. AS is strongly associated with a gene called HLA-B27. About 90% of people with AS test positive for this gene, indicating a genetic predisposition for developing the disease.

Symptoms

Some of the common symptoms of AS include:

• Low back pain and stiffness that is worse in the morning and improves with movement
• Buttock pain that alternates between the right and left side
• Neck pain and stiffness
• Pain and swelling where tendons and ligaments attach to bone, such as at the back of the heel
• Fatigue
• Joint pain or swelling
• Reduced range of motion and flexibility
• Loss of appetite
• Eye inflammation
• Chest pain when taking deep breaths

Diagnosis

There is no single test to definitively diagnose AS. Doctors use a combination of methods to determine if AS is likely:

• Medical history - Details about symptoms and when they started.
• Physical exam - Checking for limited mobility and areas of tenderness.
• Imaging - X-rays can show bone changes indicative of AS. MRI can visualize areas of inflammation.
• HLA-B27 testing - Most with AS will test positive.
• Blood tests - Elevated markers of inflammation may be present.

Diagnosing AS early is important to prevent progressive joint damage, so seeing a rheumatologist (arthritis specialist) is recommended for evaluation.

Treatment

While there is no cure for AS, early treatment helps relieve symptoms and improve quality of life. The main goals are to:

• Reduce inflammation
• Preserve range of motion and flexibility
• Control pain
• Prevent joint damage
• Maintain proper posture and mechanics

Common AS treatment approaches include:

Medications

Anti-inflammatory medications like NSAIDs help relieve pain and stiffness. Disease-modifying antirheumatic drugs (DMARDs) like sulfasalazine suppress the overactive immune response. Biologic agents like Humira and Enbrel specifically target parts of the immune system to reduce inflammation.

Exercise

Certain exercises help fight stiffness, improve mobility, strengthen muscles, and promote good posture. Stretches, swimming, walking, yoga, tai chi, and light strength training are usually well-tolerated.

Physical Therapy

Working with a physical therapist can reinforce proper exercise techniques and spinal mechanics. They may use heat/cold therapies, massage, traction, and joint mobilization to provide symptomatic relief as well.

Surgery

Those with severe joint damage or fixed spinal deformities may need surgery to repair or replace joints or correct abnormal spine curvature. Surgery can help improve mobility and reduce pain.

Lifestyle Changes

Making adjustments to reduce stress on the joints can be helpful:

• Use good posture and body mechanics to avoid extra strain on the spine.
• Use back braces or supportive chairs and mattresses.
• Quit smoking to optimize healing and reduce progression.
• Apply heat or take warm baths to ease stiffness and pain.
• Get enough rest between activity to avoid flare-ups of symptoms.

Living with Ankylosing Spondylitis

Learning to manage AS well takes patience and perseverance. Tips for living with the condition include:

• Get regular eye exams, as uveitis is a common complication
• Visit the rheumatologist regularly to monitor disease progression and adjust treatment as needed
• Pay attention to nutrition, get enough calcium and vitamin D for bone health
• Join a support group to connect with others dealing with the condition
• Find ways to reduce stress through breathing exercises, meditation, counseling, etc.
• Make lifestyle adjustments to conserve energy and prevent injury
• Use mobility aids or devices to assist with tasks as needed
• Learn proper techniques to get in and out of chairs, bed, cars, etc. safely

While living with chronic arthritis presents challenges, many people are able to find a treatment regimen that allows them to manage symptoms and pursue an active, fulfilling life.

Ankylosing Spondylitis Awareness Day

Ankylosing Spondylitis Awareness Day is observed annually on February 3rd. This observance aims to raise public awareness of AS, a relatively unknown form of inflammatory arthritis. The goals of Ankylosing Spondylitis Awareness Day are to:

• Educate the public about ASits symptoms, diagnosis, and treatment
• Highlight the impact of AS on patients lives
• Promote early diagnosis and intervention
• Advocate for research funding and improved treatments
• Reduce stigma surrounding chronic illness and disability
• Provide support and community for those living with AS

This special day was founded in 2009 by the Spondylitis Association of America. The date of February 3rd was chosen to honor the late SAA founder Jane Bruckel, whose birthday was on this day. On Ankylosing Spondylitis Awareness Day, outreach events and awareness campaigns are held across the United States.

Get Involved

There are many ways individuals and organizations can participate in AS Awareness Day:

• Use #ASawareness on social media to share facts, personal stories, and information about upcoming events
• Wear blue, the color representing AS, to show support for the cause
• Attend or volunteer at a local AS education or fundraising event
• Make a donation to an organization like the Spondylitis Association of America to support AS research and programs
• Share a link to the SAA website spondylitis.org which offers resources about living with AS
• Watch Ankylosing Spondylitis: Real Life, Real Patients on YouTube to hear patients perspectives
• Discuss the day with coworkers, friends and family to spread awareness

Even small acts like wearing a blue ribbon on February 3rd can make a difference in building awareness of ankylosing spondylitis. Increased public knowledge and resources for AS leads to earlier diagnosis, better treatment access, and an improved quality of life for patients.

The Future of Ankylosing Spondylitis

While there is still no cure for AS, the future looks brighter thanks to a number of promising developments:

• New medications - Several new biologic drugs have been approved to target various parts of the inflammatory pathway. More are in development.
• Advanced therapies - Cutting edge treatments like stem cell transplants and CAR T-cell immunotherapy are being studied.
• Genetic insights - Research identifying genes involved in AS susceptibility sheds light on the disease process.
• Earlier diagnosis - Increased awareness is leading to more patients being diagnosed in early stages.
• Lifestyle impact - We now better understand how diet, exercise, posture, and stress affect AS.

While many questions remain unanswered, progress is being made. In the future, medications to fully halt AS progression could become a reality. Improved therapies offer hope that AS patients will experience less pain, retain more mobility, and enjoy an overall better quality of life. The future is bright for both treating and potentially preventing this condition.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.