Ankylosing spondylitis symptoms and treatment
‘Ankylosing, ‘ in Greek means, ‘causing stiffness and immobility of a joint’, and ‘ spondylitis’ means inflammation of one or more vertebrae. Ankylosing spondylitis (AS) initially causes inflammation of the ligaments and tendons that connect the vertebrae. Inflammation causes damage to the bone also. Body heals this damage by growing a new bone, which replaces the elastic soft tissue at the back of the spine. This leads to fusion of the spine. As a result the back becomes stiff and painful. In some cases, the spine curves forward, causing a person to stoop. Stiffness and pain usually begin in the pelvis and at the base of the spine, and progress upwards through the back and to the neck. The stiffness is generally more in the morning and improves during the day.
Why AS occurs is not yet known. It is neither infectious nor contagious, nor can it be caused by athletic activity or injury. It usually attacks young men but it can occur in women as well.
Symptoms
Initial symptoms are backache and stiffness. There may also be pain in the buttocks, possibly down the back of thighs and in the lower part of the back. In some cases these symptoms appear after some exertion or strain. Pain in the neck, shoulders and hips, or in the thigh ( like sciatica) may follow. In a few cases, and especially in children, the first complaint may not be in the back at all, but in the hip or knee, or in the leg- perhaps just a swollen knee.
Some people experience nothing more than a series of mild aches and pains coming and going over a period of months. Others pass through a phase of active AS. During the active phase, the symptoms are more troublesome. Patient feels sick, lose weight and tire easily.
After several months the back may stiffen, especially the lower back. The stiff back in the later stages is often painless and does not interfere with physical activity, because the upper part of the spine, the neck, hips and limbs remain quite normal. Feeling stiff in the morning is a sign of inflammation and it may indicate the need for anti-inflammatory drugs.
In some patients the disease activity subsides early and no further symptoms develop. In others the disease continues to be active, causing pain and stiffness. Sometimes AS may also affect joints of the hips, knees, ankles and shoulders. The smaller joints of the hands and feet can also be attacked. Painful spots may sometimes develop in bones that are not part of the spine. When the heel bone is affected it becomes difficult to stand and if ‘seat’ bone (ischium ) gets involved then sitting on the chair becomes painful. Chest pain can occur due to involvement of the joints between the ribs and the breastbone.
Breathing exercises should be done in such cases to maintain mobility of the ribcage.
