Ankylosing spondylitis is a long-term (chronic)
disease of the spinal column that affects
about 1 in 250 people, mainly young men.
Spondylitis means inflammation of the spine,
and ankylosis means that a joint has become
fixed solid so that it can’t bend.
It happens when the
ligaments or tendons attached to the spine
become swollen. When the swelling goes down,
new bone grows, replacing the ligaments
or tendons. If this process continues, the
individual bones (vertebrae) that make up
the spine (vertebrae) begin to fuse together,
making it difficult for the patient to move.
Eventually, in the worst cases, the patient
can lose all movement in the neck and spine.
AS can come and go
during a person’s life. Sometimes
it may become very active, causing mobility
problems for the patient. There can also
be long times of inactivity, when the symptoms
almost disappear.
Over 90% of people
with AS are fully independent, although
many lose some movement of the spine. People
with the most severe type of AS, may also
lose movement of the ribs. This does not
affect breathing.
Symptoms
AS usually starts
with lower back pain and muscle spasm, which
happen more and more often and are usually
worse at night. This pain can spread to
the upper back and neck or buttocks and
hips. The condition mostly affects young
men or teenagers under the age of 30.Symptoms
may also include severe stiffness, particularly
early in the morning, which can be eased
slightly by bending over. This can lead
to a permanent, fixed curvature of the spine
if the condition is not treated.
As the disease progresses,
fever, fatigue, loss of appetite and loss
of weight become more common. The spine
becomes less able to move freely, and smaller
breaths are taken. Eventually, the chest
may not be able to expand at all, forcing
the person to breathe using the diaphragm
and the muscles of the wall of the abdomen.
In extreme cases the spine may become extremely
stiff and sometimes no spinal movement at
all is possible.
About one patient
in three develops a severe inflammation
inside one or both eyes, with blurred vision,
dull eye-ache and redness, especially around
the edge of the cornea (the outer covering
of the front of the eye).
Causes
The cause of ankylosing
spondylitis is not known, however most people
who are affected carry a particular antigen
called HLA-B27. This antigen is inherited
which explains why the condition runs in
families.
Treatment
Daily exercise to
improve movement of the spine and posture
is the best type of treatment. Two to fours
hours a week of gentle stretching exercises
or swimming is a good target. Hydrotherapy
(physiotherapy in water) and physiotherapy
may also be helpful in increasing movement.
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Ankylosing Spondylitis
