Are you experiencing long standing back pain? Not much relief with regular pain killers? Think of other reasons for back pain. Ankylosing Spondilytis (AS) is next common cause for chronic back pain after pain due to slipped inter-vertebral disc and muscle spam.
Things you should know about Ankylosing Spondylitis (AS)
- AS occurs due to chronic inflammation of joints of spine (vertebral column). This chronic inflammatory process arises as a result of disorder in the immune system. Hence AS is termed as an autoimmune disorder. Involvement of peripheral joints is not uncommon along with the joints of axial skeleton, especially joints of pelvis. Prolonged inflammatory deposits in the joints cause fusion of the vertebral bodies. As a consequence the spine looses its flexibility. This causes stiffness along the spine and chronic back pain and pain in other affected joints. Stiffness may cause hunched-forward posture of the back, known as kyphosis, in severe cases.
- Young adult population between twenty to thirty years is commonly affected by AS. Symptoms begin at early young age with predominance in men as compared to women.
- AS is a progressive disorder and tends to have a strong genetic link. Genetic marker HLA B-27, which is a protein, is present in ninety five percent of AS patients in their lab investigations. However genetic marker is negative in many of the patients who suffer from AS.
- Constant pain and stiffness prominently in lower back, buttocks (sacro-iliac joints) and hips for more than three months are the markedly observed symptoms of AS. The severity of the symptoms depend on progression of the disease. Some patients experience intermittent pain with periods of remissions, while in others it is a continuous debilitating pain. Morning stiffness in joints is observed in majority cases. AS also affects the ligaments and tendons adjoining the joint. As a result there may be tenderness and swelling over knee joints, in the heels (Achilles tendon) or at the base of the foot (Plantar Fasciatis). When ribs (costochondritis) are involved there is pain during chest expansion while breathing. Shoulder joints are less frequently affected. Few experience inflammation of eyes (Iritis/Uveitis) with redness, pain and heightened sensitivity towards light with excessive watery eyes.Fatigue with constant debilitating pain and bodily discomfort is a marked feature of AS.
- Diagnosis of AS is usually made on physical examination wherein, there is restriction in movements of spine. There is pain and tenderness along the spine on examination. Radiological tests and MRI can be useful to confirm the diagnosis only in chronic cases as it takes years for the inflammation to cause the actual damage in spine to get detected in imaging studies.
- AS falls in the category of seronegative spondyloarthropathies. Seronegative arthropathies are those which are negative for an autoantibody called rheumatoid factor in their investigations. Other arthropathies which share their symptoms with AS are psoriatic arthritis, arthritis related to irritable bowel, chronic reactive arthritis, juvinile arthritis. But unlike rest of the arthropathies AS affects the age group of twenty to thirty years. Also in AS affection of sacroiliac joint (joint between the pelvis and sacrum of vertebral column at the base of spine) is the most distinctive presenting symptom.
- There is no cure for AS till date but to manage and control the symptoms. Therapeutically allopathic drugs like NSAIDS, corticosteroids and disease modifying antirheumatic drugs give relief in pain and stiffness for some period of time. Alternative system of medicine like Homeopathy gives long term relief in symptoms without any undesirable side effects. Moderate regular exercise like walking and swimming helps in controlling the progression in stiffness, pain and improvement in posture.
Positive attitude towards life along with medicines to control discomforting symptoms help to a great extent in management of Ankylosing Spondylitis.
Though incurable but when symptoms stay in control one can carry out day-to-day activities efficiently without much difficulty.
Dr. Mrudula, Associate Doctor at Life Force Homeopathy