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Ankylosing Spondylitis: Causes, Symptoms, Diagnosis, and Treatment

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Ankylosing spondylitis (AS) is a chronic inflammatory illness that usually affects the spine but may also affect other joints. It can cause significant pain and stiffness, particularly in the lower back and buttocks, and in severe cases can lead to spinal fusion and loss of mobility. AS is a type of arthritis, but it differs from other forms of arthritis in several important ways. The causes, symptoms, diagnosis, and management of ankylosing spondylitis will be discussed further below in this article in detail for better understanding.

What Causes Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a type of autoimmune disease that affects the spine and other joints. While the precise aetiology of AS is unknown, research has found numerous elements that contribute to the disease's progression.

A genetic mutation of the human leukocyte antigen-B gene (HLA-B) is one of the principal causes of AS, affecting around 95% of people with AS. This gene mutation results in the synthesis of a protein known as HLA-B27, which raises the likelihood of getting AS. However, not everyone who has a mutant HLA-B gene develops AS, and some people with AS do not have the HLA-B27 gene.

  • A mix of genetic and environmental factors contribute to AS.

  • Around 95% of patients with AS have a variant of the HLA-B gene that produces a protein called HLA-B27, which increases their risk of the condition.

  • The majority of people with a mutant HLA-B gene do not acquire AS, and 80% of children who inherit the gene from an AS parent do not develop the condition.

  • Besides from genetics, some medical problems, such as Crohn's disease, ulcerative colitis, and psoriasis, may enhance the risk of having AS.

  • About 60 genes have been related to the onset of AS, demonstrating the complexities of the condition's underlying causes.

  • Further research is required to completely understand the underlying mechanisms and causes of AS.

What are Symptoms of Ankylosing Spondylitis

Pain and stiffness in the lower back and buttocks are the most prevalent symptoms of ankylosing spondylitis. This pain is typically worse in the morning and after periods of inactivity, and may improve with exercise. In extreme situations, the discomfort may be persistent and make it difficult to perform daily tasks such as sitting or standing for extended periods of time.

Ankylosing spondylitis symptoms can vary greatly from person to person, and some people may not experience or feel any symptoms at all. Common ankylosing spondylitis symptoms include:

  1. Pain and stiffness in the lower back: This is the most common symptom of ankylosing spondylitis. The pain and stiffness are usually worse in the morning and after periods of inactivity.

  2. Pain and stiffness in other parts of the body: In addition to causing pain and stiffness in the spine, ankylosing spondylitis can also affect the hips, shoulders, and knees.

  3. Fatigue: Fatigue is a common symptom in AS and may be brought on by the body's inflammation.

  4. Eye inflammation: Eye inflammation brought on by ankylosing spondylitis can result in pain, sensitivity to light, and redness in the eye.

  5. Reduced lung capacity: Lung inflammation brought on by ankylosing spondylitis may result in a reduction in lung capacity and difficulty breathing.

Diagnosis of Ankylosing Spondylitis

Ankylosing spondylitis can be difficult to diagnose since its symptoms can resemble those of other kinds of arthritis. However, there are several tests and exams that can help to confirm a diagnosis.

Doing a physical examination and evaluating the patient's spine and other joints' ranges of motion are the first steps in the diagnosis of AS. In addition, blood tests to check for the HLA-B27 gene may be done and the patient's family history of AS may be discussed. Furthermore useful in the diagnosis of ankylosing spondylitis are imaging studies. A magnetic resonance imaging (MRI) scan can detect inflammation in the soft tissues around joints, while X-rays can detect abnormalities in the spine's and other joints' bones.

Treatment of Ankylosing Spondylitis

While there is no cure for ankylosing spondylitis, there are several treatments that can help to manage the symptoms and slow the progression of the disease. The most common treatments include:

Medication Treatments

  1. Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs are the first-line treatment for ankylosing spondylitis. They help to reduce pain and inflammation, and they can also help to improve stiffness and mobility. Common NSAIDs include ibuprofen, naproxen, and celecoxib.

  2. Disease-modifying antirheumatic drugs (DMARDs): DMARDs can help to slow down the progression of the disease by suppressing the immune system. Common DMARDs used to treat ankylosing spondylitis include sulfasalazine and methotrexate.

  3. Biologics: Biologics are a type of medication that target specific components of the immune system. They can be very effective in treating ankylosing spondylitis, particularly in patients who have not responded well to other treatments. Common biologics used to treat ankylosing spondylitis include adalimumab, etanercept, and infliximab.

  4. Corticosteroids: Corticosteroids are powerful anti-inflammatory drugs that can be used to control symptoms of ankylosing spondylitis. They are usually given in low doses and for short periods of time to avoid side effects.

Non-Medication Treatments

  1. Physical therapy: Physical therapy can help to improve mobility, reduce pain, and prevent deformity in patients with ankylosing spondylitis. Physical therapy may include exercises to improve posture, stretching, and strengthening exercises.

  2. Occupational therapy: Occupational therapy can help to improve a patient's ability to perform daily activities, such as dressing and grooming. It may involve the use of assistive devices, such as canes or walkers.

  3. Heat and cold therapy: Heat therapy can help to reduce stiffness and improve mobility, while cold therapy can help to reduce pain and inflammation.

  4. Surgery: In rare cases, surgery may be necessary to correct deformities or alleviate pressure on the spinal cord or nerves.

 

5 Home exercise for Ankylosing Spondylitis

Some general exercises that may be recommended by a physiotherapist to help manage the symptoms of ankylosing spondylitis include:

  1. Chest stretch: Stand in a doorway with your arms at your sides, and bend your elbows to a 90-degree angle. Place your forearms on either side of the door frame, and step forward until you feel a stretch in your chest. Hold for 20-30 seconds and repeat several times.

  2. Wall slides: Stand with your back against a wall, with your feet hip-width apart and a few inches away from the wall. Slowly slide down the wall, bending your knees and keeping your back straight. Hold for a few seconds, then slide back up.

  3. Pelvic tilt: Lie on your back with your knees bent and feet flat on the floor. Tighten your stomach muscles and tilt your pelvis upward, flattening your lower back against the floor. Hold for a few seconds, then release.

  4. Seated spinal twist: Sit on a chair or stool with your feet flat on the floor. Twist your upper body to the right, holding onto the back of the chair or placing your right hand on your right knee. Hold for a few seconds, then twist to the left.

  5. Leg lifts: Lie on your back with your legs straight out in front of you. Lift one leg a few inches off the ground and hold for a few seconds, then lower it back down. Repeat with the other leg.

At Dr. Sahil's Advanced Physiotherapy Clinic, patients with ankylosing spondylitis can receive specialized treatment to manage their symptoms and improve their quality of life. The clinic offers a range of services, including exercise therapy, manual therapy, electrotherapy, and hydrotherapy, to address the various needs of their patients.

Patients can also benefit from personalized treatment plans that are tailored to their unique needs and preferences. The clinic's team of experienced physiotherapists work closely with each patient to understand their condition, develop a comprehensive treatment plan, and monitor their progress to ensure optimal outcomes.

In addition to its high-quality care, Dr. Sahil's Advanced Physiotherapy Clinic is known for its warm and welcoming environment, which helps patients feel at ease and supported throughout their treatment journey. With its commitment to excellence and patient-centered care, Dr. Sahil's Advanced Physiotherapy Clinic is a leading choice for ankylosing spondylitis treatment in Thane and beyond.

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