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What Exactly Is Ankylosing Spondylitis?

When most people think about arthritis, they tend to think of older people who have painfully inflamed finger joints that cause deformity or achy knees that affect the way a person walks. But a condition called ankylosing spondylitis is actually an inflammatory type of arthritis that affects the spinal vertebra and other large joints in the body. It’s seen most often among men, beginning in the early adult years.

Although there may be a considerable variation in the way symptoms of ankylosing spondylitis present themselves from individual to individual, they usually gradually appear between the ages of 17 and 45. The most common symptoms reported include back and buttock pain and stiffness, as well as pain and stiffness in the larger joints of the body like the shoulders or hips. But the signature symptom of this condition is reduced spinal flexibility that, over time, results in hunched-over posture. It’s essential to understand that the back pain associated with AS is the result of an inflammatory response in the body that’s affecting the spine, and not with a mechanical issue in the spine or vertebra.

AS is another of the sometimes mysterious spinal conditions (like idiopathic scoliosis, for example) that don’t yet have any known specific causes. However, existing research points to genetic factors involved in the development of the condition, namely for people with a gene called HLA-B27, though not everyone with this gene will develop AS in their lifetime. Though not considered “causes” in and of themselves, there are also some risk factors associated with the development of AS. These factors include gender (men are more likely to develop the condition than women) and age at onset (AS typically occurs in the late teen to early adult years).

A chronic condition that can last for years or a lifetime, ankylosing spondylitis can result in disability for some individuals. This happens in severe cases as a result of the stiffening of the vertebrae and their tendency to begin to “fuse” together – forming new bone as the body attempts to heal itself from the inflammation. When this occurs, stiffness and rigidity follow, often leading to pain, difficulty with proper spinal alignment and posture, and sometimes stiffening of the rib cage, which can cause problems for lung function and capacity. But there are some treatments that can help people suffering from this painful condition rehabilitate and return to an active and healthy life.

Though there is currently no cure for AS, one crucial factor in how effective treatment is for the condition involves the timing of the diagnosis. The earlier the disease is detected in an individual, the sooner a treatment plan can be implemented – hopefully in time to spare him or her from the more severe effects of AS is it progresses, including deformity. Most of the conservative treatments for AS are designed with discomfort reduction and function improvement in mind. These may include physical therapy and occupational therapy, a regimen of daily exercise to keep the joints well-lubricated and minimize disability risk, as well as medications designed to reduce the swelling and inflammation caused by AS. In severe cases of AS, surgery may be indicated to help those who have developed severe deformities find relief. These procedures are performed by an experienced spine surgeon and may include fusion surgery or osteotomy, a process that involves removal of bone overgrowth.

If you or a loved one is experiencing back pain that has lasted longer than a few weeks, it’s essential to have it checked out by a knowledgeable medical expert. Especially in cases where the spine is involved – when the health of one part of it begins to deteriorate, it can set off a domino effect that puts other parts of the spine at risk. And in the case of AS and many other spinal conditions, earlier diagnosis can lead to better outcomes for patients both in managing the pain associated with the condition as well as preventing further damage and disability. So take your health into your hands, and when in doubt, have it checked out.

Neel Anand, M.D., Contributor

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