Ankylosing spondylitis (AS) usually affects the joints of the backbone, but it can also affect other joints especially the hips. AS can also sometimes cause inflammation of the eyes, chest wall, heart, and lungs. If this inflammation doesn’t get treated, it will eventually lead to scarring and permanent damage. Some people have a mild form of the disease, others are unlucky enough to have the competitive form.
This disorder may or may not get worse, depending upon many factors. These variables include, how old you were when the disease started, what joints are affected, and how early you have a proper diagnosis. Unfortunately there’s no cure as of yet. Doctors aren’t certain of the cause for AS, but they do know that genetics plays a role in the disease. Around 95 percent of individuals diagnosed with this disease have a gene which produces a genetic marker, HLA-B27.
However, obtaining this gene doesn’t mean a man or woman is guaranteed to find the disease. There’s only about a 40% chance of developing AS if you have this gene. Also, you don’t need to have this gene so as to develop AS. Many individuals have the HLA-B27 producing gene, around or under 25 percent of the population depending on the nation, but only between 1% and 5% of people actually develop ankylosing spondylitis.
There’s current research going on to ascertain the reasons for the inflammation that’s a part of ankylosing spondylitis. Some researchers consider this inflammation starts with a bacterial disease that causes the immune system to respond. Once the bacterial infection is gone, a normal person’s immune system reverts to’protect and scan’ mode, but in a person affected by AS their immune system remains in the’attack’ mode.
This causes cells to become inflamed. Other researchers believe AS starts when the intestinal defenses break down, causing bacteria to enter the blood, and then into the joints most affected by this arthritis, the sacroiliac joints. The most common symptom of AS is one lots of individuals are knowledgeable about, lower back stiffness or pain. This symptom can pose as early as adolescence that causes many individuals with ankylosing spondylitis to be mis-diagnosed as teens with a sports related injury. The stiffness and pain are often gradual, so many folks don’t inform their doctor about the pain.
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The stiffness and pain are due to the inflammation of the spine, which if not treated may lead to a fusing of the vertebrae or ankylosis. Once this occurs, the pain disappears, as does freedom in the spine. The ankylosis can cause a forward curving of the torso area, which reduces breathing capacity. This fusion may also extend to the rib cage, inducing bones to fuse into the backbone, decreasing lung capacity.
Other signs of AS are arthritis in other joints (usually the buttocks, knees, and ankles) and inflammation of the cartilage surrounding the breast bone, kidneys, eyes, and the heart. A proper diagnosis of AS can be tough to get. Early symptoms can frequently be caused by other, more common ailments. It’s particularly difficult to diagnose in women because they often have less involvement of the spine, usually but not necessarily.
A patient might need to live with the pain for many years prior to ankylosing spondylitis is considered. The evaluations for AS are actually pretty straightforward. They include the typical medical history and physical examination, then the physician will order an x ray of the backbone and a blood test for the HLA-B27 marker. The physical examination may show preliminary signs like restricted mobility of the spine, diminished breathing capacity, and eye inflammation.
The spine x-ray will reveal if fusion of the vertebrae has already happened. Once properly diagnosed, treatment starts. Treatment involves the taking of non-steroid anti inflammatory drugs (NSAIDs), physical therapy and then improved exercise. The NSAIDs decrease the inflammation, and pain, of the affected joints that may increase mobility. In patients where other joints, like the knees, hips and ankles, are inflamed, the NSAIDs might not work very well.
If that occurs, there are other medications which may be used like sulfasalazine and methotrexate. Methotrexate is better than sulfasalazine but it is potentially toxic to the liver and bone marrow. Patients undergoing methotrexate treatment should have regular blood tests to determine whether either of the organs are being damaged. With greater mobility comes the physical therapy and exercise to improve posture and increase mobility and breathing capability. All exercise regiments will need to be approved by a physician so the patient doesn’t unintentionally harm him/herself.