Ankylosing spondylitis is a chronic and progressive form of inflammatory arthritis. Ankylosing spondylitis affects the spine and sacroiliac joints.The symptoms start appearing commonly in the second and third decade of life.
Ankylosing spondylitis is also known as Bekhterev’s disease, Bekhterev syndrome or Marie-Strumpell disease.It is inherited genetically.
Other than affecting the joints ankylosing spondylitis may also affect organs of the body such as heart, lungs, and eyes and in some cases kidney.Hence it is also called a systemic disease.
The joint gets inflamed at the initial stage and then it is followed by stiffness that results in fusion of the spine.The condition is often called bamboo spine, as the spine gets stiff like a bamboo.The mobility of the spine is lost.
Ankylosing is taken from a Greek word ankylos, which means stiffening of a joint. Spondylos means vertebra. Spondylitis is the inflammation of one or more vertebrae.
This condition also affects children and then it is referred as Juvenile Ankylosing Spondylitis.
Caused Due To
The cause of ankylosing spondylitis is unknown. It is considered to be an autoimmune disease.
The majority of people with Ankylosing spondylitis have a gene called HLA-B27.
Ankylosing spondylitis shares many features with several other arthritis conditions such as psoriatic arthritis, reactive arthritis (formerly called Reiter’s disease)and arthritis associated with Crohn’s disease and ulcerative colitis.
How inflammation occurs and persists in different organs and joints in ankylosing spondylitis is a subject of active research. Each individual tends to have their own unique pattern of presentation and activity of the illness.
The disease most often begins between ages 20 and 40 but may begin before age 10. It affects more males than females.
• Pain in back, buttocks.
• Morning stiffness, better with activity.
• Weight loss.
• Reduced mobility and gradual development of loss of bending the back.
• Severe inflammation of the lumbar spine and sacroiliac joints can develop a complete bony fusion of the spine with low back and buttock pain.
• Some may notice pain and stiffness in the back of the heel called Achilles Tendinitis, especially while walking upstairs.Inflammation of the tissues on the bottom of the foot, plantar fasciitis, occurs more frequently in people with ankylosing spondylitis.
• In the advanced stage when the whole spine is involved patient notices stiffness and inflexibility resulting in chronic stooping and restricted expansion of spine.
Following are the signs of ankylosing spondylitis which are noticed by the patient:
• Tenderness at the sacroiliac joint.
• Cervical, thoracic spines become tender.
• Restricted movement.
• The patient cannot erect spine.
• Sits walks with a flexed spine.
• Chest expansion diminished.
• The complete rigidity of spine & involved joint.
• Kyphosis (curve in the spine).
• Blood Test
• CT scan.
• MRI to assess early cartilage abnormalities and bone marrow edema.
• Degenerative Disk Disease.
• Congenital Spinal Deformity.
• Lumbar Spondylosis.
• Imaging in Diffuse Idiopathic Skeletal Hyperostosis.
• Spine Fractures and Dislocations.
• Lumbar Disc Disease.
• Osteofibrous Dysplasia.
• Spinal Stenosis.
• Rheumatoid Arthritis of the spine.
• Medicines: NSAIDS, cytotoxic drugs, corticosteroids.
• Maintain a right posture.
Symptoms may occur at any time. Rarely, people may have problems with:
• Abnormal heart rhythm.
• Scarring or thickening of the lung tissue.
• Aortic incompetence.
• Recurrent chest infection.
• Inflammation of the iris may occur.
• Deposition of a protein called amyloid occurs in the kidneys which result in kidney failure. Progressive kidney disease leads to chronic fatigue and nausea and requires the removal of accumulated waste products in the blood by a filtering machine.
• A dull backache in the lumbosacral region.
• Heaviness and lameness in back.
• Paralytic feeling in the spine.
• Aggravation of motion.
• Rheumatic pains in spine
• Sharp pain in sacrum and coccyx.
• Worse by the cold.
• Better by lying down
• Stiffness in the nape of the neck.
• Coccyx painful.
• Worse by cold air, mental exertion.
• Better by warmth.
• Tearing pain in back and lumbar region.
• Cannot sit in one position for long.
• Crawling sensation between shoulder blades.
• Better by continued motion.
• Worse by rest.
• Early morning aggravation.
• Heaviness in back and legs.
• Worse in winters.
• Better by the warmth and open air.
• Extremely painful sore parts
• Sensitive spine
• Joints red, swollen and hot.
• Stitching and tearing pain.
• Worse at least movement.
• Every spot is painful on pressure.
• Pain worse in evening and warm weather.
• Shifting pains.
• Joints stiff and feverish feeling.
• Growing pains.
• Intolerance to pressure.
• Feeling of heat in affected part
• Try to maintain right posture while sitting, standing and sleeping.
• Exercise increases flexibility and reduces stiffness.
• Consume a well balanced, highly nutritious diet.
• Hot fermentation on affected part helps in relieving pain.
• Quit smoking.
• Low starch diet
• Diet rich in anti-inflammatory essential fatty acid
• Avoid fatty and fried foods, pastries, and chocolate.
• Foods rich in silicon include wholegrain cereals, hard nuts, seeds and apple
• Foods high in Vitamin C maintains healthy connective tissue.
• Avoid acid forming food.
• Potato, tomato, aubergine, chili, and peppers can aggravate joint inflammation.
• Eat plenty of vegetables, fruits, and whole-grain products.
• Drink 8-10 glasses of water a day
• Spend an hour of a day in direct daylight or add dietary supplementation of vitamin D
• Fresh, natural yogurt is a good source of acidophilus bacteria that maintain a healthy bowel and digestive system.
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