Ankylosing Spondylitis
Ankylosing Spondylitis (AS) is a type of spinal problem that causes the back to become stiff and inflexible.
It is caused by initial inflammation of the spine where the ligaments or tendons attach to the bone (spond = bone, itis = inflammation).
As the inflammation settles extra bone is produced by the body and this can lead to bony bridges being formed between the vertebrae and stiffness follows this. This is the ankylosing part of the name.
- AS affects about 1 in 200 men and 1 in 500 women in the UK.
- It can affect anyone but usually shows up in late teens or early twenties.
- Occasionally, the diagnosis of AS is missed in younger life and is only made when someone is older.
- It’s a bit hard to diagnose in the early stages as there may be no X-Ray changes, and it can be mistaken for simple lower back pain.
- Ankylosing spondylitis usually starts at the base of the spine in the sacroiliac joints.
- It can affect other joints, mainly the hips, shoulders and feet and ankles.
Symptoms
- Gradual onset of lower back pain and stiffness. The important thing here is the stiffness, usually worse in the morning and taking a good while to improve on rising. I have met sufferers of AS who are stiff for an hour or more in the mornings.
- The stiffness usually wears off with exercise and movement as the day goes on.
- The lower back pain may radiate into the legs and buttocks.
- Weight loss, fatigue and fevers with night sweats often accompany the illness.
AS is a progressive disease that does need ongoing management but it can be controlled in most people and is not life threatening.
Diagnosis
This is a bit difficult and is usually made by a specialist rheumatologist who will examine X-Rays and other clinical findings. There are no blood tests that show whether you have AS or not but a blood test will sometimes show signs of inflammation in the early stages.
Treatment
The main ways that this is managed is using anti-inflammatory drugs and exercise.
The exercise programme needs to be tailored to your individual needs and carefully supervised initially.
Further Resources
If you suspect you have AS discuss it with your doctor and if you have been diagnosed with this then you should have regular contact with your own physiotherapist and rheumatology specialist.
The National Ankylosing spondylitis Society has some very useful information.
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01-Feb-2008
