Ankylosing Spondylitis

Ankylosing spondylitis is a form of chronic inflammation of the spine and the sacroiliac joints. The sacroiliac joints are located in the low back where the sacrum (the bone directly above the tailbone) meets the iliac bones (bones on either side of the upper buttocks). Chronic inflammation in these areas causes pain and stiffness in and around the spine. Over time, chronic inflammation of the spine (spondylitis) can lead to a complete cementing together (fusion) of the vertebrae, a process referred to as ankylosis. After years of ankylosis, however, stress fracture may also occur. Ankylosis leads to loss of mobility of the spine.

Ankylosing Spondylitis

Ankylosing spondylitis is also a systemic disease, meaning it can affect other tissues throughout the body. Accordingly, it can cause inflammation in or injury to other joints away from the spine, as well as to other organs, such as the eyes, heart, lungs, and kidneys. Ankylosing spondylitis shares many features with several other arthritis conditions, such as psoriatic arthritis, reactive arthritis, and arthritis associated with Crohn's disease and ulcerative colitis. Each of these arthritic conditions can cause disease and inflammation in the spine, other joints, eyes, skin, mouth, and various organs. In view of their similarities and tendency to cause inflammation of the spine, these conditions are collectively referred to as "spondyloarthropathies." 

Causes, Incidence & Risk Factors:

The tendency to develop ankylosing spondylitis is believed to be genetically inherited, and a majority (nearly 90%) of people with ankylosing spondylitis are born with a gene known as the HLA-B27 gene. Blood tests have been developed to detect the HLA-B27 gene marker and have furthered our understanding of the relationship between HLA-B27 and ankylosing spondylitis. The HLA-B27 gene appears only to increase the tendency of developing ankylosing spondylitis, while some additional factor(s), perhaps environmental, are necessary for the disease to appear or become expressed.

Recently, two more genes have been identified that are associated with ankylosing spondylitis. These genes are called ARTS1 and IL23R. These genes seem to play a role in influencing immune function. It is anticipated that by understanding the effects of each of these known genes researchers will make significant progress in discovering a cure for ankylosing spondylitis.

The disease most often begins between ages 20 and 40, but may begin before age 10. It affects more males than females. Family history of ankylosing spondylitis & male gender are the main risk factors for it. 

Symptoms

The disease starts with low back pain that comes and goes.

• Pain and stiffness are worse at night, in the morning, or when you are not active. It may wake you from your sleep.
• The pain typically gets better with activity or exercise.
• Back pain may begin in the sacroiliac joints (between the pelvis and the spine). Over time, it may involve all or part of the spine.

You may lose motion or mobility in the lower spine. You may not be able to fully expand your chest because the joints between the ribs are involved. Fatigue is also a common symptom. Other, less common symptoms include:

• Eye inflammation or uveitis
• Heel pain
• Hip pain and stiffness
• Joint pain and joint swelling in the shoulders, knees, and ankles
• Loss of appetite
• Slight fever
• Weight loss

Advanced spondylitis can lead to deposits of protein material called amyloid into the kidneys and result in kidney failure. Progressive kidney disease can lead to chronic fatigue and nausea and can require removal of accumulated waste products in the blood by a filtering machine (dialysis).


Signs and tests

Tests may include:

• CBC Complete Blood Count
• ESR erythrocyte sedimentation rate
• HLA-B27 antigen
• X-rays of the spine and pelvis

Treatment

Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and pain. Corticosteroid therapy or medications to suppress the immune system may also be prescribed. High doses given over prolonged periods of time turn these steroids into "scare-oids". However, we can use Tourmanium Ceramic or Jade Stone Heated Mats for controlling inflammation & pains.

Physical therapy for ankylosing spondylitis includes instructions and exercises to maintain proper posture. This includes deep breathing for lung expansion and stretching exercises to improve spine and joint mobility. Since ankylosis of the spine tends to cause forward curvature, patients are instructed to maintain erect posture as much as possible and to perform back-extension exercises. Lying flat on the back at night can help maintain normal posture. Automatic jade roller massager beds can also be used to bring the spinal cord to normal posture which has heated jade rollers fitted in it. During a Yugalife Thermal massage bed session, the user optimally alleviates their spinal column, positioning it in the horizontal position, while a massage carriage with JADE massage rolls glides from their neck over the spinal column to the coccyx and back again which improves the posture very much.

Finally, orthopedic surgery maybe required when there is severe disease of the hip joints and spine.