Ankylosing spondylitis. Ready reference!

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Mild back pain occurring years after endoscopic spine surgery does not necessarily mean that the previous surgery has failed. At 68 years, degenerative changes of the lumbar spine, muscle weakness/stiffness or adjacent-level degeneration are relatively common causes. If by “AS” you mean ankylosing spondylitis, this diagnosis cannot be confirmed from the prescription alone. New-onset ankylosing spondylitis at this age would be unusual, since symptoms typically begin much earlier. If your orthopaedic doctor has specifically suspected inflammatory spinal disease, evaluation may include ESR, CRP, X-ray of the sacroiliac joints and, when appropriate, HLA-B27 testing . The handwriting in the attached prescription is not clear enough for me to safely identify every medicine, so please take the medications exactly as prescribed by your treating doctor rather than changing or adding medicines. If the pain is mild and there are no neurological symptoms, review with your orthopaedic surgeon and gradually restart back-strengthening and physiotherapy exercises as advised. Further MRI/X-rays are generally considered if symptoms persist, worsen or are associated with leg symptoms. Seek earlier evaluation if there is increasing leg weakness/numbness, severe radiating pain, difficulty walking, bladder/bowel disturbance, fever, unexplained weight loss or severe night pain.

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