Ankylosing spondylitisis (AS) often referred as ‘arthritis of spine’ is an overlooked cause of back pain. It is a disease of young adults. Unfortunately, ankylosing spondylitis often remains misdiagnosed as ‘simple’ back pain for years. The symptoms, especially in the early stages, can be very similar to more common back problems. Because of this, many people put up with the pain for some time before seeking help. Also, widely available pain killers like Brufen, Combiflam, voveran mask symptoms of Ankylosing spondylitis.
What is ankylosing spondylitis (AS)?
The word spondylitis means inflammation of the spine. The word ankylosing means bones that tend to join together (fuse). The spine's bones (vertebrae) fuse together, resulting in a rigid spine like bamboo. It mainly causes pain and stiffness in lower back. Other joints and other parts of the body are sometimes affected.
What are the symptoms of ankylosing spondylitis (AS)?
- Lower back pain usually starts before the age of 40 years (commonly 15 and 25 years of age)
- Comes on slowly over time
- Back pain and stiffness in the mornings or after period of inactivity
- Improves with exercise
- Can often cause pain in the buttocks
The buttock pain may be felt sometimes on one side and sometimes on the other side. Pain can get worse with rest/inactivity. Instead, exercise and movement usually ease the pain. The pain tends to be worse first thing in the morning.
Ankylosing spondylitis is a systemic disease, which means symptoms may not be limited to the joints. People with the condition also may have fever, fatigue, and weight loss. Eye inflammation (redness and pain) occurs in some people with spondylitis. Some people also have pain, stiffness and swelling in their knees, ankles, or the smaller joints of their hands and feet.
Who should I consult for ankylosing spondylitis?
Rheumatologists specialize in medical aspects of arthritis and orthopedic/spinal surgeons specialize in surgical aspects of arthritis. Ideally patients must first visit the rheumatologist as most rheumatic diseases do not require surgery. It is preferable to try medical interventions long before there is a need for surgery.
The diagnosis of ankylosing spondylitis is made by a rheumatologist after looking at several factors, including: Symptoms, findings of an physical exam by an expert, MRI scan or X-rays of the back and pelvis, results of lab tests.
What treatments are there for ankylosing spondylitis (AS)?
With recent advances in management of AS there are a variety of treatments options available. Modern treatment aims at easing your pain and stiffness, keeping the spine mobile and thus helping you to live a normal life. A rheumatologist is an expert in this disease and should be consulted early in the course of the illness. Disease-modifying medications and newer therapies (Biologics) used by the rheumatologist can slow and in many cases stop the disease progression. Simple painkillers will not prevent joint damage. Exercise or diet alone cannot stop disease progression.