Ankylosing spondylitis (AS) is a form of rheumatiod arthritis, which is an autoimmune disease. In autoimmune diseases, the body's immune system, whose job is to fight off invaders such as infection, somehow gets out of whack and begins to attack the body - in the case of rheumatoid arthritis, primarily the joints.
Ankylosing Spondylitis can be a debilitating disease. It primarily affects the spine, and causes the vertebrae to become inflamed. As inflammation progresses, the spine begins to grow little bone spurs between the vertbrae. If the disease continues to progress, the spine becomes stiff and inflexible, and can eventually become fused into what is basically one solid immoveable bone.
Still, there are some people who have been diagnosed with AS who feel symptoms only occasionally and have little pain. I read a story of an elderly woman who was involved in an auto accident. At the hospital, her spine was found to have been fractured in the accident. It was also found to have been completely fused by AS over the years, yet the woman claimed to have never had one iota of back pain prior to the accident.
The cause of ankylosing spondylitis is not known at this time, but researchers feel genetics and heredity play a large part. A certain gene called HLA-B27 appears in around ninety percent of the people with ankylosing spondylitis. However, there are other factors involved, because less than two percent of those having that gene get AS. The disease usually begins in the twenties and thirties, although it may take a decade or more to be diagnosed. It can also affect older adults and children. Men get the disease around twice as often as women do, and on average, women seem to have milder symptoms.
The disease frequently starts with pain and stiffness in the hips and lower back. Usually, the symptoms are worse upon getting up in the morning or after some other period of inactivity, and improve with movement or exercise. The stiffness and pain can extend out from the spine to tendons and ligaments, or to other joints such as the hips, knees, feet or shoulders. AS can even affect the eyes, through a type of eye inflammation known as iritis.
If ankylosing spondylitits reaches the advanced stage, restricted expansion of the chest, bowel inflammation, iritis, fatigue and weight loss can accompany the exaggerated stooping that is the worst case scenario result of the fused spine. In past years, there have been individuals with advanced cases of AS whose spine had fused in such a stooped position that they had to walk backwards, looking through their legs!
There is no cure for AS, but the pain and stiffness can usually be well managed through the use of non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids or TNF blockers. Physical therapy and exercise is an absolute must to control the effects of the disease. Some of the exercises will focus on maintaining the spine in a straight position, so that if it does fuse, living with the condition will be easier.
Regarding alternative therapies, acupuncture has been found to be helpful in many cases. Some AS patients have found relief with chiropractic and massage, but there are a number of doctors who caution against manipulating the ankylosed spine, since it can be brittle.
