Ankylosing spondylitis, sometimes called Bechterew’s disease, is a form of chronic inflammatory arthritis that affects the spine and sacroiliac joints. It is part of a larger family of inflammatory rheumatic diseases called spondyloarthritis. Over time, the disease can cause the bones in the spine to fuse together, causing extreme stiffness, lack of mobility and intense pain. As the disease progresses, pain can move up the spine into the shoulders and chest. This can lead to spine rigidity, hunched posture and even trouble breathing.
What Causes Ankylosing Spondylitis?
Unlike other types of arthritis, AS isn’t caused by physical injury, aging, wear and tear on the joints or lifestyle factors. The only known link to the disease is genetics. Individuals with a family history of the disease are more likely to develop ankylosing spondylitis themselves. 90% of Caucasian people with AS have a gene called HLA-B27. Conversely, only 8 percent of Caucasians without AS have this gene. For this reason, scientists believe HLA-B27 may be linked to the development of AS. Additional genes have also been connected to the disease.
Symptoms of Ankylosing Spondylitis
Symptoms of ankylosing spondylitis usually surface in late adolescence to early adulthood.
Initially, AS sufferers may experience unexpected pain and stiffness in the lower back, hips and buttocks that comes and goes. Typically, the pain is worse in the morning and improves with physical activity. Over time, the pain becomes more constant and may travel from the lower back to the mid-back and shoulders. AS can also cause symptoms in organ systems outside the joints, including the lungs, kidneys, and heart. Many people with the disease experience fatigue, low-grade fever, eye inflammation, and bowel inflammation. As the disease progresses, individuals may find it hard to sit up straight due to the stiffness of the spine. They may also develop rigid bone in the ribs, making it harder to breathe normally. If left untreated, AS can lead to brittle and weakened bones and, eventually, osteoporosis.
How is Ankylosing Spondylitis Diagnosed?
There is no single test for diagnosing AS, but there are tests for spotting inflammation in the sacroiliac joints–the hallmark of AS. Your rheumatologist will first collect key information about your medical history, family history, and the nature of your pain. He or she will then perform x-rays and possibly an MRI to check for inflammation in the sacroiliac joint.
Blood tests are also used to help diagnose AS. People with the disease often have a higher erythrocyte sedimentation rate, a hallmark of inflammation. ESR is a test that monitors the rate at which red blood cells settle at the bottom of a test tube. Because inflammation causes red blood cells to clump together and become denser, they sink more quickly when placed in a tube. A C-reactive test may also be used to diagnose AS. This test can check for a heightened level of inflammation in the blood, as well.
Treatment for Ankylosing Spondylitis
Early stage ankylosing spondylitis pain can often be treated with NSAIDs (non-steroidal anti-inflammatory drugs). Other common treatments include physical therapy and light exercise to keep the joints flexible. Deep breathing and posture training may also improve symptoms. If NSAIDs don’t provide relief, your doctor may recommend the use of biologic medications or drugs commonly used to relieve inflammation in other rheumatic diseases.
For advanced or exceptionally painful ankylosing spondylitis, joint replacement may be recommended. Hip replacement is sometimes necessary to relieve severe hip pain related to AS. It’s important to visit a rheumatologist if you’ve been suffering from common symptoms of ankylosing spondylitis.
The rheumatology team at Mobility Bone & Joint Institute can diagnose and treat ankylosing spondylitis. We are the only practice in the area that can diagnose diseases, infuse medications, and perform x-rays on site.