A GUIDE TO ANKYLOSING SPONDYLITIS !
CASE HISTORY:
A young male from northern area of pakistan approached me via this page.
He had ANKYLOSING SPONDYLITIS since 10 years ago.
unfortunately has was treated by many medical doctors and orthopedic surgeons but no Rheumatologist.
He has already had both hip joints replaced due to severe damage.
Now he is suffering from severe deformity of spine.he came to me with a hope that I can cure it !
I had to be honest with him without giving any false hopes!!
A young male from northern area of pakistan approached me via this page.
He had ANKYLOSING SPONDYLITIS since 10 years ago.
unfortunately has was treated by many medical doctors and orthopedic surgeons but no Rheumatologist.
He has already had both hip joints replaced due to severe damage.
Now he is suffering from severe deformity of spine.he came to me with a hope that I can cure it !
I had to be honest with him without giving any false hopes!!
since he has advance disease the damage already done is irreversible.however with TREATMENT further damage can be prevented.
I have several other patients under my care who had been to orthopedic surgeon, neurosurgeon for years for backache before it was correctly diagnosed by me.
There are lots of queries and questions about this topic from patients so below is some useful information.
WHAT IS ANKYLOSING SPONDYLITIS?
1-It is type of arthritis causing painful, inflammation of SPINE (back).
1-It is type of arthritis causing painful, inflammation of SPINE (back).
2-Over time it can cause FUSION of vertebrae.
3-It can also cause inflammation in eyes,heart and other organs and joints.
3-There is no cure but treatment can slow down or prevent it from getting worse.
WHO GETS ANKYLOSING SPONDYLITIS?
1-more common in men.
1-more common in men.
2-age between 16-35 years.
3-can run in families.
4-HLA-B27 positive.
WHAT ARE THE SYMPTOMS?
1-PAIN & STIFFNESS:
pain and stiffness in lower back.Gets better with Exercise and worse with rest.Hence it is intense in morning.
pain and stiffness in lower back.Gets better with Exercise and worse with rest.Hence it is intense in morning.
2-ENTHESITIS:
means swelling and pain at the point where tendon and ligament insert at bone.
It is more common at heel,ribs,shinbones.
means swelling and pain at the point where tendon and ligament insert at bone.
It is more common at heel,ribs,shinbones.
3-ARTHRITIS :
other joints can be involved like knee,shoulder,hips.
other joints can be involved like knee,shoulder,hips.
4-OSTEOPOROSIS:
weak ,brittle bones.patients are at more risk.of fracture.
weak ,brittle bones.patients are at more risk.of fracture.
5-ANEMIA:low levels.of haemoglobin in blood causing inadequate oxygen supple to body causing lethargy and fatigue.
6-RED EYES:causing blurring of vision and sensitivity to light.
7-BREATHING PROBELMS:
due to reduced lung capacity and pain at rib cage.
due to reduced lung capacity and pain at rib cage.
DIAGNOSIS OF ANKYLOSING SPONDYLITIS:
1-starts with history and clinical examination.
1-starts with history and clinical examination.
2- blood test for inflammatory markers ESR CRP.
3-HLA -B27
4-XRAY and MRI to check for spine damage.
TREATMENT OF ANKYLOSING SPONDYLITIS:
there is no cure !
treatment can help by making your life easy and holding off more severe and long term effects.
treatment can help by making your life easy and holding off more severe and long term effects.
1-NSIADS
NSAIDs are anti-inflammatories that reduce pain. Ibuprofen, naproxen, and aspirin.
NSAIDs are anti-inflammatories that reduce pain. Ibuprofen, naproxen, and aspirin.
2-STERIODS:
Corticosteroids may be offered when AS symptoms are severe and don’t respond to other medications. They also help reduce inflammation and pain.
Corticosteroids may be offered when AS symptoms are severe and don’t respond to other medications. They also help reduce inflammation and pain.
3-DMARDS:
Disease modifying anti-rheumatic drugs are used to help slow down the inflammatory process. Examples include sulfasalazine and methotrexate. These drugs are used for long-term treatment.
Disease modifying anti-rheumatic drugs are used to help slow down the inflammatory process. Examples include sulfasalazine and methotrexate. These drugs are used for long-term treatment.
4- BIOLOGIC:
Biologic agents are used to block proteins that cause inflammation. Seven different biologics are approved for treatment ,example are
adalimumab (Humira),etanercept (Enbrel),golimumab (Simponi)
infliximab (Remicade)
Certolizumab.
Biologic agents are used to block proteins that cause inflammation. Seven different biologics are approved for treatment ,example are
adalimumab (Humira),etanercept (Enbrel),golimumab (Simponi)
infliximab (Remicade)
Certolizumab.
HEALTHY HABITS :
1-STAYING ACTIVE
stay as active as you safely can.iys one of the best things you can do for AS.
stay as active as you safely can.iys one of the best things you can do for AS.
2-KEEP YOUR WEIGHT UNDER CONTROL.
so you don't put extra strain on your back and joints.
so you don't put extra strain on your back and joints.
3-take calcium and vitamin D supplement.
4-avoid smoking
As smoker gets more severe form of spinal disease.
As smoker gets more severe form of spinal disease.
5-POSTURE
when you walk or sit don't slump.
Keep your spine straight ,shoulders square and head up
Chose hard upright chairs instead of soft cushy ones
Use a pillow behind your neck.
when you walk or sit don't slump.
Keep your spine straight ,shoulders square and head up
Chose hard upright chairs instead of soft cushy ones
Use a pillow behind your neck.
6-PHYSICAL THERAPY :
Individual tailored Exercise plan to ease pain and build strength and improve your range of motion
Use cold packs or icing for general pains and swelling .
In morning you can try hot shower and gentle stretches to ease stiffness
Individual tailored Exercise plan to ease pain and build strength and improve your range of motion
Use cold packs or icing for general pains and swelling .
In morning you can try hot shower and gentle stretches to ease stiffness
LONG TERM OUTLOOK:
1-when treated AS doesn't typically effect or limit your abilities.
However symptoms may come and go and often get better or worse.
However symptoms may come and go and often get better or worse.
2-In severe or advance cars it can cause deformity such as hunch- over posture or spinal fusion.
3-It's important to get a regular checkup by eye doctor if your vision is getting blurring or painful red eyes.
BOTTOM LINE:
IF YOU ARE HAVING ABOVE SYMPTOMS,GET IT CHECKED BY RHEUMATOLOGIST.
EARLY TREATMENT CAN PREVENT PERMANENT JOINT DAMAGE !
IF YOU ARE HAVING ABOVE SYMPTOMS,GET IT CHECKED BY RHEUMATOLOGIST.
EARLY TREATMENT CAN PREVENT PERMANENT JOINT DAMAGE !
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