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Ankylosing Spondylitis - Treatment of Ankylosing Spondylitis

What is Ankylosing Spondylitis?

Ankylosing spondylitis is a form of arthritis that mainly affects the lower back. It causes inflammation and damage at the joints, and first affects the sacroiliac joints between the spine and the pelvis. It varies from intermittent episodes of back pain that occur throughout life to a severe chronic disease that attacks the spine, peripheral joints and other body organs, resulting in severe joint and back stiffness, loss of motion and deformity as life progresses. Ankylosing spondylitis affects about three hundred thousand Americans or 0.2% of the adult population. The hallmark feature of AS is the involvement of the joints at the base of the spine where the spine joins the pelvis - the sacroiliac (SI) joints. Ankylosing spondylitis course is highly variable, and while some individuals have episodes of transient back pain only, others have more chronic severe back pain. People of any age can develop AS, but it usually appears between the ages of 15 and 40. Since patients with spondylitis could easily hurt their rigid necks or backs, special care should be taken to avoid sudden impact, such as jumping, or falling

Causes of Ankylosing Spondylitis

Ankylosing spondylitis is relatively rare. The cause of AS is not known, but all of the spondylarthropathies share a common genetic marker, called HLA-B27, in most affected individuals. The disorder most often appears between the ages of 20 and 40, but can develop in children.

How is spondylitis diagnosed?

The diagnosis of spondylitis is based on several factors, including:

  • Presence of signs and symptoms as noted previously
  • Findings on physical examination and X-rays

Symptoms of Ankylosing Spondylitis

A person with ankylosing spondylitis commonly will feel pain or stiffness in the lower back, especially in the morning or after periods of inactivity. Most Common symptoms of thsi disease are -

  • back pain in the sacroiliac joint
  • Recurring inflammation in the eyes causing pain, redness, blurred vision, and sensitivity to bright light
  • can affect the entire spine
  • pain and tenderness in the thighs, hips and other joints of the torso.
  • Knees and ankles can be inflamed
  • Fatigue
  • Fever
  • Loss of appetite
  • Weight loss

Treatment of Ankylosing Spondylitis

Medical treatment consists of nonsteroidal anti-inflammatory medications. Indomethacin is most effective, while sulfasalazine may benefit those with more severe involvement. Peripheral joint arthritis may respond to methotrexate. Treatment usually includes physical therapy and exercise. A physical therapist will develop an exercise routine for you that probably will include range-of-motion and stretching exercises to help the spine remain flexible.

The treatment of ankylosing spondylitis involves the use of medications to reduce inflammation or suppress immunity, physical therapy, and exercise. Medications decrease inflammation in the spine, and other joints and organs. For those with severe disease who have inflamed joints, a drug called sulfasalazine can help manage the symptoms, and better control the disease. Sulfasalazine is one type of a family of medicines called disease-modifying anti-rheumatic drugs (DMARDs).


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