Ankylosing Spondylitis

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  • What Is Ankylosing Spondylitis?

    Ankylosing spondylitis (AS) is a type of arthritis. It causes inflammation of the joints of the spine resulting in pain. AS often affects the joint where the spine and pelvis meet. No one knows what causes AS, but genes are involved. People inherit genes that make them more likely to get this condition. Then, an unknown trigger, possibly an infection starts the disease process.

  • Who Is at Risk?

    About 2.7 million American adults have AS, according to the Spondylitis Association of America. AS is most common in young men. The condition usually starts between ages 17 and 45. However, women and children can also get AS. People who have the HLA-B27 gene and a family history of the disease are more likely to get AS. However, you don’t need the gene to have AS, and some people who do have the gene never get the disease.

  • Sacroiliitis

    The most common symptom of AS is sacroiliitis. The sacroiliac joints are located at the spine’s base, where it connects to the pelvis. In sacroiliitis, this joint becomes inflamed, causing pain in your lower back and buttocks. It can even cause pain in your legs. This pain can worsen if you stand for a long period of time. If your doctor suspects AS, they will likely check for sacroiliitis.

  • Hunched Over

    When ankylosing spondylitis is severe, the vertebrae of the spine can grow together and fuse into one. The fused bones may force the spine into a forward curve. This is called kyphosis. As the spine curves, the back curls into a stooped-over position. People with severe AS may be so bent over that they have trouble even lifting their head. Fortunately, treatment advances have made kyphosis less common.

  • Pain and Stiffness

    AS affects the spine, but it can also cause pain and stiffness in other parts of the body including the hips, lower back, neck, and shoulders. Pain and other symptoms of AS start slowly. In fact, you may not notice them at first. But they can get worse over time, and the pain may come and go. Or you may be in constant pain. Some people notice the stiffness in the morning when they wake up.

  • Fractures

    AS may also be accompanied by osteoporosis (OP), even in the early stages of AS. Over time, the bones can become brittle and more likely to fracture. If the fractures are in your spine, the vertebrae may collapse and cause your back to bend forward even more than it already does. Some fractures can even compress nerves in the spine.

  • Painful Eyes

    One of the most common side effects of ankylosing spondylitis involves the eyes. In a condition called uveitis, the eyes can swell up, causing pain, blurred vision, and sensitivity to bright light. They may also get very red and watery. Uveitis is a serious side effect. Call your doctor for an appointment right away if your eyes start to bother you.

  • Trouble Breathing

    When you breathe, your lungs expand. The ribcage that houses and protects your lungs expands slightly to accommodate the expansion. If the joints of your ribs are inflamed from AS, their movement may be restricted. You may feel pain when you breathe. And, you probably won’t be able to inflate your lungs all the way. This will make it hard for you to catch your breath.

  • Fatigue

    Fatigue is one of the biggest complaints people with AS have, according to the Spondylitis Association of America. It takes a lot of energy for your body to deal with the inflammation AS causes in your body. Also, the pain of AS can make it hard for you to sleep. Some people with AS have anemia—too few of the blood cells that transport oxygen to the body. All of these things may make you feel more tired than usual.

  • Seeing a Doctor

    Because AS is a type of arthritis, you’ll see a doctor called a rheumatologist to treat it. To find out whether you have AS, you’ll have an exam. The doctor will ask about your symptoms and will check your back. You may also have tests, including X-rays or MRI scans to look at your spine from the inside. A blood test can find out whether you have the HLA-B27 gene.

  • Manage the Pain

    There is no cure for AS, but treatments can reduce pain and help you feel better. You can take medications such as NSAIDs (aspirin, ibuprofen). Or there are also drugs called DMARDs that slow the disease and reduce swelling in the joints of the spine. Stretching and exercising can help with stiff joints and improve your movement. Sometimes a damaged joint may need to be replaced with surgery.

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