Ask Your Doctor

You’ve been diagnosed with ankylosing spondylitis (AS), a form of arthritis that causes inflammation of the joints in the spine. But putting a name to your back pain is only the beginning. There’s still a lot to learn about taking good care of your spine and making the most of medical treatment. And the more you educate yourself, the better you’ll be able to manage your pain now and reduce serious problems in the future.

Below are 10 key questions to ask your doctor about AS. Add your own questions, and create a master list to take with you to your next appointment.

What do you need to know about my back pain?

The information you provide is crucial. It helps your doctor choose a treatment plan for you and gauge how well it’s working. Among other things, your doctor will want to know how long you’ve had pain, where exactly you feel it, when it feels better (such as after exercise), and when it feels worse (such as first thing in the morning).

Is there a medical test that can confirm my diagnosis?

A diagnosis of AS is based largely on your medical history and physical exam. There’s no single test that can tell for sure whether you have the disease. But in some cases, your doctor might recommend getting an X ray, CT or MRI scan, or blood test to confirm the diagnosis and rule out other conditions.

Could a problem other than back pain be due to AS?

The primary symptoms of AS are back pain and stiffness. However, the disease can also cause various other symptoms throughout the body. For example, it sometimes leads to pain in other joints, heel or chest pain, eye problems, and fatigue. If you have additional symptoms, ask your doctor whether they might be related to AS.

Which type of medication do you recommend for me?

Treatment for AS usually involves taking medication. But several different classes of drugs are available, and one may work better for you than another. If your doctor prescribes a medication, make sure you know which class it falls into (for example, nonsteroidal anti-inflammatory drug, tumor necrosis factor inhibitor), how it works, and why it’s the best choice in your situation.

What are the risks and benefits of this medication?

If you’re prescribed medication, also make sure you know how much to take, when to take it, and whether there are any special precautions to follow. In addition, you should understand what benefits to expect, what side effects to watch for, and when to call your doctor about problems.

Which kinds of exercises should I be doing?

When you have AS, exercising and stretching play a key role in managing your pain and maintaining your flexibility. Both strengthening and range-of-motion exercises are important. Ask your doctor for recommendations on specific exercises and activities. At times, a referral to a physical therapist may be helpful.

What steps can I take to maintain good posture?

Practicing good posture is another integral part of managing AS. Your doctor or physical therapist can recommend exercises to help maintain good posture. In addition, make sure you know how to monitor you posture so you can detect any changes early, before your spine becomes fixed in an abnormal position.

What else can I do to take care of my spine?

Your overall lifestyle affects the health of your spine. For example, if you’re overweight, losing a few pounds can take some stress off painful joints. If you smoke, quitting can make it easier to breathe, which is especially crucial if your lung capacity is already limited by AS-related changes to your ribcage. Talk with your doctor about healthy lifestyle changes that help you live well with your disease.

What is the outlook for my health in the future?

AS is a progressive disease, which means that it tends to get worse over time. However, it may sometimes be possible to prevent or delay this progression, especially if you start treatment early. At any stage, treatment can also help relieve pain and improve quality of life. Ask about your doctor’s treatment goals for you.

Where can I find more information and support?

Your doctor may be able to recommend local resources and support groups. Other reliable sources of information include the Spondylitis Association of America (www.spondylitis.org, 800/777-8189) and Arthritis Foundation (www.arthritis.org, 800/283-7800). When it comes to living with AS, knowledge really is power.