Ankylosing spondylitis is a form of arthritis that mostly affects the spine.
The effects of ankylosing spondylitis on the body systems
Although other joints can be involved, ankylosing spondylitis (AS) primarily affects your spine. In this particular type of arthritis, the joints and ligaments of your spine become inflamed. This can cause back pain and stiffness. In time, the bones may fuse together, making it difficult to bend and move. AS can affect other joints, and in some cases, it can damage your eyes, heart, or lungs.
According to University of Washington Orthopaedics and Sports Medicine, most people are diagnosed before the age of 35. The cause isn’t entirely understood, but some may have a genetic predisposition toward developing AS.
AS is a chronic disease, but most who have it continue to lead active lives. People with AS must pay special attention to posture and how they hold themselves. Daily exercise can help, and treatment generally revolves around symptom management.
The main area of inflammation is your spine, particularly your lower spine. Pain and stiffness are generally greater in the morning or after a long period of sitting. Moving around usually alleviates the symptoms. Over many years, AS can lead to curvature of your spine, resulting in a stooped posture.
Pain may also occur in your upper spine, neck, and even in your chest. Unlike some other forms of arthritis, AS usually doesn’t affect the fingers. According to the Spondylitis Association of America, about 10 percent of people with AS have jaw inflammation, which can get in the way of chewing.
Chronic inflammation can cause bones to fuse together, restricting your ability to move. If bones in your chest fuse, it could affect your breathing. In some cases, inflammation also occurs in other joints, such as your shoulders, hips, knees, or ankles. This can cause pain and reduced mobility.
Imaging tests, like X-rays and MRI scans, can clearly show areas of inflammation, and are useful diagnostic tools. Treatment revolves around reducing inflammation and easing pain. Early treatment may help prevent permanent damage to joints.
Maintaining a straight posture is key, even when you sleep. Choose a hard mattress and avoid thick pillows. Sleeping with your legs straight rather than curled is a good idea. Avoid stooping or slouching when standing or sitting.
In addition to medications, performing low-impact exercises regularly can help you maintain flexibility and reduce pain and stiffness. Swimming and other water exercises are often recommended for people with AS. Your doctor can advise you about what exercises may help, or refer you to a qualified physical therapist. A hot shower or bath can also help relieve soreness.
In severe cases, reconstructive surgery might be considered. But because this surgery may stimulate extra bone growth, its risks need to be carefully weighed against its benefits.
Over many years, severe cases of AS can result in the formation of scars in the bundle of nerves at the spine’s base. This can lead to problems such as incontinence, lack of bowel control, and sexual dysfunction.
AS is more likely to affect your eye than any other organ in your body. Eye inflammation is a problem for about one in three people with AS, according to National Health Service U.K. The result is pain of the eye, called iritis, which intensifies in bright light and can cause vision problems. You should report eye pain or vision problems to your doctor immediately. Blindness is a rare complication, but early treatment is required to help prevent permanent damage to your eye.
Integumentary system (skin, hair, nails)
In a rare number of cases, people with AS may also develop psoriasis. Psoriasis is an autoimmune skin condition that causes red, scaly patches of skin. These patches can appear anywhere on your body, but are more common on the scalp, elbows, and knees. Sometimes, skin can blister or form lesions. Symptoms include itchiness, tenderness, burning, and stinging. Topical medications can ease discomfort.
Some people with AS may develop anemia, or general fatigue, caused by a deficiency of red blood cells. Rarely, inflammation caused by AS can affect the area where your aorta and heart connect. This can cause your aorta to enlarge. People with AS are also at increased risk of cardiovascular disease, which can lead to angina, stroke, or heart attack.
You can lower your risk by seeing your doctor regularly if you have high cholesterol, high blood pressure, or diabetes. Try to maintain a healthy weight through a healthy diet and regular exercise. Avoid use of tobacco products.
A gene called HLA-B27 is present in many people with AS. This gene is found more often in Caucasians with AS than in those of other races. On the other hand, the gene can also be found in people who don’t have AS and never go on to develop the condition. A blood test, while not conclusive, can aid in the diagnosis of AS.
Only rarely does AS affect the lungs. Inflammation or fusing in joints where your ribs meet your spine can result in poor chest wall movement. You may have difficulty taking deep breaths.
A small number of people develop scarring or fibrosis at the top of their lungs. This can make it difficult to fight off respiratory infections and colds. People with AS shouldn’t smoke.
During a physical examination, your doctor can listen to your breathing to check for problems. Damage to the upper portion of your lungs can be seen on a chest X-ray.
Fatigue is a major problem reported by people with AS. This may be due to the efforts of fighting chronic inflammation. Sleep disrupted by pain may also be a contributing factor of fatigue.
Although AS doesn’t usually present a problem to childbearing, some medications used to treat AS may be harmful to an unborn baby. If you have AS and plan to have a baby, speak to your doctor about potential harmful effects of your medications.
Healthy lifestyle choices will help keep you in overall good health.