Sometimes, you may think treating ankylosing spondylitis (AS) seems more trouble than it’s worth. And we understand. But at the same time, forgoing treatment can mean the difference between living a healthy, productive life and feeling left in the dark. Here are seven things that could happen if you bypass treatment.
AS mainly affects the spine. With repeated attacks of inflammation, your spine starts to lose its flexibility. As the disease progresses, moving your spine gets increasingly difficult. The less you move your spine, the stiffer it can get.
In the most severe cases, chronic inflammation causes the formation of extra bone between your vertebrae. In time, the vertebrae can become fused together. Once that happens, your ability to move is severely restricted.
Think about all the everyday tasks that require bending, stretching, or twisting. As for posture, curvature of your spine can leave you permanently stooped over. Fully straightening your spine is no longer possible.
AS medications are designed to control inflammation. Physical therapy can help keep your spine flexible. Following a complete treatment plan can help keep your spine flexible so you can avoid or delay this complication of AS.
Beyond this point, there are few options. A type of surgery called osteotomy might be able to straighten and support your spine. It’s a procedure in which a surgeon has to cut through your spine. For that reason, it’s considered high risk and is rarely used.
AS is chronic and progressive. Over time, it can fuse your spine and sacroiliac (SI) joints, which are in your hips.
For 10 percent of people with AS, inflammation of their jaw becomes a problem. It’s potentially debilitating because it makes it hard to open your mouth enough to eat. This could lead to malnutrition and weight loss.
About one-third of people with AS develop problems with their hips and shoulders. Some may have damage to their knees.
Inflammation can also occur where ligaments attach to bone. This can affect your back, chest, SI joints, and pelvic bones. It can also create problems for your heels (Achilles tendonitis).
These issues can cause chronic pain, swelling, and tenderness, and keep you from getting a good night’s sleep. They can interfere with everything from bending to the inability to turn your head while driving. Mobility becomes a growing problem.
Untreated spine problems can have a serious impact on your quality of life.
Treatment for AS can help prevent permanent joint damage and fusion. Once you have severe damage to your hips or knees, your options are limited. You may need surgery to replace your damaged hip or knee with a prosthetic one.
Another potential complication of AS is osteoporosis. This is a condition in which your bones become weak and brittle. It puts all your bones at risk of fracture, even without a fall or hard bump. This is particularly worrisome when it involves your spine.
With osteoporosis, you may have to curb some of your favorite activities. Regular visits with your rheumatologist will help identify osteoporosis as a problem early on. There are a number of effective treatments to help strengthen your bones and lower your risk of fracture.
Inflammation can also cause problems with your eyes. Anterior uveitis (or iritis) is a condition in which the front of your eye gets red and swollen. It’s more than a cosmetic problem. It can also cause blurry or cloudy vision, eye pain, and light sensitivity (photophobia).
Unchecked, anterior uveitis can lead to partial or complete loss of vision.
Sticking to your treatment regimen and having regular visits with your doctor will help catch anterior uveitis before your eye suffers permanent damage. Prompt treatment from an eye specialist, or ophthalmologist, can help protect your vision.
Because AS is a chronic inflammatory autoimmune disease, it increases your risk of cardiovascular disease. Cardiovascular disease includes:
- high blood pressure
- irregular heartbeat (atrial fibrillation)
- plaque in your arteries (atherosclerosis)
- heart attack
- heart failure
You can lower your risk of cardiovascular disease by adhering to AS therapy. This should include a balanced diet, regular exercise, and not smoking.
Because you’re at higher risk, it’s a good idea to see your doctor regularly. The sooner you catch the warning signs of cardiovascular disease, the sooner you can start potentially lifesaving treatment.
Chronic inflammation can prompt new bone growth and scar tissue where your ribs and breastbone meet. Just as it does to your spine, it can cause bones in your chest to fuse.
That makes it very hard for your chest to fully expand when you breathe. Chest compression can cause pain that worsens when you take a deep breath. Not being able to breathe easily strains even the simplest activity.
You can lower your chances of this complication by taking medications to control inflammation. A physical therapist can also help you perform deep breathing exercises to expand your ribcage.
Any of the complications listed previously can leave you with permanent disabilities. Having just one can lead to:
- inability to participate in your favorite physical activities
- mobility problems
- decreased ability to work
- loss of independence
- lower quality of life
The goal of AS treatment is to slow disease progression and prevent the types of complications that can lead to permanent disability. A rheumatologist experienced in treating AS can help devise a treatment plan based on your particular needs and preferences.