It is a musculoskeletal condition defined as arthritis of the spine and pelvis. It predominantly affects the spine leading to fusion of the bones over a period of time leading to pain and stiffness resulting in loss of movement in the back. Due to the presence of structural changes, functional changes become imminent which may end up reducing the quality of life if not managed in the right way.
Certain blood tests and an X-ray help in identifying and confirming the diagnosis of Ankylosing Spondylitis. The blood work indicates the presence of HLAB27, and the spine X-ray shows reduced curvature. In advanced stages, the spine appears to be straight on the X-ray which is called a bamboo spine.
There is no reasoning as to why this condition arises. The exact cause of ankylosing spondylitis is unknown, but researchers believe it to be a result of a combination of genetic and environmental factors.
How does a patient with ankylosing spondylitis present? What are the signs and symptoms to look out for??
Slow onset of pain present in the lower back and buttocks progressing towards the entire spine.
The age group below 45 years. Occurs mainly in males (15-30yrs)
Symptoms being present for more than 3 months
Early morning stiffness makes it difficult to move for not less than 30 minutes
Stiffness is noticed after a long period of rest, but movement makes it better
Nights are painful and difficulty is noticed in trying to change positions in bed after being in one position for a long
As the condition advances, it starts to affect the eyes along with pain and stiffness in the hip and knee joints. Once the mid back starts to become stiff, people may experience difficulty in breathing due to a reduction in overall chest expansion.
At the moment there is no cure for ankylosing spondylitis, but there are treatments that help in controlling the symptoms and slow down the progress of the condition thus improving quality of life.
Treatments include non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, Exercise, and maintaining good posture.
Physiotherapy plays a major role in managing this condition as it not only helps in delaying the progress of the condition but also helps to manage the daily activities of a person with modifications.
During the earlier stages of the condition, more painful episodes are seen due to an increase in the inflammatory markers in the body, during this period medications along with pain modalities, hot packs, and mild range of motion exercises can be given.
As the condition progresses the painful episodes become less, and stiffness starts to set in. During this time the physiotherapists will suggest stretches for the tight structures, strengthening exercises targeting the core, and functional exercises to keep the axial structures stable.
Ergonomic advice and postural corrections must be followed so that as and when the spine fuses, it does so in a manner that doesn’t limit too much of mobility and the range of motion can be retained. Movement is better than stationary positions in this condition.
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