Ankylosing spondylitis is a chronic inflammatory disease that causes pain and stiffness in the spine. The word “ankylosing” refers to the fusion of bones, and “spondylitis” means inflammation of the spinal vertebrae. Over time, AS can cause the small bones in the spine (vertebrae) to fuse, resulting in a loss of flexibility and a hunched posture.
Symptoms and Early Warning Signs
One of the key features of AS is inflammatory back pain, which is different from the more common mechanical back pain caused by injuries or overuse. Inflammatory back pain typically:
It worsens with rest. The pain is usually more intense in the morning after a night's sleep or after prolonged periods of inactivity.
Improves with exercise: Unlike mechanical back pain, AS pain often gets better with physical activity.
Is associated with stiffness: Morning stiffness lasting more than 30 minutes is a common symptom.
These symptoms often start in early adulthood, typically before the age of 45, and can persist for years before a diagnosis is made. Unfortunately, it takes an average of 7 to 12 years for many patients to receive a proper diagnosis.
The Importance of Early Diagnosis
Early diagnosis is crucial in managing ankylosing spondylitis. Delayed diagnosis can lead to irreversible damage, such as the fusion of the sacroiliac joints (where the spine connects with the pelvis), as seen in severe cases. This fusion can severely limit mobility and increase the risk of complications.
To diagnose AS, a rheumatologist will look for signs of inflammatory back pain, examine the patient for other symptoms (like heel pain or inflammation in other areas), and order imaging tests such as X-rays or MRI scans. Blood tests may also be done to check for the presence of the HLA-B27 gene, which is associated with a higher risk of developing AS.
Treatment and Management
The goal of treatment in AS is to reduce pain, improve function, and prevent or slow down the progression of the disease. The first line of treatment usually involves nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen. These medications can help reduce inflammation and relieve pain.
For patients who do not achieve sufficient relief with NSAIDs alone, biologic medications, particularly tumor necrosis factor (TNF) inhibitors, may be prescribed. These medications target specific pathways in the immune system to reduce inflammation and prevent joint damage.
In addition to medication, exercise is a critical component of managing AS. Regular physical activity, especially exercises that promote flexibility and strength, can help maintain posture and improve overall quality of life. Stretching exercises, yoga, and swimming are particularly beneficial for people with AS.
Why You Shouldn’t Ignore Persistent Back Pain
If you or someone you know has been experiencing persistent back pain, particularly if it’s associated with morning stiffness or improves with exercise, it’s important to seek medical advice. Early intervention can make a significant difference in managing ankylosing spondylitis and preventing long-term complications.
While AS is a lifelong condition, with the right treatment and lifestyle modifications, many people with AS lead full and active lives. Remember, it’s not just about managing pain—it’s about maintaining mobility and preventing further damage.
Ankylosing spondylitis is more common than many people realize, yet it often goes undiagnosed for years. Awareness is key to early detection and effective management. If you suspect your back pain might be more than a temporary discomfort, don’t hesitate to consult a healthcare professional. With the right approach, you can keep moving forward, no matter what life throws your way.
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