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What is Ankylosing Spondylitis
 
 
Ankylosing spondylitis is a long-term (chronic) disease of the spinal column that affects about 1 in 250 people, mainly young men. Spondylitis means inflammation of the spine, and ankylosing means that a joint has become fixed solid so that it cannot bend. It happens when the ligaments or tendons attached to the spine become swollen. When the swelling goes down, new bone grows, replacing the ligaments or tendons. If this process continues, the individual bones (vertebrae) that make up the spine (vertebrae) begin to fuse together, making movement difficult. In severe cases, some people lose all movement in the neck and spine. AS can come and go during a person’s life. Sometimes it may become very active, causing mobility problems for the patient. There can also be long times of inactivity, when the symptoms almost disappear. Over 90% of people with AS are fully independent, although many lose some movement of the spine. People with the most severe type of AS, may also lose movement of the ribs. This does not affect breathing.
To find out more about "AS" have a look at this site.> www.asresearch.co.uk

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Symptoms
 
AS usually starts with lower back pain and muscle spasm, which happen more and more often and are usually worse at night. This pain can spread to the upper back and neck or buttocks and hips. Symptoms may also include severe stiffness of the back, particularly early in the morning. This generally eases during the day with exercise, but can lead to a permanent, fixed curvature of the spine if the condition is not treated. As the disease progresses, fever, fatigue, loss of appetite and loss of weight become more common. The spine becomes less able to move freely, and smaller breaths are taken. Eventually, the chest may not be able to expand at all, forcing the person to breathe using the diaphragm and the muscles of the wall of the abdomen. In extreme cases the spine may become extremely stiff and sometimes no spinal movement at all is possible. AS can affect any joints and it is common to experience aching, pain and swelling in the hips, knees and ankles. It may also have a mild affect on the heart and lungs. Around one in three people develop a severe inflammation inside one or both eyes ( Iritis ), with blurred vision, dull eye-ache and redness, especially around the edge of the cornea (the outer covering of the front of the eye).
 

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Diagnosis
 
Diagnosis is based on the pain, stiffness and progressive decrease in the range of spinal movements. Your GP may refer you to a rheumatologist, (a doctor specialising in arthritis), who will study X-rays of your spine and look for characteristic changes to the joints in the lower back. A blood sample can also be taken to test for other possibilities such as rheumatoid arthritis, and for the HLA-B27 antigen.
 

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Treatment
 
Daily exercise to improve movement of the spine and posture is the best type of treatment. Two to fours hours a week of gentle stretching exercises or swimming is a good target. Consult you GP before starting any new exercise programme to make sure it will be beneficial to you. Hydrotherapy (physiotherapy in water) and physiotherapy may also be helpful in increasing movement. Drugs to control pain and diminish inflammation are usually prescribed for people with AS. The most useful group is the non-steroidal anti-inflammatory drugs (NSAIDs). Although some drugs can reduce the symptoms of AS, there are no drugs available at present that can slow or stop the condition. A small number of people with very severe AS will need surgery such as hip replacement operations. Surgery is not often used to treat severe spine deformity.

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Causes
 
The cause of ankylosing spondylitis is not known, however most people who are affected carry a particular antigen called HLA-B27. This antigen is inherited which explains why the condition runs in families. Symptoms of AS may appear following a long period of bed rest. It has also been linked to a group of symptoms known as Reiter`s Syndrome. These include iritis (or uveitis), which is inflammation of part of the iris; and conjunctivitis, which causes red and painful eyes.
 

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Complications
 
AS is commonly associated with an eye disorder (uveitis) in which the iris of the eye and the focusing muscle that surrounds the root of the iris become inflamed. Fortunately, this complication is not usually severe, and permanent damage to the eye can be prevented if specialist eye treatment is given. Joints other than the spine can also become swollen and osteoporosis is more common in people who have AS. This can mean that people who have AS are more likely to receive fractures of the spine, particularly as a result of impact such as in a road traffic accident.
 

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Prevention
 
There is not much that can be done to prevent cervical spondylosis, as it is part of the normal ageing process. It may be possible to prevent some of the symptoms by taking regular physical exercise and limiting activities that place pressure on the head, neck, and shoulders. The best exercises for the health of the cervical spine are low-impact activities, such as swimming, walking, or yoga. Prevention of neck injury (such as using the correct equipment and techniques when playing sports) may reduce the risk of developing cervical spondylosis. Good posture whilst standing, sitting, working at the computer, driving and sleeping will also help to prevent damage to the spine.
 

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Exercise & Posture
 
Exercise is the most important treatment. It is vital to have a good posture and a regular exercise routine. This helps to keep a full range of spinal movement, and to prevent your spine from `stiffening up`. Regular exercise is thought to limit the extent of any spinal deformity that may develop. Exercise may also ease back pain. A physiotherapist will usually advise on the types of exercise. The advice may include: * When sitting, keep your back straight and erect. Move your neck and back frequently. This may require changes to chair, desk, or work routines. * Every day lie face down for 20 minutes before getting out of bed. Do this again before going to sleep. This helps to stop the tendency for the spine to become fixed in a stooped position. * Sleep on a firm bed, preferably with a board under the mattress. * Exercises to maintain the full range of movement of your spine. * Breathing exercises to help maintain the full movement of your ribcage. Exercises should become a routine part of life. Aim for about 2-4 hours of exercise per week. Swimming is an excellent additional exercise.

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Medication
 
Anti-inflammatory painkillers An `anti-inflammatory` is usually prescribed for you to take when symptoms flare up. They reduce inflammation, and ease pain. However, they do not alter the course of the disease. An important part of these medicines is to ease pain so that you can do regular exercises without much discomfort. There are several different brands of anti-inflammatory painkillers. If one does not suit, another may be fine. Side-effects sometimes occur with these medicines. For example: * Stomach pain and bleeding from the stomach are the most serious. The risk of this is higher if you are over 65, or have had a duodenal or stomach ulcer. Stop taking the medicine and see a doctor if you develop stomach symptoms. * You may not be able to take anti-inflammatory painkillers if you have asthma, high blood pressure, kidney failure, or heart failure. Ordinary painkillers Painkillers such as paracetamol may be sufficient if symptoms are mild between flare-ups. You can also taker paracetamol in addition to an anti-inflammatory for top-up pain relief. Other medicines A specialist may advise other medicines if symptoms become severe. One is more likely to be needed if joints outside your spine become inflamed. * An injection of steroid medicine directly into a badly inflamed joint is sometimes needed to ease symptoms. * Other pain relieving medicines may be tried. For example, low dose antidepressants have a pain relieving effect separate to their action on depression. * Some medicines that are used to reduce joint damage in rheumatoid arthritis have also been shown to help in AS. For example, sulphasalazine and methotrexate. They seem to work best if non-spine joints are affected. They do not appear to help much if the spine alone is affected. A specialist may advise one in severe cases.

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Other Treatments
 
* TENS machines are sometimes used to ease pain. (These give tiny electrical currents into the affected area). * Heat, for example, a hot shower, may help to ease pain, particularly each morning. * Other physiotherapy treatments may help. For example, some people find regular massage is soothing. * About 1 in 20 people with AS need hip replacement surgery at some stage as the hip sometimes becomes badly affected. Rarely, surgery is needed to correct a severe spinal deformity.
 

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 What is the outlook (prognosis) for people with ankylosing spondylitis?
 
Although there is no cure for AS, the outlook is quite good. After an initial period of inflammation, the disease often settles down. Flare-ups of symptoms occur from time to time, but are often mild or moderate. About 9 in 10 people with AS have a good quality of life, remain fully independent, and develop little or no disability. Most people with AS are able to work full-time for the whole of a normal working life. Heavy manual work may become difficult though. In most cases, episodes of arthritis outside the spine, and/or eye inflammation do not occur, or only occur now and again. In a small number of cases these problems outside the spine recur frequently, or become severe. In most cases, regular exercise and medication keep symptoms away, or much reduced. However, about 1 in 10 people with AS have a severe form of the disease, and may become quite disabled over time.

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Kids Heath
 
This is a link to a health site for kids, if you are a parent it will be obvious why, if not I am posting it for those of you who work in health fields and/or do research for your websites and support groups. This site is purely for info-you won't have to subscribe or part with money- but includes recipes etc for kids/people with food intolerances and illnesses, ranging from Asthma and Eczema to Cystic Fibrosis. It has questions and answers, glossary of words with their meanings all aimed at children- so really easy to understand. I hope you find it of use, if not send it to someone who will.
http://kidshealth.org