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
___________________________________________________
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).
___________________________________________________
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.
___________________________________________________
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.
___________________________________________________
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.
___________________________________________________
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.
___________________________________________________
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.
___________________________________________________
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.
___________________________________________________
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.
___________________________________________________
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.
___________________________________________________
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.
___________________________________________________
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