The Rheumatologist’s Role In Treating AS

Rheumatologists are uniquely educated to diagnose and treat AS and can also serve as educators to other physicians and patients about this disease. Rheumatologists in basic and clinical research are the leaders in improving our understanding and treatment of this disease.

Ankylosing Spondylitis Treatment

The severity of joint involvement and the degree of systemic symptoms vary greatly from one individual to another. Early, accurate diagnosis and therapy may minimize years of pain and disability.

Medical treatment consists of nonsteroidal anti-inflammatory medications. Indomethacin is most effective, while sulfasalazine may benefit those with more severe involvement. Peripheral joint arthritis may respond to methotrexate.

Rehabilitation therapies are essential. Proper sleep and walking positions, coupled with abdominal and back exercises, help maintain posture. Exercises help maintain joint flexibility. Breathing exercises enhance lung capacity, and swimming provides aerobic exercise. Even with optimal treatment, some people will develop a stiff or "ankylosed" spine, but they will remain functional if this fusion occurs in an upright position. Continuing care is critical. AS is a lifelong problem, and people often fail to continue treatment, in which case permanent posture and mobility losses occur.

Ankylosing Spondylitis Diagnosis

Delayed diagnosis is common because symptoms are often attributed to more common back problems. A dramatic loss of flexibility in the lumbar spine is an early sign of AS. Although most symptoms begin in the lumbar and sacroiliac areas, they may involve the neck and upper back as well. Arthritis may also occur in the shoulder, hips and feet. Some patients have eye inflammation, and more severe cases must be observed for heart valve involvement.

At times, AS may presage the development of inflammatory bowel disease, and some patients have fever, fatigue, weight loss, anemia, eye inflammation (called iritis), and more severe cases may involve heart valve dysfunction. Other disorders of the internal organs and bones mimic spondylarthropathies and must be distinguished. Laboratory evaluation may reveal an elevated sedimentation rate (an indicator of inflammation), anemia and a positive HLA-B27 assay. X-rays and bone scans may show characteristic changes.

Cause of Ankylosing spondylitis

The cause of AS is not known, but all of the spondylarthropathies share a common genetic marker, called HLA-B27, in most affected individuals. In some cases, the disease occurs in these predisposed people after exposure to bowel or urinary tract infections.

Ankylosing Spondylitis

Ankylosing spondylitis is a type of arthritis of the spine. It causes swelling between your vertebrae, which are the disks that make up your spine, and in the joints between your spine and pelvis. Ankylosing spondylitis is an autoimmune disease. This means your immune system, which normally protects your body from infection, attacks your body's own tissues. The disease is more common and more severe in men. It often runs in families.

Early symptoms include back pain and stiffness. These problems often start in late adolescence or early adulthood. Over time, ankylosing spondylitis can fuse your vertebrae together, limiting movement. Symptoms can worsen or improve or stop altogether. The disease has no cure, but medicines can relieve the pain, swelling and other symptoms. Exercise can also help.