Visual Guide to Ankylosing Spondylitis

Visual Guide to Ankylosing Spondylitis

What Is It?

This type of arthritis causes painful
inflammation in the spine. Over time, it may
make your vertebrae -- the small bones of
the spine -- fuse together. It can also
inflame other joints, like hips and knees,
and it can damage your eyes, heart, and
other organs. There's no cure, but
treatment and taking care of yourself can
often slow it down or prevent it from getting
worse.

Who Gets It?

Three times more men than women get
ankylosing spondylitis (AS), typically
between ages 16 and 35. It's more
common in people who are white, Asian, or
Hispanic. You're more likely to get it if one
of your parents or siblings has it. Most
people with the disease have a gene called
HLA-B27, though having this gene doesn't
mean you'll get AS. But you can't prevent it.



Low Back Pain

The classic symptom is pain and
stiffness in your hips and lower
back. It often gets better with
exercise and worse with rest, so it
may wake you up at night and feel
more intense in the morning.

Enthesitis

That's a big word for the pain and swelling AS can
cause where your tendons and ligaments connect
to bones. You're likely to feel this at the top of
your shinbone, the back or bottom of your heel, or
where your ribs connect to your breastbone.
When your ribs are affected, you may have
trouble breathing or it may hurt when you breathe
because you can't fully expand your chest.

Other Effects on Your Body

Since AS is a kind of arthritis, joints like
your hips, knees, and shoulders can also
hurt and swell. AS can lead to weak, brittle
bones (osteoporosis). Feeling drained of
energy is common, and you may have
anemia. You could lose weight because of
problems in your gut, such as colitis. AS
can cause inflammation that damages your
eyes, heart, and lungs, too.
Long-Term Outlook

When it's treated, AS doesn't typically affect
how long you'll live or limit your abilities too
much. Your symptoms may come and go,
and often get better and worse. Some
people will have more severe problems
related to the disease and its effects, such
as a hunched-over posture and vertebrae
that have grown together, which limit the
spine's movement.

When to See a Doctor

Symptoms usually show up slowly over many
months or years. They vary from person to person.
You should get checked out if your lower back, hips,
or bottom have been hurting more and more for a
few months, especially when the pain wakes you at
night or feels bad in the morning, or it gets better
with exercise and worse when you rest.
Go to an eye doctor right away if your vision is
blurry, your eyes are red and hurt, or light bothers
you.

Diagnosis

AS can take a while to confirm. Your doctor will
start by asking when your symptoms began and
what they're like. She'll check your spine's
flexibility, what positions cause pain, and your
breathing. You may get blood tests for
inflammation and the HLA-B27 gene, but they can
only offer evidence, not say for sure that you have
AS. X-rays and MRIs show spine damage, but
they may not catch it early.

Treatment

There's no cure for AS, but treatment can help
you keep doing your usual activities and living
your life by easing symptoms and holding off
more severe, long-term effects. The earlier you
begin, the better.
Rheumatologists are specialists who treat
arthritis and other diseases of the bones, joints,
and muscles. Depending on your symptoms,
you might need to work with other health
professionals, too

Medication

You usually start with nonsteroidal antiinflammatory
drugs (NSAIDs) -- like aspirin,
ibuprofen, and naproxen -- to help with
pain, stiffness, and swelling. Biologic drugs
work on your immune system to interrupt
the inflammation process. Other arthritis
drugs won't help your spine, but they may
lessen pain and swelling in other joints.

Healthy Habits

Stay as active as you safely can. It's one of the
best things you can do for AS. It will also help
keep your weight in check, so you don't put extra
strain on your back and joints. Eat less bread,
rice, and potatoes, and more lean protein,
vegetables, and fruits. Make sure to get plenty of
calcium and vitamin D for your bones. Avoid
smoking: It's not good for your body in general,
but smokers with AS tend to have more spinal
damage.

Posture

When you walk or sit, don't slump. Keep
your spine straight, shoulders square, and
head up.
Choose hard, upright chairs instead of soft,
cushy ones. A pillow behind your back can
give you support.

Bedtime

Use a firm mattress that has some give.
Avoid a lot of pillows. It's best to sleep on
your belly with no pillow, or on your back
with one thin pillow. Keep your legs
stretched out, rather than curled up

Physical Therapy

Treatment for AS often includes an
individual, tailored exercise plan to ease
pain, build strength, and improve your
range of motion. A physical therapist can
coach you on posture and sleeping, too.
Massage and other bodywork may help
with your comfort and flexibility.

Dealing With Your Aches

In general, use cold packs or ice for
swelling, and heat for stiff joints or tight
muscles. Tough to move in the morning or
when you go to exercise? Try a warm bath
or shower and then some gentle stretches.
If pain keeps you up at night, try an electric
blanket.

At Work

You'll need to adjust your surroundings to
encourage good posture. Avoid lifting, stooping,
and tasks that are awkward for your body. Use a
sit/stand desk so you can change positions
throughout the day. Take short breaks often.
If you're having a hard time, an occupational
therapist might be able to help you change your
movements and workspace, or show you devices
to make it easier to do your job.

Driving

For most people with AS, driving won't be a
problem. But if your range of motion is affected
and it's difficult to check to the side and behind
you, get extra-wide mirrors for your car so you
can see and be safe. Fit your headrest correctly -
- level with the top of your ears (or higher), with
as little distance between it and the back of your
head as possible. On longer trips, make regular
stops to get out and stretch

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