Everything You Need to Know About Ankylosing Spondylitis

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Ankylosing spondylitis is a kind of arthritis that affects the backbone. In extreme cases, the backbone will get swollen, leading to prolonged pain and eventually deformity. The disease can progress to such an extent that an extra bone will start growing on the backbone. This can lead to your back getting distorted.

You might experience symptoms in other parts of your body. This includes experiencing pain and stiffness on your bigger joints, like on your hips, knees, and even shoulders.

Ankylosing Spondylitis Signs

The signs of this disease will depend on the individual that is affected. Mostly, you will experience swelling outbreaks followed by regression.

One of the most popular signs of this disease is getting backache in the morning and during night time. You might also feel sore on your hip joint and shoulder joints.

Other signs of this disease include:

  • Feeling stiff early in the mornings
  • Bad body posture or your shoulders might stoop
  • Fever
  • Exhaustion
  • Loss of weight
  • Loss of appetite
  • Anemia
  • Your lungs won’t work at full capacity

Ankylosing spondylitis primarily causes swelling in the body. This can have an effect on other parts of your body. Other symptoms that you might experience include:

  • Swelling in your bowels
  • Swollen eyes
  • Achilles tendonitis
  • Swollen heart valves

It is not just your backbone that will get affected, but other body parts as well.

Ankylosing Spondylitis Causes

There’s no known cause of Ankylosing spondylitis.

There is a chance that this disease is inherited since it runs in families. In case any of your parents or siblings have this condition, there is a 10-20% chance that you will also get this disease as compared to someone who does not have a family history of this condition.

Risk Factors

Genetics

You are at risk of acquiring this disease if someone in your family has it. In addition, if you have the HLA-B27 protein in your body, you are more likely to get this disease. A research study that was conducted in 2002 showed that over 90% of people who have this disease have the gene that manufactures this protein in their body.

Age

Signs of this disease will be first seen in individuals when they are between 20 to 40 years old. This is in contrast to other arthritis diseases, which are mainly diagnosed in older people.

Gender

Men are three times more likely to get ankylosing spondylitis as compared to females. However, even women can get this condition as well.

Race

It is mostly Caucasian people who get this condition. A small number of blacks and other races can get this condition as well.

Ankylosing Spondylitis Treatment

Ankylosing spondylitis cannot be treated. Treatment focuses on managing the pain and symptoms experienced and minimizing chances of getting disabled. If this condition is diagnosed in its early stages and timely medical intervention made, then there are high chances of slowing down its progression and even preventing deformity from happening.

Drugs

In order to keep swelling under control and pain, you will need to use Nonsteroidal anti-inflammatory drugs (NSAIDs). This includes drugs like naproxen and ibuprofen. The advantage of these drugs is that they will act for a long time on the body and they have minimal side effects.

In case the pain is too much for NSAIDs to help, then the doctor will prescribe stronger painkillers for you. The doctor will most likely prescribe Corticosteroids for short-term relief. It will help to reduce swelling and slow down damage to the backbone.

The doctor might also prescribe Tumor necrosis factor (TNF) inhibitors. This medication prevents your body from getting swollen. It also helps to minimize soreness and stiffness. TNF inhibitors will mainly be prescribed when NSAIDs are no longer effective for you.

Disease-modifying antirheumatic drugs- DMARDs -can also be used as a last resort in extreme cases. This medicine slows down the progression of this disease and prevents symptoms from getting worse.

Surgical Operation

In case you have extreme deformity either on your hips or joints, you might need to undergo a surgical operation to replace your joints. Also, if you have poor body posture as a result of your bones getting joined together, you will have to undergo osteotomy. In this case, the doctor will cut up the bones and then straighten them up in line.

The treatment used will mainly depend on how bad the disease is and how extreme the symptoms are.

Home Remedies for Ankylosing Spondylitis

You can use alternative treatments to help you deal with the symptoms of Ankylosing spondylitis. This is in addition to the medical treatments that you are already getting. Before you start using any home remedy, it is advisable that you talk to your doctor first.

Exercise

Working out on a regular basis can help to ease the symptoms experienced. Do strength training, as well as motion exercises. These exercises will make your joints stronger, as well as increase your flexibility. It might be best for you to consult a physical therapist so that they can show you the correct way to exercise, so as to get maximum results.

Better Posture

You might develop bad body posture as a result of ankylosing spondylitis causing your spine to become stiff. This can eventually cause your bones to get attached together in a sagging position. Try as much as possible to use correct posture all the time, so as to reduce chances of getting bad posture.

Since this is something that might have happened over many years, it might be challenging for you to remember to use the correct postures. Therefore, it is best that you use reminders. Also, use pillows and cushions to support your posture.

Acupuncture

Acupuncture is a great remedy for pain and other symptoms experienced when you have ankylosing spondylitis. It triggers hormones that provide pain relief.

Hot and Cold Therapy

You can use ice packs to help reduce swelling in joints. Taking a hot shower can help to ease stiffness in the joints and the backbone. Alternatively, you can use heat packs.

Massage Therapy

Massage therapy is quite good in helping you to enhance your suppleness and range of motion. It is also quite relaxing. Let your masseuse know that you have ankylosing spondylitis. This will help them be gentler on areas where your backbone might be sore.

Quit Smoking

Males, especially those who smoke are more likely to get ankylosing spondylitis. When you stop smoking, you will minimize the damage caused by ankylosing spondylitis. Your health will also greatly improve.

Transcutaneous Electrical Nerve Stimulation Therapy

Transcutaneous electrical nerve stimulation (TENS) therapy excites your nerves through the use of electricity. An electrode node from the TENS machine will be placed on the area where you are experiencing pain. Your physical therapist will show you how to use the TENS machine so that you can use it on your own at home.

Alexander Method

Use the Alexander method to draw attention to your body posture throughout the day. This will help you to remember to strike the right posture at all times. It will also show you the correct postures.

How to Get Better Sleep

If you have ankylosing spondylitis, you might find it hard to sleep at night. This is because your pain might tend to get worse, as your bed and beddings might be uncomfortable. When sleeping on your side, your mattress should allow your back to be in a straight line and when you are lying on your back; your spine should be in an S shape.

Here are some things you can do to get better sleep:

  • Use a mattress with medium firmness. This can help to shape your backbone.
  • Use pillows to support your neck, such that your body will be properly aligned.
  • Heat therapy can be used before bed, to ease the pain.
  • Avoid placing a pillow in between your legs when you are sleeping.
  • Medical treatments

You can use medical treatment to help reduce swelling, pain, and stiffness. There are various medicines that you can use.

You can use NSAIDs to minimize pain. NSAIDs include ibuprofen, aspirin, and naproxen. The doctor will prescribe Corticosteroids in case your symptoms are not improving even after you have been placed under medication. Corticosteroids minimize pain and swelling. in order for you to get relief from pain fast, the Corticosteroids will be injected directly onto the affected joint.

Long-term treatment options include the use of anti-rheumatic medications to decelerate progress of the disease. This includes medicines like methotrexate and sulfasalazine.

You can also use Biologics to minimize swelling by blocking substances that cause swelling. Here are the biologics that have been approved for treating for ankylosing spondylitis by the U.S. Food and Drug Administration:

  • Humira- adalimumab
  • Inflectra – infliximab
  • Enbrel – etanercept
  • Remicade -infliximab
  • Simponi – golimumab
  • Cosentyx -secukinumab
  • Cimzia – certolizumab pegol

These medicines are usually administered intravenously or injected into the body.

Nutrition

There is no specific diet that you should be on if you have ankylosing spondylitis. However, it is advisable that you eat a healthy and balanced diet. You should include a wide variety of foods in your diet so that you can get lots of vitamins and minerals.

Takes foods such as:

  • Foods that have lots of omega 3 fatty acids. This includes some oils, fish, and nuts.
  • Lots of different kinds of vegetables and fruits
  • Whole grain foods like quinoa,
  • Foods that have live cultures, such as yogurt

Foods that you should minimize from your diet include salt, sugar, and fat. This means that you should stay away from foods that have been processed. This includes canned, boxed and bagged foods that have preservatives and trans fats. This is because such foods can worsen the swelling in your body.

If possible stop taking alcohol or minimize how much of it you take. This is because alcohol might inhibit the medications that you are taking and hamper how they work. In addition, alcohol can worsen your symptoms.

There are some supplements and foods that can make your symptoms better or make them worse.

Can Exercises Help with Ankylosing Spondylitis?

Working out on a regular basis is recommended as it will help you stay supple, plus increase your range of motion.

Here are some great exercises to do if you have ankylosing spondylitis:

  • Yoga
  • Meditation
  • Swimming
  • Posture
  • Stretching

Diagnosing Ankylosing Spondylitis

You will need to consult a rheumatologist if you have arthritis. This is the doctor who will diagnose whether you have this condition or not.

The first thing that this doctor will do is to thoroughly examine you physically. He will ask about the symptoms that you are experiencing and your medical history.

Then you will have to take an x-ray to diagnose whether your backbone has any problems and if there is any bone damage. Every painful joint that you have will also be x-rayed. In case the disease is just starting out, then it can be hard to observe any damages on the backbone. The doctor might also want you to undergo an MRI scan.

You will also have to undertake a blood test known as erythrocyte sedimentation to check if there are any signs of swelling. you can also check if you have the protein HLA-B27 in your blood. Just because you test positive for HLA-B27 does not mean that you have ankylosing spondylitis, it just means that you possess the gene that manufactures this protein.

It can be hard to diagnose this condition.

Ankylosing Spondylitis Complications

If you don’t get immediate treatment when you have ankylosing spondylitis, then there are several complications that might come up.

These are:

  • Due to swelling in the backbone, your bones might get joined together
  • The swelling on your backbone might extend to your shoulders and even hips
  • The swelling might affect your tendons, ligaments. This might make you stiff
  • You will have trouble breathing
  • Your eye might get irritated
  • Damage to your lungs, bowels, and heart
  • Your spine might get fractured

When you have this condition, get treatment for pain in your lower back and prolonged stiffness in your joints.

Can Ankylosing Spondylitis Be Prevented?

Since there is no known cause for ankylosing spondylitis, it’s hard to know how to prevent it.

Nevertheless, if you have been diagnosed with this condition, you can take certain steps to minimize the chances of getting infected:

  • Eat a healthy and balanced diet
  • Exercise and lead an active lifestyle
  • Try not to be overweight or underweight

Taking these measures can help to slow down the disease.

The Outlook for People Who Have Ankylosing Spondylitis

Ankylosing spondylitis tends to get worse with time and might eventually lead you to become disabled. This is a prolonged condition which cannot be cured.

You can slow down the progress of the disease through exercising, using medicines and exploring alternative treatments. This will slow down the swelling and damage done to the body but it cannot permanently stop it. In addition, you can improve the symptoms experienced by working out regularly, drugs and physical therapy.

In case you have prolonged backache, it is best that you talk to a doctor, so that they can diagnose what is causing it. It could be ankylosing spondylitis. Once the cause is established, the doctor will then formulate a treatment plan.

Start treatment as early as possible, so as to slow down any damage that might be done to the body.

Things You Should Never Say to Someone Who Has Ankylosing Spondylitis

It is hard to know the proper thing to say when you encounter a friend or family who has a condition that you do not know much about, leave alone a condition that you have never even heard about. Saying the wrong thing can hurt the person, even if you had no ill will towards them.

Here is a guide on what to say and what not to say when talking to someone who has ankylosing spondylitis.

What is That?

Given that just 0.2% to 0.5% of people in the US might have this condition, chances are that you might have never have heard of this disease before. However, bluntly asking your friend what that it is can invalidate their feelings or make them feel as if you think that they have made up the disease and this can hurt their feelings.

In case there is no time for you to research, then ask your friend to politely explain to you more about the condition.

You Don’t Look Sick!

The symptoms of ankylosing spondylitis might not be so obvious. Even though these symptoms, like pain, exhaustion and fatigue might not be displayed, they are still there and causing suffering to the affected person.

The pain experienced might be too much such that your friend might cancel out on any plans that you have made together. Therefore, try and understand them when they explain to you that they might be stiff, in pain or just sore.

Isn’t That a Disease for The Aged?

You can get ankylosing spondylitis at any age and not necessarily when you are old. Even children can get it as it might be genetic.

Unlike arthritis, ankylosing spondylitis does not just affect the joints in the body, but it also affects other organs of the body, such as the lungs and eyes.

Can’t You Just Use Painkillers to Get Rid of The Pain?

Patients with ankylosing spondylitis can use NSAIDs such as ibuprofen and naproxen for pain relief. However, these might not be strong enough for all patients. You might need to use biologic drugs such as TNF blockers or interleukin 17 inhibitors for treatment.

I Know Someone with Ankylosing Spondylitis and It’s Not That Bad

Everyone responds differently to this condition. There are some people who might experience severe pain and become incapacitated. Other people might have a mild form of this disease to the extent that they are not affected by it; therefore, avoid comparing two individuals who have the same condition. Rather, ask the individual how the ankylosing spondylitis affects them.

Here is What You Should Do…

If you are not a medical doctor, desist from giving people medical advice. Since there are a number of proven treatments, it is not wise to recommend a questionable herbal remedy to a patient. This might fail to work or might even prove to be dangerous.

Don’t Worry, You’ll Be Okay

There is no known cure for this disease and it is hard to predict the course this disease might take. In addition, the patient is doing everything they can possibly do so that they can recover fast.

Therefore, instead of telling them that they will be fine, yet you have no way of verifying this, offer them your support. For example, for those days when they are down, help them with cleaning or their grocery shopping.

At least You Don’t Have to Go to Work!

Due to the pain and stiffness felt, people who have ankylosing spondylitis miss 10 days of work annually on average. It might not be as fun as you think to stay home and watch TV yet you have to provide for yourself as well as work to afford health insurance. According to research, at least 50% of people with ankylosing spondylitis have job insecurity.

Don’t Think About Ankylosing Spondylitis

It is quite hard not to think about ankylosing spondylitis if it is making you stiff and leaving you in constant pain.

Are You About to Die?

This is quite an insensitive question, given that ankylosing spondylitis is not even fatal even though it can cause a great deal of pain and suffering and disability, death is definitely not on the forefront for someone suffering from this condition. There are rare chances that you might develop complications, such as heart or lung problems, that can lead you to die early. It’s possible to live a long life with this disease.

What Are Biologics for Ankylosing Spondylitis?

Biologics are proteins that have been genetically engineered. They have been developed from biological organisms that have been designed to imitate human biological functions. This is a targeted therapy that is directed towards proteins in the immune system that causes swelling. These proteins are known as tumor necrosis factor –TNF- and interleukin 17- IL-17.

The US Food and Drug Administration approved the first biologic in 1988. It was used to treat rheumatoid arthritis. Multiple other biologics have been developed since that time. At the moment, there are six biologics that have been approved for use by the US Food and Drugs Administration.

They are:

TNF blockers

  • Enbrel
  • Humira
  • Cosentyx
  • Cimzia
  • Remicade
  • Simponi, Simponi Aria

Interleukin 17 (IL–17) inhibitors

How Are Biologics Administered?

Biologics are administered either just under the skin or deep into the muscle. They are injected or infused into the body.

How frequently you need the injections or infusions will largely depend on the specific biologic therapy you are on. You might get infused after every couple of months. Alternatively, you might get a number of starter injections and then get follow up injections later in the year.

You should be able to observe improvements within 4 to 12 weeks of getting started on biologics. The main aim of biologics is to suppress your symptoms so that you can live a normal life.

What’s the Right Biologic Therapy for Ankylosing Spondylitis?

There are different kinds of biologics and you might respond differently to them. Your doctor can always switch to another one if there is no improvement observed after you have been on one for a couple of weeks. However, you cannot use two or more biologics simultaneously. But you can use biologics with other kinds of medicines like DMARDs and NSAIDs.

Biologics for AS Side Effects

Here are some of the side effects that you might experience when using biologics:

  • Soreness
  • Pain
  • Bruising where you got injected
  • Increased risk of cancer and infections as they suppress the immune system

In most cases, the symptoms experienced are not extremer and might disappear after a while. But be sure to let your doctor know about the side effects you are experiencing. The doctor should test you for tuberculosis, hepatitis B, and C.

In case you notice that you have contracted an infection after your ankylosing spondylitis treatment, consult your doctor.

Signs of infection include

  • Chills
  • Fever
  • Coughing
  • Shortness of breath
  • Losing weight
  • Feeling tired

Will Biologics Work for You?

You are not guaranteed that biologics will work for you. However, there are some factors that increase the chances of success.

These include:

Did Other Medications Work For You?

Use biologics if you have a moderate or extreme case of ankylosing spondylitis and other medications have not worked for you.

Biologics are usually not prescribed at first but after the doctor has already tried other remedies first.

By making lifestyle changes, ankylosing spondylitis might get better. This includes exercising, stress management and losing weight.

Can You Stick to The Treatment Plan?

You cannot take the drug orally, rather, you will have to get infused or injected. Infusions will have to be done at the doctor’s office a couple of times in a year. Based on the specific medication that you are using, you can inject yourself every one to two weeks.

In order for this treatment to work, you must be consistent. Stopping treatment can lead you to develop the symptoms again. This is because biologics target specific proteins in your body that cause swelling and pain in the body. Therefore, to keep these proteins suppressed, you must stick to your treatment schedule.

You should realize that the work of biologics is not to cure ankylosing spondylitis since there is no cure for this condition.

Should You Take Other Drugs When You are on Biologics?

If you are undergoing targeted therapy, your doctor might recommend that you just take biologic alone or that you combine it with another drug. You can take a biologic together with an antirheumatic drug but you should not take two biologics at the same time.

Who Shouldn’t Take Biologics?

This treatment is quite effective but it is but suitable for everyone.

Biologics do not suppress your entire immune system; however, they can still weaken your immune system and increase your chances of getting infected. In addition, it might be harder for you to recover from disease if you are using biologics.

If your immunity has already been weakened, let’s say you have HIV or cancer of hepatitis C, then your doctor will not put you on biologics. This is because it might make your infection worse. Therefore, in case you are sick, it is best that you wait until you have recovered before you start treatment.

Also, if you use biologics for a long period of time, you greatly increase your risk of getting cancers, like lymphoma. Once you start using biologics and then you develop cold or flu or weight loss, bruising and exhaustion, be sure to consult your doctor, especially if your symptoms are not improving.

Conclusion

In case you notice stiffness or pain in your joints, it’s best that you see a doctor about this. Don’t ignore these symptoms.

When you get ankylosing spondylitis, it can make you become immobile and resulted in ongoing pain. In case you neglect treating this disease, then your condition will deteriorate and your symptoms will get worse. The good thing is that if you get treatment on time, then you can control this disease. However, it is vital that you use the right biologic and that you stick to the treatment plan that your doctor has put in place for you.

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