Ankylosing Spondylitis Diagnosis and Treatment

September 30, 2019
Most people with ankylosing spondylitis have the HLA-B27 gene. However, only some of them develop the disease.

Ankylosing spondylitis is a chronic inflammatory disease that primarily affects the facet joints. These joints tend to fuse, leading to a decline in mobility. As a result, the column becomes less flexible. It’s for this reason that’s people with this condition end up adopting a hunched forward stance.

Nobody knows exactly what causes this disease, but DNA plays an important role in its appearance. Most people who have ankylosing spondylitis have the HLA-B27 gene. However, only some people with this gene develop the disease.

The Symptoms of Ankylosing Spondylitis

A woman with back pain.
When a person has ankylosing spondylitis, some of their vertebrae fuse and it leads to stiffness and pain.

This rheumatic disease produces outbreaks of inflammation of the facet joints. However, there may be inflammation of other joints such as those in the shoulders, hips, knees or ankles.

The first symptoms of ankylosing spondyloarthritis include pain and stiffness in the lower back. However, these mainly occur in the morning and after periods of inactivity. Neck pain and tiredness are also frequent.

Some of the most commonly affected areas are the facet joints between the base of the spine and the pelvis and the hip joints. However, it can also affect the points where tendons and ligaments join the bones, especially those in the spine.

When there is ankylosing spondylitis, new bone forms as part of a body’s attempt to heal. This new bone reduces the space between the vertebrae. As a result, sections of both vertebrae fuse.

Then, those parts of the spine become rigid and inflexible. Fusion can also seize the rib cage and decrease the capacity and function of the lungs.

Read also: Five Exercises to Strengthen Your Spine

Ankylosing Spondylitis complications

Some of the complications of ankylosing spondylitis are:

  • Ocular inflammation (uveitis): This is one of the most frequent complications of ankylosing spondylitis. It causes rapid onset of eye pain, sensitivity to light and blurred vision.
  • Damage to the heart valves: This disease can cause problems in the aorta. The inflamed aorta can affect the shape of the aortic valve in the heart, which will alter the functioning of the valve.

Diagnosis

There are several identifiable symptoms of ankylosing spondylitis. These include:

  • Clinical symptoms such as lower back pain that lasts over three months. It may improve with exercise but doesn’t go away with rest. Also, you must take into account the limitation of thoracic expansion, as well as the mobility of the spine.
  • Radiological evidence of inflammation of the sacroiliac joints.

You may also like to read: How to Stretch Your Spine in Just Two Minutes

Depending on the criteria presented in the patient, an ankylosing spondylitis diagnosis will be either defined (through clinical criterion and a radiologist) or likely (in case a person presents 3 clinical criteria or 1 radiological one).

Blood and urine tests can help support the diagnosis by the presence in blood of the HLA-B27 antigen. They can also determine the intensity of the inflammatory process that may afflict a person.

Treatment for Ankylosing Spondylitis

An array of painkillers.
Painkillers soothe joint pain, along with rehabilitation and surgery.

The treatment of ankylosing spondylitis combines different pharmacological options and rehabilitation.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics. These are pharmacological treatments aimed at controlling pain and reducing or suppressing joint inflammation. As a result, the patient’s quality of life improves. Also, by relieving discomfort, they improve nighttime rest.
  • Disease-modifying drugs. These act on the immune system itself.
  • Biological drugs. Although these drugs do not cure the conditions, they do control the symptoms of this disease in many people.
  • Rehabilitation. You must do rehabilitation exercises continuously, together with pharmacological treatments. Physical and respiratory exercises improve spinal mobility and muscle strength.
  • Also, you should do gentle exercises that strengthen your back, like swimming.
  • Surgery. Surgery is rarely used, only the joints are badly damaged and mobility is nearly lost.

When you mix and match the possible treatments you can avoid stiffening. Also, they can help you prevent other muscle and locomotor function disorders.

We hope you’ve enjoyed this article. You might also enjoy reading about fibromyalgia and it’s treatment:

  • Castro Villegas, M. C., & Collantes Estévez, E. (2013). Espondiloartritis. Medicine – Programa de Formación Médica Continuada Acreditado. https://doi.org/10.1016/s0304-5412(13)70554-7
  • Estévez, E. C., Contreras, A. E., & Pérez, V. C. (2001). Espondiloartritis tratamiento actual y perspectivas futuras. Reumatologia.
  • Sanhueza Z., A., Prieto R., J. C., Weisz C., J., Leiter Herrán, F., Soto F., S., Chiang O., F., & Lira S., L. (2016). Espondiloartritis anquilosante: revisión de hallazgos imagenológicos en la columna. Revista Chilena de Radiologia. https://doi.org/10.1016/j.rchira.2016.11.004