If one likens the human body to a car, then a car engine is the heart, the gear box is the brain and bones make up the car frame and design. What about the wheels of the car? The body part in comparison is joints and muscles. The working of joints in tandem allows an individual to move any part of the body. What we tend to forget is that, unlike cars who need an annual tune-up once in a while, our bodies and the joints in them need care and rest. If it gets to pain or ache in a joint, well know that it is almost unbearable and can be non-stop. In this article, learn more about ankylosing spondylitis, a lower back disorder and its key symptoms.
What is Ankylosing Spondylitis?
Arthritis is a disorder which affects one or more joints and causes them to swell or inflame. There are over 100 types of arthritis, based on location of affected joints. Ankylosing Spondylitis is one such type, which affects the spine in the spinal joints (vertebrae). The sacroiliac joints (lower back, where the upper buttocks meet the tailbone) are also affected.
These areas become inflamed or severely swollen and the swelling can worsen over time. The spine can turn stiff and rigid. Such inflammation is called spondylitis. As the joints swell, they mesh and fuse together, a process called ankylosing. In severe occurrences, this can lead to a deformed spinal posture or formation, such that the individual's posture is stopped or bent-over. This condition can also spread to other body areas, causing inflammation and stiffness. It is known to affect the hips, heels, ribs and joints of the hands and feet. It can even damage organs like lungs and kidneys, but this is very rare.
What is the cause or who is at risk for the occurrence of symptoms? As of now, the exact cause for such a condition is not known. Research shows a genetic disposition to contracting this disorder, with the presence of an indicative gene HLA-B27. Individuals with that specific gene account for 95% of ankylosing spondylitis cases. But on the other hand, this gene is present in others too, who are not affected by this condition.
There is also a gender preference. Men have a much higher chance of getting this condition over women, by a ratio of 3:1. The symptoms of this disorder are more painful and severe with the male gender. In women, this condition affects the joints away from the spine, as opposed to the actual vertebrae, hence there is less pain and aches. Between 0.1-0.5 % of the American population is affected with ankylosing spondylitis.
Ankylosing Spondylitis Symptoms and Signs
The main symptoms of this disorder are:
- Stiff and rigid muscles in lower half of the body
- Aches and pain in the lower back, hips and buttocks
- Bent-over or stooped posture
- Walking and other activities is difficult due to rigid spine
- Fused muscles in the ribs result in difficult breathing
- Pain in the ligaments and tendons and other small joints
- Swollen and red joints and parts of the body, which are warm to touch
- Eye inflammation (uveitis and iridocyclitis) in some cases
- Feeling tired or fatigued
- Mild to high fever
- Loss of weight
Pain is the predominant sign of all ankylosing spondylitis symptoms. The extent and severity of pain varies from patient to patient. With lower back pain, the pain can radiate from the back to the buttocks and back of the thighs. Exercising or moving the body makes the pain ease, resting or lying down can make it worse.
In the morning, the body can get very stiff and the pain can be most severe at this time. A point to be noted with symptoms of this condition is their episodic nature. At times, there will be severe and acute pain for a period of time, to subside slowly into less pain and finally nothing at all. Such episodes or attacks are called flares.
Ankylosing Spondylitis Prognosis
Typically the onset of ankylosing spondylitis symptoms is young adulthood, from the age of 20 to 40. But they can appear in children above 10 years of age. Diagnosing this condition, even with obvious symptoms is difficult. The range of signs and their severity appears gradually and can fade back into remission. An X-ray of the spine and pelvic area can confirm the presence of fused vertebrae and change in spine formation. But such physical evidence is only possible in a later stage of the disease.
MRI scans and the Schober's test can detect this condition in the early stages. There is no cure for this disorder but easing of symptoms and reducing or limiting the progress of deformity are 2 ways to deal with the condition. A physician can prescribe non-steroidal anti-inflammatory drugs to ease pain and help with swelling. Other medicines include painkillers and immunosuppressant drugs. Surgery is conducted only if a joint is severely damaged and needs to be replaced.
Physical therapy and exercise designed for ankylosing spondylitis is highly recommended to prevent stiffness and keeping the body flexible with the proper posture. But any physical activities must be done with supervision by a trained professional, as certain movements can do more harm than good. Though this condition seems serious, with early detection and good treatment, its complications can be severely minimized and the affected individual can live a normal and complete life.