Ankylosing spondylitis is known by many other names: Bechterew’s syndrome, poker back, Marie Struempell disease, rheumatic spondylitis, spondyloarthritis. It is a chronic inflammatory disease that attacks the spine and the sacroiliac joints, causing arthritis. This can also cause inflammation of the eyes, bowels and other joints, and may induce fatigue, weight loss, and photosensitivity. Symptoms may eventually improve, or grow worse over time. In the latter case, new bones may grow in an attempt to heal the inflammations, causing rigid stiffening of the joints and spine. While this disease is more prevalent in men than in women – three times more men suffer from ankylosing spondylitis than women, though women take considerably longer to be diagnosed – it can also affect younger people as young as 15 years old and may exhibit some signs at even 10 years of age. As a matter of fact, people older than 40 will have a less likely chance of developing this kind of condition.
There is no exact known cause on how people contract ankylosing spondylitis, although heredity seems to be the key factor. More specifically, people possessing the HLA-B27 gene have an increased chance of developing ankylosing spondylitis. While only 6% of the population carry this gene, it is found in an overwhelming 93% of those suffering from AS.
When diagnosed with ankylosing spondylitis, doctors would often recommend their patients to a rheumatologist. There is currently no cure for ankylosing spondylitis, so majority of the suggested treatments revolve around lessening pain brought about by symptoms, as well as remedies to prevent deformities cause by the stiffening of the joints and spine. Physical therapy compounded by regular breathing exercises is the most common treatment. If able to, swimming, jogging, Pilates, and slow stretching exercises that include yoga, and tai chi are popularly recommended workouts, as well as proper back exercises. Proper sleeping positions and corrective posture is also common practice in therapy, where most patients are asked to lie face down on flat on their back on the floor for certain time every week, to maintain flexibility of the spine. Other alternatives towards treating ankylosing spondylitis also include applying hot compresses or heat on affected joints, and acupuncture, all of which lessens pain and promotes more joint mobility.
There are medications prescribed to treat ankylosing spondylitis, including nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs). corticosteroids, and tumor necrosis factor (TNF) blockers. NSAIDs are the most common drugs used, although DMARDs and TNFs can still be prescribed in cases of severe inflammation of the joints. Corticosteroids may also be prescribed for joint pain, but are limited due to their side effects. One new medical drug that can also be described is called biological response modifiers, or BRMs, which blocks certain parts of the immune system that contains cytokines, and has been known to slow down ankylosing spondylitis in some patients. BRMs however, also consequently decrease the immune system, and it is advisable to discontinue prescription of this drug if infections or fevers occur. For those suffering from severe, more advanced cases of ankylosing spondylitis, may require surgery, commonly for total hip joint replacement.
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