Ankylosing spondylitis is a form of arthritis, mainly affecting the sacroiliac joints, the spine, and nearby structures. In ankylosing spondylitis, the joints become inflamed and eventually stiff and immovable. The elastic cartilage disks between the vertebrae (bones of the spine) become dense, as does adjacent connective tissue. Bony connections form between the vertebrae. The lower vertebrae may become fused together, creating the appearance of a straight "poker spine," frequently accompanied by a curve in the upper spine.

Causes

The cause of ankylosing spondylitis is unknown, but there appears to be an inherited tendency toward the disease. The disease affects men ten times more often than women. People born with a certain trait in their blood, called HLA-B27, are more likely to suffer the disease.

Ankylosing spondylitis is predominantly a disease of young men, occurring most commonly between the ages of 15 and 40. The disease may progress slowly for 10 to 20 years and then stop or slow down.

Symptoms

Chronic low-back pain and stiffness is a chief sign of the disease; hip pain is also quite common, as is an inflammation of the eye known as anterior uveitis. Symptoms, such as low backaches, begin gradually. There may be morning stiffness and pain extending down the leg along the sciatic nerve, commonly alternating from one side to the other. The back pain and stiffness eventually affect the upper spine and sometimes the neck.

In up to one-third of the cases, large joints (such as those of the hips and shoulders) are affected. Knees and other smaller joints may be affected by symptoms matching those of rheumatoid arthritis. The heart is affected in approximately 3 percent of cases (after many years of disease), and inflammation of the lining of the eye occurs in about 25 percent of cases. As the disease progresses, it is more difficult for the patient to flex the back and expand the chest.

X-rays of the back-related joints -- especially those between the upper portion of the hip bone and the sacrum (the bony structure at the base of the spine) -- reveal changes typical of ankylosing spondylitis. A sign of advanced disease is "bamboo spine," in which bony bands around the disks cement the vertebrae together.

Treatment

Although there is no cure for ankylosing spondylitis, certain measures can lessen the effects of the disease. These include rest; breathing exercises; and exercises designed to help maintain posture and keep the back as flexible as possible. To prevent curvature of the upper spine, sleeping on the back on a firm mattress with a small pillow or no pillow is advised. Locking the fingers behind the head and pushing the elbows back as far as possible is a good way to straighten the upper back and stretch the chest muscles. Painkillers and anti-inflammatory drugs may be given.

Corticosteroid drugs are generally not prescribed because of side effects. Surgery is rarely needed.



This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.