What is Ankylosing Spondylitis (AS)?
AS is a disease which causes inflammation and pain in your spine. AS is an inflammatory disease that, over time, can cause some of the bones in the spine, called vertebrae, to fuse. This fusing makes the spine less flexible and can result in a hunched posture. If ribs are affected, it can be difficult to breathe deeply.
Axial spondyloarthritis has two types. When the condition is found on X-ray, it is called ankylosing spondylitis, also known as axial spondyloarthritis. When the condition can’t be seen on X-ray but is found based on symptoms, blood tests and other imaging tests, it is called non-radiographic axial spondyloarthritis.
It can also affect other joints including shoulders, hips, knees, ankles and the joints between your ribs. There may also be other symptoms including bowel irritation, sore eyes and fatigue. AS usually first appears between the ages of 15 – 40 yrs and is more common in men.
What Causes AS?
The exact cause of AS is unknown it can often run in families. It is thought that the presence of the gene HLA-B27 and environmental factors seem to be involved in developing AS. People who carry the HLA-B27 gene are at greater risk of developing AS.
There is no cure for ankylosing spondylitis, but treatments can lessen symptoms and possibly slow progression of the disease.
What are the Most Common Symptoms of AS?
Early symptoms of ankylosing spondylitis might include back pain and stiffness in the lower back and hips, especially in the morning and after periods of inactivity. Neck pain and fatigue also are common. Over time, symptoms might worsen, improve or stop at irregular intervals.
The areas most commonly affected are:
- The joint between the base of the spine and the pelvis.
- The vertebrae in the lower back.
- The places where tendons and ligaments attach to bones, mainly in the spine, but sometimes along the back of the heel.
- The cartilage between the breastbone and the ribs.
- The hip and shoulder joints.
How is AS Diagnosed?
Your doctor will diagnose AS from your symptoms, a physical examination and blood tests to measure levels of inflammation. Your doctor may also order x-rays of your spine, but these tests can all be normal in the early stages. If your doctor suspects you have AS you should be referred to a rheumatologist, a doctor who specialises in arthritis.
How is AS Managed?
Medicines: Modern medicines for AS can reduce inflammation, decrease pain and stiffness and prevent joint damage.
Team Based Care: Your care is likely to involve many different healthcare professionals, although how this will work will vary from person to person. If you attend a clinic in a public hospital, most of your team-based care will be organised through the clinic.
More people will see a private rheumatologist. In this situation, your GP may coordinate most of your care. They will communicate with your rheumatologist and arrange many of your tests and prescriptions. They may also refer you to allied health workers, such as a physiotherapist or occupational therapist (OT), for support in the home or community.
Counselling: Many people find that counselling can help when dealing with the emotional aspects of AS. A psychologist or social worker may also be an important person in your
healthcare team.
Exercise, healthy eating and lifestyle: One of the best things you can do for yourself is get some
exercise every day. You can also play an active role by not smoking, reducing stress, and eating a healthy diet.
Surgery: In some cases your doctor may recommend surgery – such as an arthroscopy or joint replacement.
What are Flares?
A flare is a period when AS symptoms worsen. This can be the result of triggers such as overexertion, stress, infection or poor sleep or the natural progression of the disease. How you experience a flare may vary depending on the type of arthritis you have and the trigger. Some triggers may be obvious. Flares can vary in intensity, duration and frequency, but they’re usually reversible — if treated promptly.
For some people, flares are an inevitable part of the arthritis journey. Although flares can be difficult to predict, there are some things you can do to reduce their number and minimize long-term damage. You can also make a flare plan with your rheumatology team.
If your symptoms are severe or last for more than a few days then contact your rheumatologist, who can prescribe additional medications or alter your regular medications until the flare subsides.
Want to Learn More About AS?
AS Australia https://asaustralia.org/
Empowered Australia https://empowered.org.au/ankylosing-spondylitis/
MyAS Australia https://myas.org.au/
