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WHAT IS IT? ANKYLOSING SPONDYLITIS

Ankylosing Spondylitis (AS) is an inflammatory condition which results in bony growth and fusion. It is also recognized as a form of arthritis.

 

Ankylosing refers to the fusion of vertebra and joints of the spine. Spondylitis refers to inflammation.

 

Inflammation occurs where soft tissue (ligaments/tendons) attach to the bone. Once this settles, healing takes place. This results in the formation of new bone, and ultimately fusion.

 

Men are affected 1:200, women 1:500. Onset occurs during teenage years or in their twenties. Areas affected mainly include the SIJ and spine.

 

1/3 of individuals with AS are affected in other joints (shoulders, knees ankles etc)


 

Signs and symptoms

  • Slow gradual onset of pain

  • Stiffness

  • Swelling

  • Restricted movement of lumbar spine

  • Restricted chest expansion measurement

  • Pain lingers for months

  • Pain is not relieved by rest

  • Pain decreases with exercise

  • Fatigue, fever, weight loss

  • Flattened lumbar curve

  • Accentuated thoracic kyphosis

  • Tender Achilles and plantar fascia insertions

     

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WHAT CAUSES IT?​

Researches are uncertain of the definite cause of AS. However, there appears to be a familial tendency. Also there is a strong association (96% of individuals with AS) with Genetic Cell Marker - Human Leucocyte Antigen B27.

HOW TO SELF MANAGE

  • See your GP for assessment, and referral to a Rheumatologist

  • Confirmation may require an x-ray and/or MRI

  • Once diagnosis confirmed:

  • Stretching

  • Exercise (swimming and hydrotherapy can be good as they are low impact and promote mobility)

  • Medication (non-steroidal anti-inflammatories) to reduce pain

  • Posture awareness – Pilates may be helpful

  • Sleep with a firm mattress and a single pillow to maintain normal spinal curvatures 

PROGNOSIS

AS is usually managed with increased body awareness, exercise, and medication. If joints are severely affected then surgery may be indicated at a later stage.

HOW PHYSIO HELPS?

  • Conduct a thorough posture analysis

  • Prescribe an exercise program addressing spinal mobility, encourage extension, increased breathing, and improved posture)

  • PilatesHydrotherapy

  • Massage

  • Stretching

 

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